Off-Label Use of GLP-1s for Addiction

Hunger quiets, cravings fade, and the conversation around recovery shifts when biology finally meets behavior. We unpack GLP-1 receptor agonists—how they signal fullness early, slow gastric emptying, and may unexpectedly lower alcohol intake and even smoking—through personal experience and fresh science. Ryan shares how a weekly injection moved his A1C from prediabetic to optimal without losing strength or ditching the gym, while also softening the pull of old addictive patterns. Dr. Daryl Shorter explains why these drugs, approved for type 2 diabetes and obesity, are generating buzz well beyond weight loss, and how they challenge the willpower-only model that has long fueled shame around food and substance use.We break down a recent phase 2, placebo-controlled trial of low-dose semaglutide that showed reduced alcohol self-administration, lower cravings, and fewer drinks per drinking day, with a bonus signal on smoking. Then we get practical: what responsible, off-label consideration looks like; why first-line treatments and therapy still matter; and how to weigh lawsuits, side effects, and costs against the reality of stalled recovery. The goal isn’t hype—it’s clarity. For some, GLP-1s may be a bridge to consistent habits, social meals without overeating, and a quieter mind around alcohol. For others, the risks or lack of indication mean they’re not the right fit.We also look ahead to oral formulations in development and a care model where metabolic health, psychiatry, and recovery intersect. If you’re curious whether biology-informed tools can make change stick, this conversation offers nuance, guardrails, and hope. Listen, reflect, and share with someone who’s weighing their options. If this resonated, follow the show, leave a review, and tell us: could GLP-1s be a game changer in your recovery toolkit?Follow The Menninger Clinic on Twitter, Facebook, Instagram and LinkedIn to stay up to date on new Recovery Playbook episodes with Ryan Leaf and Daryl Shorter, M.D.  To submit a topic for discussion, email [email protected]. If you are a new or regular listener, please leave us a review on your favorite listening platform! Visit www.menningerclinic.org to learn more about The Menninger Clinic’s research and leadership role in mental health.