The Evidence on Ozempic to Treat Addiction
The New Yorker Radio Hour
Host: David Remnick
Guest: Dr. Dhruv Kullar (physician, New Yorker writer)
Date: February 24, 2026
Episode Overview
This episode explores the emerging science and real-world experiences around GLP-1 drugs like Ozempic—not just for diabetes and weight loss, but their potential impact on addiction and the brain’s reward system. Host David Remnick speaks with Dr. Dhruv Kullar about the promise and pitfalls of these medications, cultural debates over their use, and how they might change addiction treatment.
Key Discussion Points & Insights
1. The Widespread Impact of GLP-1 Drugs
- Adoption: Approximately 12% of Americans have taken a GLP-1 agonist like Ozempic, and use is rising as obesity remains prevalent.
- Cultural Impact: Drugs transitioned from diabetes treatment to mainstream pop culture via social media, Hollywood, and anecdotal weight loss stories.
- (00:14) David Remnick: “It’s rare that a drug has had as big an impact on our lives as Ozempic.”
2. Anecdotal Evidence Linking GLP-1 Drugs to Addiction
- Anecdotes Mount: Reports that people on Ozempic feel less desire to drink, smoke, gamble, or even shop compulsively.
- Research State: The science is still catching up to these observations, moving from animal models to larger human trials.
- (01:27) Dhruv Kullar: “All these stories...people who start taking the drugs...they don’t feel like drinking anymore, they don’t feel like smoking, they’re not doing opioids, they don’t wanna gamble... there’s an avalanche of these stories.”
3. Mechanisms: The Brain’s Reward System
- How GLP-1 Works:
- Traditional role: stimulates insulin, slows gastric emptying.
- New finding: interacts with brain’s mesolimbic “reward” pathway, potentially muting dopamine spikes—the mechanism behind cravings.
- Desire Dampening: While often beneficial, in some cases the reduction in desire is too broad, leading to a lack of pleasure (anhedonia).
- (06:43) Dhruv Kullar: “We’re understanding they’re modulating what’s called the mesolimbic pathway... sometimes called the brain’s reward system.”
4. Risks and Caveats
- Anhedonia: Some users report losing joy not only in vices, but also in everyday pleasures—sometimes affecting relationships and life satisfaction.
- (05:09) Dhruv Kullar: "People...report loss of not just desire for food or alcohol, but loss of desire for pretty much everything. And so you have this phenomenon of what’s called anhedonia."
- Side Effects: Nausea, vomiting, potential pancreatitis, and cancer risk (seen in animal models). Weight loss includes loss of muscle mass, especially risky for older adults.
- Unknowns: Long-term effects, development of medication tolerance, and appropriateness for addiction treatment require more study.
- (16:11) Dhruv Kullar: “...People have experienced pancreatitis... continued significant nausea, vomiting... losing muscle mass.”
5. Addiction Treatment: Where Are We Now?
- Small-Scale Trials: Early studies show potential, but it’s premature to recommend widespread clinical use for addiction.
- (08:42) Dhruv Kullar: “There are some cases of rehab centers starting to use it. But the science is not there yet.”
- Root Causes Untouched: GLP-1 drugs offer a potential “reset,” but do not address deep-seated causes of addiction like stress, trauma, and social factors.
- (10:50) Dhruv Kullar: “These drugs aren’t doing anything to address the underlying root causes of addiction... but they can provide an opportunity to reset some things in your life.”
6. Policy, Access, and Social Debates
- Political Lens: Figures like RFK Jr. critique reliance on medication over systemic food and lifestyle change. Dr. Kullar agrees broader reforms are needed but sees pharmaceutical advances as complementary, not competing.
- (12:26) Dhruv Kullar: “The challenge is we haven’t really been able to do those things for most people... while obesity rates have been skyrocketing. So there’s no argument about changing the underlying causes. But... this is a remarkable advance to help people in the immediate term.”
- Class and Access: Use of GLP-1 drugs is currently shaped by class and insurance coverage. Expansion is expected as drugs become more common and affordable.
- (15:41) Dhruv Kullar: “So far, it is certainly powerfully affected by class... as public programs... start to cover these medications... I think that will change over time.”
7. Memorable Stories & Ethical Considerations
- Loss & Gain of Desire: A woman finds herself indifferent to gardening due to the drug; another leaves her husband as “mental space” opens up, freeing her from old inhibitions.
- (05:46) David Remnick: “Are we sure it’s because she was taking Ozempic?”
- (05:47) Dhruv Kullar: “Well, you can never be sure, but at least in her experience, she stopped taking it and her mood got better...”
- (13:27) Dhruv Kullar: “...I talked to one woman who... started on this medication... within months, she left her partner... this gave her the space to do that.”
- Philosophy of Chemical Control: Raises questions about agency and the “second-order desires” (choosing what we want to want).
8. Impact on Obesity Rates
- Data: First declines in U.S. obesity rates in decades; attributed in part to GLP-1s.
- (14:53) Dhruv Kullar: “For the first time in the last four decades, we’re seeing a plateau and even a decline in obesity rates.”
9. Personal Take (Dhruv Kullar)
- Would He Take It?
- (16:58) David Remnick: “If you were overweight. You're not. But if you were overweight, would you take these drugs?”
- (16:58) Dhruv Kullar: “Absolutely... I think it’s something that anyone in that position should consider.”
Notable Quotes & Memorable Moments
- (01:15) David Remnick: “God, are you willing to admit it’s a wonder drug?”
Dhruv Kullar: “I don’t know about a wonder drug, but it’s the closest thing we have.” - (05:46) On pleasure blunting:
David Remnick: “Because she was taking Ozempic?”
Dhruv Kullar: “Because she started taking Ozempic.” - (08:13) On social media addiction:
David Remnick: “If I take Ozempic, I’m [going to] stop looking at my phone every 13 seconds?”
Dhruv Kullar: “I don’t want to make that claim just yet. But it’s not out of the realm of possibility...” - (13:27) On personal change:
Dhruv Kullar: “...she said, I had been kind of inhibited by this alcohol noise in my mind... this gave her the space to do that.”
Important Timestamps
- 00:14: Introduction to Ozempic’s impact
- 01:27: Anecdotes of addiction improvement
- 03:14: Emerging data on addiction benefits
- 05:08: Risks of anhedonia / pleasure blunting
- 06:43: How GLP-1 drugs act on brain reward pathways
- 08:42: Use in addiction treatment centers
- 10:50: Addressing root causes of addiction
- 12:26: Policy debate: medication vs. prevention
- 14:53: Decline in obesity rates
- 16:11: Physical side effects and risks
- 16:58: Would Dr. Kullar take Ozempic?
- 17:44: Dr. Kullar on medical dramas and empathy in medicine
Final Thoughts
This episode offers an accessible, nuanced look at the rapidly shifting landscape of GLP-1 drugs—delving deep into their science, promise, and perils as society races ahead of the research. While the story of Ozempic as an “addiction drug” is still being written, Dr. Kullar’s reporting and reflections provide essential context, skepticism, and hope for the future of both obesity and addiction treatment.