Women's Well Being
Could Ozempic Help Treat Substance Use Disorder?
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Nora D. Volkow, MD, is director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health.
Ozempic and other similar weight-loss drugs (collectively known as GLP-1 agonists) have revolutionized the treatment of obesity and diabetes, providing results previously achievable only with bariatric surgery. But in my two decades of studying the neuroscience behind what motivates us to eat and take drugs, and the ways they may overlap, these weight-loss medicines are also the most promising option I’ve seen for a drug that could treat addiction, whether to alcohol, opioids, or nicotine.
Over the past few years, these medicines have exploded in popularity, so much so that shortages dominated recent headlines. Initially, GLP-1 agonists were developed to treat diabetes, hitting the market in 2005. (GLP-1 stands for glucagon-like peptide-1 and is a hormone produced within the digestive system and in parts of the brain after we eat.)
Patients and clinicians soon realized their powerful weight-loss effects: Semaglutide (a.k.a. Ozempic and Wegovy) could induce someone to lose, on average, 15 percent of their body weight. From there, dosing was tested and approved by the FDA specifically to treat obesity. Today, nearly 2 percent of Americans have been prescribed semaglutide—a 40-fold increase over the past five years, per CNN.
Even more recently, some people using semaglutide to lose weight report that the drugs not only suppress their appetite for food (you might have heard people talk about losing that “food noise”), but also, surprisingly, reduce their desire to smoke cigarettes or drink alcohol too.
These anecdotal observations line up with what we know about how overeating—and motivation and addiction—work in the brain, and what we know about GLP-1 agonists so far.
We know that one way semaglutide works is by mimicking a hormone that tells the body you’ve eaten enough.
But for reasons we don’t fully understand yet, it also weakens the brain’s association between food and pleasure, further reducing the drive to eat. At the National Institute on Drug Abuse (NIDA), we have worked on and support preclinical studies that explore this phenomenon, including one study that suggests GLP-1 agonists tamp down addicted rats’ appetites for cocaine. Other studies found that rats given a GLP-1 agonist drank less alcohol, and their brains were less affected by dopamine when they did drink, suggesting it was no longer as desirable for them.
Though we’re still figuring out the exact way these medications work in the brain, what we do know (and what anyone working in the addiction space will tell you) is that we need more treatment options to help people suffering from addiction, a chronic mental health condition.
More than 48 million Americans 12 years or older had a substance use disorder in 2022, yet only 24 percent received treatment, according to the National Survey on Drug Use and Health. In 2021, as the world was still reeling from the pandemic, nearly 106,000 people died of a drug overdose, a 50 percent increase in just two years.
A breakthrough medication treatment that actually targets the brain mechanisms involved in addiction could also be particularly important for ending the national opioid crisis. As of 2020, approximately 75 percent of overdose deaths are caused by an opioid. How many lives could we save if we had a medicine that reduced the hunger for a drug?
What’s so powerful about this idea is that GLP-1 agonist medications would theoretically target the addictive behavior itself, rather than symptoms of the addiction.
Current medications help reduce the “high” feeling and can prevent the awful feelings that come with withdrawal. Additionally, many of the medicines we use right now to help treat substance use disorders work by targeting a person’s “drug of choice.” For example, drugs like Chantix help people quit smoking work by binding to nicotine receptors in the brain, making it less painful to stop smoking. Medicines used to treat opioid use disorder bind to opioid receptors and either block the effects of opioid drugs like heroin, or activate the receptors enough to quell withdrawal symptoms and cravings. But GLP-1 agonists may be able to work directly on the parts of the brain that drive a compulsive need to take the drug.
For background, decades of research have shown us that there is actually a lot of overlap in the mechanisms that drive us to eat and the ones that drive us to take drugs. Both involve our brain’s motivation and reward systems, which are made up of complex interactions of neurocircuitry and hormones, including stress hormones and dopamine. These systems are crucial for our survival. They are what drive us to take actions that keep us alive— like eating, reproducing, and forming attachments.
Addiction is, in effect, a hijacking of these pathways. Taking addictive drugs produces intense pleasure by activating our brain’s reward circuits more powerfully than typical rewards we encounter each day (such as when we eat food or have social interactions). At the same time, the dopamine released in these circuits reinforces this new learned connection between the feeling of pleasure and the activity that produced it, making it easier to repeat that “feel-good” activity over and over again. The desire to avoid a nasty withdrawal state adds to this motivation to seek the drug out. (People who know someone with substance use disorder, or who have struggled with it themselves, understand this very well.)
