We Need To Talk About Ozempic

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GLP-1 drugs are everywhere. GLP-1. GLP-1s. People scramble to get their hands on GLP-1 drugs.

**Alok Kanojia** (1:06)
Today, we're gonna talk about the psychiatric effects of GLP-1 agonists or medications like Ozempic. And if you're thinking about taking a GLP-1 agonist, or if you're taking a GLP-1 agonist, what you should be aware of, because things are a little bit complicated. Some studies will show improvements in binge eating. Some studies will show increases in anorexia. Some studies will show improvements in mood. Some studies will show triggering of depression. And so what's going on here? And it turns out that actually all of that is true, and that's why we need to dive into it with a little bit more detail. So we're gonna start off by doing a quick review of glucagon-like peptide, and what its role is in the body. So the first thing to understand is that GLP is a hormone. So the hormones are chemical signals that travel everywhere in your body, everywhere that blood exists. Okay, so the first thing to understand about hormones is that they have differential effects on different parts of your body. So let's use a simple example of hormone, testosterone. So testosterone has differential effects, depending on the tissue that it reaches. So the skin cells on the top of my head will make me bald. The skin cells over here will make me actually grow hair. The skin cells on my back will also start to grow hair. So it causes a differential pattern of hair growth, depending on the target tissue. When testosterone travels to my brain, it'll increase my sense of protectiveness, maybe some degree of aggression, some degree of competitiveness. When it travels down to my scrotum and testicles, it stimulates sperm production. And so depending on where a hormone travels in the body, it will have a differential effect. And when it comes to GLP-1 agonists, this will explain a lot of the contradictory information. So next thing we have to understand about GLPs is what is the role of glucagon-like peptide? Why does the body secrete it? What is its job? So GLP is a satiety hormone, okay? So satiety is to feel sated, to feel satisfied. So basically, when we eat something, our stomach stretches, glucose gets entered into our bloodstream, and so our body has these two modes. It has a hungry mode, and it has a no longer hungry or satisfied mode. And GLP is one of the key signals that tells our body we are satisfied. GLP also works in concert with insulin. So you can sort of think about it like in the same way that you get a food coma from insulin, GLP-1 will signal to parts of your brain that we have had enough to eat. I keep seeing comments, Dr. K, how do I apply this to a situation in my life? That's literally why we created a coaching program. Our coaches are certified on an evidence-based curriculum designed to help you get unstuck. This involves analyzing your patterns, increasing your understanding, and working with you week to week to help you develop a plan to create lasting change. So if y'all are interested, check out the link in the description below. If we look at insulin, insulin is focused primarily on glucose metabolism, so it regulates our blood sugar, okay? But GLP is not related to blood sugar, but it is related to other parts of satiety. So GLP travels to this part of our brain called the ventral tegmental area, which is where our dopaminergic reward circuitry is. So when we have a craving, that comes from our dopaminergic reward circuitry, right? Like I want to eat French fries, and then I eat French fries, and then it feels pleasurable. So eating food is tied with pleasure. Eating fatty food, having intense cravings for sugary food, all of those are tied to pleasure. And I don't know if you guys have kind of experienced this, but like, hopefully, you know, you can eat a cookie and it tastes really good, and then you eat a second one, you eat a third one, you eat a fourth one, you eat a fifth one. And if you look at the volume of cookies you're eating, they're actually pretty small, right? Like you can eat five cookies, and it's not like the same quantity of food. It's not the same volume of food as, let's say, like a big salad that is like low calories, right?