Health
How Ozempic reduces ‘food noise’ and cravings in the brain
Are you plagued by obsessive food thoughts and uncontrollable cravings? The new wave of weight-loss drugs could act as a mute button on these disruptive brain pathways.
By Sabrina Rogers-Anderson
From the second she opened her eyes in the morning to her very last moment of consciousness as she fell asleep at night, Sarah could only think about one thing: food, delicious food.
“Since I was a kid, the second I woke up, I started thinking about everything I was going to eat that day,” she says. “I’d plan every morsel of food that would go into my breakfast, lunch, dinner and snacks. My mouth would start to water before I was even out of bed. All day long, all I could think about was whether I should have a biscuit from the break room at work or how many minutes were left until lunch.”
While Sarah wasn’t clinically obese, she’d been progressively gaining weight since she’d had children and even more so after she hit 50.
“To be honest, I was miserable,” she confesses. “Food took up too much valuable real estate in my brain, I was constantly exhausted and I didn’t like my body, so I started pushing my husband away and it was affecting my marriage. I knew something needed to change and all the diet and exercise programs I’d tried simply weren’t working. I couldn’t stop obsessing about food.”
Sarah’s GP suggested she try Ozempic to stop her weight gain in its tracks. She was sceptical of the new wonder drug at first, but she was also desperate for change and decided to give it a go.
“Within a week of taking it, I noticed that the food noise in my brain had quieted down,” says Sarah. “My first thought in the morning wasn’t food anymore and I could walk past the break room without having an irresistible craving for biscuits. It was as if someone had turned down the volume on the 24-hour Food Channel in my mind.”
How Ozempic and other GLP-1 agonists suppress food noise
“Food noise” is a term used to describe intrusive or obsessive thoughts about food and a growing number of Australians are taking GLP-1 agonists to turn it down.
GLP-1 agonists are a class of drugs that include semaglutide (Ozempic and Wegovy), tirzepatide (Mounjaro) and liraglutide (Saxenda). Originally developed to treat type 2 diabetes, they’re increasingly being prescribed to manage a range of other health conditions (more on that below).
In Australia, Wegovy, Mounjaro and Saxenda have been approved by the Therapeutic Goods Administration for weight loss while Ozempic hasn’t. But that doesn’t stop medical professionals from prescribing Ozempic “off label” for weight loss – which is what Sarah’s GP did.
So, how do all these medications turn down the volume on food noise?
“We have salience pathways [in our brains] that encode things that are beneficial for survival, like eating and sex, and motivate us to reproduce and thrive,” says Professor Michael Cowley, Head of the Department of Physiology at Monash University.
“They're the pathways that are hijacked by drugs of abuse, particularly amphetamine and cocaine, and they’re also responsive to signals from the body that tell us when we’re hungry or full. One of those signals is GLP-1, which is the molecule that Ozempic mimics, but Ozempic is more potent and lasts longer than GLP-1.
“We think that food noise occurs when these pathways are more active than they should be and GLP-1 helps suppress them. But the mechanism still isn’t well understood.”
Ozempic may also reduce alcohol and drug cravings
Some GLP-1 agonist users report that their desire for alcohol, nicotine, drugs, gambling and other addictive behaviours is also dulled.
One small study found that participants with alcohol use disorder who took a low dose of semaglutide for 9 weeks craved alcohol less and reduced their alcohol consumption. More research is needed, but these results are promising.
“All drugs of abuse have the capacity to trick our salience pathways into being more active and it seems that GLP-1 class drugs have the capacity to inhibit these pathways,” explains Professor Cowley. “It could be that they have applications in helping control drug use relapse and there are studies underway investigating that, but there's no definitive data yet.”
Should Ozempic be prescribed for food noise?
Due to high demand, semaglutide has been in short supply in Australia since 2022. As such, the TGA recommends that health professionals only prescribe Ozempic and Wegovy for their approved indications.
That means Ozempic shouldn’t be supplied to patients for weight loss or to control food noise, but doctors continue to prescribe it off label.
Some critics argue that this practice robs patients with type 2 diabetes and complex medical conditions of medication they more urgently need. Others say it gives people who don’t want to exercise and change their eating habits an easy way out when it comes to weight loss – and that taxpayers shouldn’t have to fund their medication.
“Leaving these arguments aside, as a broader principle, I think anything people can do to improve their health should be considered,” says Professor Cowley. “There's a stigma around obesity that it’s due to sloth and gluttony and that’s just not true for most people who are obese.
“Think about mental health. For the longest time, depression was considered a moral failing. But with the development of effective antidepressants, we medicalised mental health and we now regard it as a health condition that can be treated with much less stigma. I believe the same is happening with obesity. The advent of effective medicines often paves away for better understanding of the medical basis of disease.”
Potential future uses of semaglutide
In addition to managing type 2 diabetes and supporting weight loss, research has shown that semaglutide reduces the risk of heart attack and stroke in people with obesity and heart disease. It may also help improve the symptoms of obesity-related heart failure.
And there are currently multiple studies underway to examine whether semaglutide could help manage a range of other health conditions, including addiction, Alzheimer’s disease, Parkinson’s disease, polycystic ovary syndrome (PCOS), sleep apnoea and metabolic dysfunction-associated steatotic liver disease (MASLD).
But as with any other medication, side effects such abdominal pain, nausea, vomiting, diarrhoea and constipation can occur – though they tend to decrease over time. And semaglutide may not be suitable for everyone.
If you’re curious about whether semaglutide or another GLP-1 agonist is right for you, talk to your GP.
The information on this page is general information and should not be used to diagnose or treat a health problem or disease. Do not use the information found on this page as a substitute for professional health care advice. Any information you find on this page or on external sites which are linked to on this page should be verified with your professional health care provider.
Feature image: iStock/JNemchinova
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