As you continue using the drug, your brain’s circuits begin to adapt to the pleasurable feelings and become less sensitive. You crave that original high, yet the more you seek it out, the more of the drug you need to achieve it, because it has literally changed your brain chemistry. So, by altering the brain’s reward and motivational systems, addictive drugs create an environment where consuming the drug becomes so important that prioritizing basic needs and other things that matter to you becomes incredibly difficult.
These underlying brain changes can be observed in anyone who struggles with addiction, whether it’s an addiction to opioids, cocaine, methamphetamine, or alcohol.
But now, observations and studies suggest that another hormone may also modify our motivational pathways: GLP-1.
As GLP-1 levels rise in the body, the body registers that it’s getting full, which in turn tamps down hunger cravings. In people with diabetes and obesity, their GLP-1 levels may be disrupted, so they don’t get signals that they’re full, which causes them to overeat.
Drugs containing GLP-1 agonists—like Ozempic and Wegovy (semaglutide), Mounjaro (tirzepatide), and Byetta (exenatide)—mimic naturally occurring hormones and may help restore balance so you don’t eat past the feeling of fullness. The presence of GLP-1 actually reduces dopamine levels, which lowers our brain activity in response to the anticipation of eating that food. The result: a decrease in cravings and what’s known as “food noise” (a.k.a. obsessive thoughts about food).
Here’s how it plays out: If a person who loves desserts and has difficulty resisting them is taking Ozempic or Wegovy and that person goes to a birthday party and sees a cake, they’ll feel less of a compulsion to eat it. This is because the brain signals that used to repeatedly connect the pleasurable food (and the environmental cues that come with a birthday party) to the expectation of a reward are believed to be diminished by these medications.
It stands to reason, then, that if there are similar mechanisms that drive us to overeat and take drugs, and a GLP-1 agonist works on the one for overeating, then a GLP-1 agonist could also potentially help interrupt the urge to misuse drugs.
As exciting as all this sounds, we have a long way to go to see if this hopeful hypothesis about GLP-1 agonist medications is correct.
Animal studies don’t always translate to humans. We need to do clinical studies—randomized, placebo-controlled studies, which are considered the gold standard for providing true results—in people before we can use GLP-1 agonists to treat addiction.
At present, scientists have completed two randomized, placebo-controlled clinical trials looking at these drugs and their impact on substance use, and the results were mixed. (“Randomized and placebo-controlled” means the study looks at two groups of participants who were randomly placed in a group that gets the test treatment or a group that gets the placebo treatment. These kinds of studies are the best at reducing bias in results.)
In one study, researchers looked at people who were trying to quit smoking. One group received a GLP-1 agonist called dulaglutide, while the other group received a placebo. After 12 weeks, there was no significant difference in quit rates between the two groups. A disappointing result, for sure.
But in another paper published in 2022, researchers followed two groups of patients with alcohol use disorder for 26 weeks. One group got doses of the GLP-1 agonist exenatide, while the other group received placebo. Researchers then measured the patients’ alcohol intake and did brain scans to measure dopamine and reward activity. In the end, they found no difference between the two groups’ alcohol intake—except in a subgroup of participants with obesity who did drink less. They also noted a reduction in reactivity in the brain region that drives that the feeling of reward for all groups who received exenatide. These findings, and especially the result for those in the subgroup with obesity, suggest that perhaps with the right compound and the right dosing, a GLP-1 agonist may work.
More clinical trials are underway now, looking at a variety of substance use disorders using newer, more powerful GLP-1 agonists such as semaglutide. We can expect results in the next two to three years.
There are also efforts to examine the electronic health records of people who were prescribed a GLP-1 agonist for obesity or diabetes. By looking at the data, which is de-identified, we should be able to see if there’s a difference in rates and severity of substance use disorders among people prescribed these drugs compared to the general population.
If the studies bear out, GLP-1 agonist drugs could be used to treat addiction to drugs of all types.
That would be groundbreaking because as more people become addicted to multiple drugs, we could provide a single medication that would be able to jumpstart substance use disorder recovery, along with social and psychological support.
Perhaps we can also use GLP-1 agonists in concert with other medications we already have, like methadone and buprenorphine (one of the ingredients in a medication called Suboxone), which are used to treat opioid addiction. These medications help reduce cravings and withdrawal symptoms, but we know that around half of patients who start medications for opioid use disorder stop taking them after six months. It’s possible that GLP-1 agonists could help people stay in treatment longer.
