Prognosis
By muting dopamine.
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Hi, it’s Jessica in New York, where I’ve been digging into a lesser-known side effect of weight-loss drugs. More on that in a minute, but first …

Today’s must-reads

  • The federal probe into UnitedHealth is broader than just possible Medicare fraud.
  • Lilly’s weight-loss pill moves closer to a potential approval.
  • A UnitedHealth alum steered a merger aimed at upending drug middlemen.

Stealing joy

Blockbuster weight-loss and diabetes-management shots like Wegovy and Ozempic are seemingly everywhere in the cultural zeitgeist. From celebrity partnerships to social media chatter, people are hawking all the benefits of losing pounds. 

Most of this chatter doesn’t emphasize the drugs’ steep costs. And they rarely discuss dangerous side effects, like a rare form of vision loss.

But you almost never hear about how they can cause you to lose your joy. 

Semaglutide, a GLP-1 drug that’s the main ingredient in treatments like Ozempic and Wegovy, targets dopamine in the brain’s reward system, so you feel less satisfaction from eating that next bite. It dampens “food noise,” the continual preoccupation with eating that can lead to overconsumption. Semaglutide can also decrease motivation to eat at all. 

But this rewiring of your brain can seep into other aspects of your life. Weight-loss drug users might find their hobbies are less pleasurable, or they feel less happiness spending time with loved ones. This is anhedonia, a common symptom of depression. 

Clinical psychologist Robyn Pashby of Health Psychology Partners in Washington, cites by way of example a person taking a GLP-1 drug going to celebrate an anniversary at a fancy dinner with another person. The person on the weight-loss drug may “feel a little bit more disconnected from that joy that you might otherwise get.”

These weight-loss drugs are still relatively new, and potentially harmful side effects are still being discovered. But many people are concerned about the impact of tampering with dopamine triggers.

 “What are the long-term consequences of dampening that?” asked Erin Parks, co-founder of the telehealth eating disorder treatment company Equip. “What does that do for our joy of life?” 

Wegovy’s safety information warns that the drug can cause depression or thoughts of suicide, and patients should talk to a health-care provider right away if they experience sudden changes in mood, behaviors, thoughts or feelings. 

But these weight-loss drugs have also been shown to have positive psychological benefits. Studies suggest GLP-1s can actually help with addiction, reducing cravings for opioids, alcohol and nicotine.

And, Pashby says she’s seen patients who feel higher levels of happiness and confidence because they aren’t succumbing to food noise anymore. Or they feel less pain or inflammation after weight loss and are able to enjoy their lives more.

The upshot is that people considering taking GLP-1 drugs should follow time-tested advice: Talk to your doctor first. – Jessica Nix 

What we’re reading

Concerns about food dye led Ferrero to cuts its acquisition offer to WK Kellogg by about $75 million, the Wall Street Journal reports

RFK Jr.’s push to get Americans to drink whole milk is backed by new research, the Washington Post reports

The US has scaled back its foodborne illnesses surveillance program, NBC News reports

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Health questions? Have a tip that we should investigate? Contact us at AskPrognosis@bloomberg.net.

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