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In a large-scale study (Nature Medicine), researchers compared more than 215,000 patients with type 2 diabetes who began therapy with GLP-1 receptor agonists to several control groups (other glucose-lowering drugs and “usual care”). GLP-1 users showed lower risks across several addiction-related disorders: alcohol (HR 0.89), tobacco (0.84), stimulant (0.85), cannabis (0.88), and opioid (0.87), that is, approximately 11–16% lower than in the control groups. The authors also noted a reduced risk of bulimia and a number of neuropsychiatric outcomes.

Importantly, the study itself did not measure pathological gambling as an outcome; conclusions about “gambling disorder” are extrapolated from other addictions. Nevertheless, the summary press materials and discussion emphasize an overall trend toward reduced addiction risks with GLP-1 use.

Why this might work

According to Boston University researchers, GLP-1 drugs dampen the reactivity of the brain’s reward system and reduce dopamine release. This makes not only food cues but also alcohol, nicotine, and potentially gambling less “reinforcing”, hence the hypothesis of reduced drive toward addictive behavior during therapy.

This mechanism is consistent with accumulating data in animals and humans: GLP-1 therapy has previously been linked to a lower risk of disorders related to alcohol and tobacco. The new study extends the picture to other types of addictions and neuropsychiatric outcomes, but it requires confirmation in randomized trials with direct behavioral metrics.

Limitations and risks

The study is observational and based on a veterans’ cohort (predominantly older men), which limits the generalizability of the results to broader populations. The authors themselves underscore the risk of residual confounding and the need for further clinical trials — especially to assess effects on gambling as a distinct outcome.

At the same time, GLP-1 medications have known side effects and risks, including gastrointestinal disturbances, arthritic/joint complaints, nephrolithiasis, and drug-induced pancreatitis. Materials from Nature and specialist media remind readers that therapy should be prescribed by a physician, taking indications and contraindications into account. This news item is not medical advice.

Source: https://www.nature.com/articles/s41591-024-03412-w