Bottom Line: My biggest hope is that these discoveries, and the discussion surrounding them, could go a long way toward ending the stigma surrounding addiction. We need to, once and for all, change the narrative of addiction as a self-control issue to an understanding that it is a chronic mental health condition. Showing that a medication can help someone stop taking drugs makes it easier to communicate this and helps people to understand that addiction is a mental health disorder, not a moral failing.
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Women's Well Being
Find Your Ideal Exercise Routine With Our Tool
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Feeling inspired to work out but not sure what to do? Well, consider your problem solved: The Women’s Health Workout Finder Tool is here to help you find a routine that fits your goals, equipment preferences, and timeframe in seconds.
How it works: In the interactive window below, select your responses to the following three questions.
- What type of workout do you want to do today?
- How much time do you have?
- Do you want to use equipment?
Next, you’ll be prompted with personalized options from the WH workout database that check *all* the boxes you were looking for. Hit “Get Started” beneath your winning choice, and the workout will open in a new browser window.
Then, you’re ready to sweat. It’s that easy!
Should you prioritize cardio or strength training workouts?
The WH workout database features hundreds of workouts that are either strength-focused, cardio-focused, or a blend of both. The type you choose ultimately depends on your personal goals.
For example, if you are looking to build muscle and improve overall strength, trainers generally recommend prioritizing resistance training (and doing it before you get your cardio in so you have the energy to lift heavy). On the other hand, if you’re working on endurance or training for, say, a 5K, lean into cardio workouts first and foremost—then supplement them with strength training. (This complete guide to cardio versus resistance training goes even deeper.)
How should you warm up and cool down?
Most of the workouts provided include a brief warm-up and post-workout stretch. You’re always encouraged to tack on additional warm-up and cooldown time to ensure you’re priming your joints and muscles properly beforehand and stretching out and relaxing your body after.
Here’s a list of bonus warm-ups and cooldowns to choose from:
Ultimately, the WH Workout Finder Tool is designed to make planning your workouts easier than ever and help you stick to—and crush–your goals. Keep coming back to the tool to discover all new sweat sessions, trainers, and modalities so you never get bored. This is fitness, *your* way.
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Women's Well Being
Megan Thee Stallion On Her New Album, Workout Routine, And More
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Megan Thee Stallion has changed.
She’s a new woman—head to toe—thanks to a period of transformation, which included learning how to become the ultimate hype woman for herself.
The proof is in the clips of her workouts she posts on social media: She delivers fast-talking, hilarious voice-over about powering through booty-burning donkey kicks by renaming them “stallion kicks” and declaring thigh work with resistance bands worth it because “my thighs look good as f*ck!” Known for keeping it real and raw—especially when it comes to her ratchet bars—the aptly named Thee Hot Girl Coach and Mother Fitness is the baddie giving I’ve-got-this energy.
Megan, 29, playfully tosses strands of blonde hair out of her face as she declares to me of her ability to incite inspo, “I’m that girl.” But let’s be honest: “Getting out of bed to work out in the morning is a struggle,” she says. “I have to get mentally prepared. I’m like, ‘I can stay here for another hour, or I can get up and go work out and be a bad bitch. If I want to be a stallion and not a pony, I got to get up and put in the work.’”
This dedicated grind has played a massive part in her becoming an undeniable force in music and entertainment. Going from playing small gigs in Houston in the mid-2010s to dominating the charts with No. 1 hits like “Body” and the Grammy-winning “Savage Remix” with Beyoncé, Megan (born Megan Pete) has secured her spot as hip-hop’s hot girl. And with her third album on the way via her imprint Hot Girl Productions—and more acting roles on the horizon after appearing in the movie Dicks: The Musical and the TV show P-Valley—she’s showing no signs of slowing down. “I always feel like, ‘I got to do something better,’” Megan says of her drive. “I can’t be stuck. I can’t be stagnant.”
A few years ago, however, static is exactly how she felt. In July 2020, Megan was shot by rapper and former friend Tory Lanez after leaving a Hollywood Hills party together. The shooting, for which Tory was found guilty in December 2022, left Megan bloodied, unable to walk, and with bullet fragments in her feet.
