A new generation of obesity medications is creating hubbub and hype not seen since Prozac‘s arrival in the 1980s. The excitement is warranted: These drugs have the potential to transform patients’ lives for the better — but also to worsen inequities, increase anti-fat bias, and strain health spending. Which is why in December 2022, STAT’s newsroom met to discuss a series examining how these new GLP-1 drugs were about to “change everything.” Reporters shared anecdotes from friends about Ozempic driving down food cravings.
This struck science writer Megan Molteni as odd. All the coverage at the time focused on how these drugs promoted feelings of fullness. Cravings are about reward and desire, and are mediated through different neural circuitry than satiety. She proposed a feature-length look at the science behind these drugs. What did researchers really know about the hormone GLP-1, its natural role in driving or moderating cravings, and how these drugs were altering them?
It turned out to be quite a lot, much more than had been surfaced in the popular press up to that point. Over six months, as Molteni spoke to more than two dozen scientists and read nearly 60 studies, the story that emerged was engaging and surprising; it became clear that although pharmaceutical firms had designed these drugs to mimic a gut hormone, when it came to weight loss, the drugs worked their magic most powerfully in the brain. That raises a tantalizing question, she writes: “If hormone hacking can erase food cravings, what other destructive desires might it liberate us from one day?”
Her reporting described how scientists are pumping drug-addicted lab animals full of GLP-1 medications “in the hope that they can put out the fire in their brains,” and how clinical trials evaluating the medications’ ability to turn down the intensity of cravings for alcohol and opioids are now underway.
