GLP-1 drugs are a miracle for diabetes and obesity. There are rumors that they might also be a miracle for addiction to alcohol, drugs, nicotine, and gambling. That would be good. We like miracles. But we just got the first good trial and—despite what you might have heard—it's not very encouraging.

Semaglutide—aka Wegovy / Ozempic—is a GLP-1 agonist. This means it binds to the same receptors the glucagon-like peptide-1 hormone normally binds to. Similar drugs include dulaglutide, exenatide, liraglutide, lixisenatide, and tirzepatide. These were originally investigated for diabetes, on the theory that GLP-1 increases insulin and thus decreases blood sugar. But GLP-1 seems to have lots of other effects, like preventing glucose from entering the bloodstream, slowing digestion, and making you feel full longer. It was found to cause sharp decreases in body mass, which is why supposedly 12% of Americans had tried one of these drugs by mid [...]