Over time, she healed physically, but mentally, she suffered. “A lot of people didn’t treat me like I was human for a long time,” says Megan, who endured an immense amount of hate from fellow artists, strangers, and bloggers who questioned her recollection of the experience. “I feel like everybody was always used to me being the fun and happy party girl. I watched people build me up, tear me down, and be confused about their expectations of me. As a Black woman, as a darker Black woman, I also feel like people expect me to take the punches, take the beating, take the lashings, and handle it with grace. But I’m human.”
She suppressed her true feelings for a while, appearing to love every moment of superstardom. But as Megan’s career continued to heat up—her raunchy collab “W.A.P.” with Cardi B. became the first female rap duet to debut at the top of the U.S. Billboard Hot 100 in August 2020—so did her behind-the-scenes struggle. “Before I went onstage, I would be crying half the time because I didn’t want to [perform], but I also didn’t want to upset my fans,” Megan says. The weight of her emotions eventually caught up with her, leading to what she calls “dark times.” “I didn’t want to get [out] from under the covers,” she says, tears building in her eyes. “I stayed in my room. I would not turn the lights on. I had blackout curtains. I didn’t want to see the sun. I knew I wasn’t myself. It took me a while to acknowledge that I was depressed. But once I started talking to a therapist, I was able to be truthful with myself.”
Therapy was just the beginning of Megan’s healing. She also ended relationships that no longer served her and deleted social media from her phone to avoid trolls and doomscrolling. Then she was inspired to move her body as she started mending her soul. “Working on myself made me get into working out because I needed to focus my energy somewhere else,” she says. “I used working out to escape and to get happy.” Now, she gets physical regularly.
Four or five days a week, Megan sweats it out in Pilates class, at the gym, or at the beach with one of her two trainers, Emory “Joc” Bernard and Tim Boutte. For cardio, she runs up sand hills at the beach or spends 40 minutes on the StairMaster or elliptical. When targeting her legs and thighs, she does hip thrusts, goblet squats, leg extensions, and those “stallion kicks.” Weighted situps work her abs, and lat pulldowns, lat flies, and renegade rows strengthen her back.
Flaunting the assets she works hard for is a flex Megan takes pride in. “I’m in a space where I feel good mentally, so I want to look as good as I feel,” says the rapper, who has a sportswear collection with Nike. For her, looking good means having a bod that resembles a volleyball player’s. The appeal? “Strong legs!” says the 5’10” Stallion. “You look like you can jump high. I love that look.” On her way to achieving her ideal physique, Megan noticed that no matter how much she worked, she still had “this little gut,” she says. So, she leveled up her diet by scaling back on bread, tuna melts, and red meat and eliminating sugary drinks like soda, juice, and cognac. Today, she drinks about a gallon of water a day and reaches for tequila instead. When Megan realized she no longer felt bloated and her skin became noticeably clearer, she knew she was on the right track.
Modifying her diet wasn’t all about vanity, though. Megan also wanted to feel better. She’s eased long-standing stomach issues by consuming more nutrient-rich foods, like avocados. These days, she maintains healthy eating habits by drinking a strawberry, banana, almond milk, and protein powder smoothie or a green juice in the morning before she works out, eating pan-seared salmon for lunch, and having sea bass or cod for dinner along with tomatoes, sweet potatoes, kale, or brown rice; she snacks on cucumber slices with salt and pepper, and cherry tomatoes with light balsamic vinaigrette. But she’ll never give up pepper jack cheese and dark chocolate. “I am still a Southern girl, so I like to eat what I want,” she says. “I just don’t go overboard.”
What does remain boundless is the lyricist’s power with a pen. Strengthening her mind-body connection through journaling has led to writing deeper rhymes and transforming how she shows herself love. By jotting her emotions down daily, Megan says she’s moving away from the tendency to “slip into using hate language toward myself.” Instead, she’s discovering “a more positive approach” to the way she speaks to and about herself.
Every morning, she reserves time to journal, meditate, pray, apply a hydrating face mask, play with her dogs, and listen to music. Currently in rotation are Linkin Park, Three 6 Mafia, Paramore, and UGK. “Alone time is something I need,” she says. “I like getting up and being able to be at peace. In my everyday life, I speak with so many people. When I perform, I take on so many energies. I like to recharge my battery. Let the start of the day be about me; then, I can give my energy to everybody else.”
She also finds solace in the shower. “I love the sound of running water,” she says. “I can clear my head.” Megan does a lot of her best writing in the shower. She feels most powerful when writing and recording. And her next album, she says, will be her strongest yet. “I was inspired to create this album about rebirth because I feel I am becoming a new person physically and mentally,” says Megan, who chose a snake as the project’s motif because it is emblematic of her renewal. “They’re feared, misunderstood, respected, healing,” she adds, a sizable diamond-encrusted snake necklace sparkling around her neck.
At the time of this interview, Megan dropped two singles from the project: “Cobra,” on which she discusses battling anxiety, depression, thoughts of suicide, and the deaths of both her parents, and “Hiss,” where she comes for those who tried to threaten her peace. On the first track, Megan displays sensitivity, while on the second, she’s full of fierce energy. Admittedly, she battles with showing both emotions in her music. “I’ve always struggled to figure out how to be vulnerable and still make music that is going hard at the same time,” she says. But she’s learning that showing her softer side doesn’t mean she’s compromising her strength, even when social pressures might cause her to feel otherwise. “I’m getting into a better space with making music that is still true to myself but also true to my message,” she adds. “I am very much a flower, but my flower has thorns.”
The sentiment is classic Megan: layered, inspiring, authentic, and with her strength to persevere in full bloom. “I’m proud to still be here,” she says. “I didn’t quit. I want to see myself grow and be better than I am right now. And I will. I know I will.” No doubt, an attitude like that is worth all the hype.
Photography by Ramona Rosales; Styling by Kristen Saladino; Hair by Kellon Deryck; Makeup by Lauren Child; Manicure by Ginger Lopez; Set design by Carlos Anthony Lopez of Winston Studios; Production by Kindly Productions.
1ST IMAGE: Lady Grey Jewelry earrings, ladygreyjewelry.com
3RD IMAGE: Louise Olsen x Alex and Trahanas earrings, dinosaurdesigns.com; Alexis Bittar ring, alexisbittar.com
4TH IMAGE: Lady Grey Jewelry earrings, bracelet, and rings, ladygreyjewelry.com
5th IMAGE: Dinosaur Designs earrings and ring, dinosaurdesigns.com
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Jessica Herndon is an award-winning, Los Angeles-based writer who has contributed to Women’s Health, Vanity Fair, Cosmopolitan, Elle, The Hollywood Reporter, Essence, the Associated Press, People, Spin, Flaunt, Nylon, and Seventeen.
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Women's Well Being
Steak Burrito Bowl Salad Recipe
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Meal prepping? Stash components separately (in fridge), so you can enjoy a crisp salad when ready to chow down.
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- Yields:
- 1 – 4 serving(s)
- Total Time:
- 30 mins
- Cal/Serv:
- 570
Ingredients
- 1
15-oz can black beans, rinsed and patted dry
- 3 1/2 tbsp.
olive oil, divided
- 1 tsp.
tsp Tajín, plus more for sprinkling
- 1
1-lb sirloin steak (11/2 in. thick), trimmed
-
Kosher salt and pepper
- 2 c.
cilantro, chopped
- 1
small shallot, roughly chopped
- 1/2
jalapeño, seeded and roughly chopped
- 1/4 c.
cup fresh orange juice
- 2 tbsp.
fresh lime juice
- 2 tbsp.
Greek yogurt
- 2 c.
cooked short-grain brown rice
- 1/4
small head red cabbage (8 oz), cored and thinly sliced
Directions
-
- Step 1Heat oven to 425°F. Add black beans to rimmed baking sheet and toss with 1/2 Tbsp oil and Tajín. Roast until beans are dry, split, and crispy, 18 to 20 min.
- Step 2Meanwhile, heat 1 Tbsp oil in large cast-iron skillet on medium-high. Pat steak completely dry and season with 1/2 tsp each salt and pepper. Cook to desired doneness, 5 to 6 min. per side for medium-rare. Transfer to cutting board and let rest at least 5 min. before slicing.
- Step 3Meanwhile, in blender, combine cilantro, shallot, jalapeño, orange and lime juices, yogurt, and remaining 2 Tbsp oil. Puree on high until homogeneous but still bright green, 30 seconds.
- Step 4Divide rice among bowls. Top with cabbage and roasted black beans. Add sliced steak and drizzle with green sauce and sprinkle with more Tajín if desired.
Per serving: About 570 cal, 28.5 g fat (8 g sat), 76 mg chol, 726 mg sodium, 48 g carb, 9 g fiber, 5 g sugar (0 g added sugar), 32 g pro
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