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GLP-1 medications like Wegovy, Ozempic, and Zepbound are widely recognized for their ability to suppress appetite and support weight loss. But what happens when these medications start affecting more than just your relationship with food?

For many people, food—and sometimes alcohol—has served as a way to cope, self-soothe, or unwind. So it’s completely valid to ask: If that response gets blunted, what else might change? Could social situations feel flat? Could sleep be disrupted? Could mood take a hit?

In this post, we’re unpacking the complex but important reality of how GLP-1 medications interact with the brain’s reward system. We’ll look at what might shift emotionally and socially, what to be aware of, and—just as crucially—how many people experience life-opening benefits when food is no longer at the center.

GLP-1s and the Brain's Reward System

GLP-1 medications like semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro, Zepbound) work by regulating blood sugar and appetite, but their effects extend beyond the gut. One key way they operate is by altering how the brain responds to food-related stimuli—blunting the dopamine surge we often associate with eating.

For many patients, this is a welcome shift. Cravings diminish. Emotional eating fades. But because dopamine isn't limited to food rewards, some people notice a dulling effect in other areas too, like drinking, socializing, or other activities they once enjoyed.

This isn't universal, but it's worth acknowledging. If your go-to coping mechanisms include food or alcohol, removing that reward loop can feel jarring at first.

The Role of Coping Mechanisms and Mental Health

A really common worry people have before starting GLP-1 medications is: What happens if my go-to coping tools stop working?

And it’s a fair question because for a lot of us, food and alcohol aren’t just about hunger or fun. They’re ways we unwind, soothe stress, or get through tough moments.

Take alcohol, for example. It might feel like it helps you sleep, but in reality, it messes with deep, restorative REM sleep. Poor sleep then affects your appetite and cravings, which can make food feel even harder to manage. It’s a cycle that looks like relief in the short term but tends to backfire over time.

What’s interesting is that GLP-1s often break that loop. They naturally reduce cravings—not just for food, but for alcohol too. In fact, some of these medications are now being studied (and used) to treat alcohol use disorder. 

• Most people find that they just don’t want to drink anymore
• The shift is often effortless—it happens without willpower
• Alcohol-related sleep issues tend to improve as use declines

That said, when food or alcohol has been your emotional fallback, suddenly not needing them can leave a void. In rare cases, people report feeling emotionally flat or disconnected, like nothing feels enjoyable anymore. It’s not common, but it can happen. Watch for red flags like:

• Loss of interest in activities you used to enjoy
• Persistent low mood or emotional numbness
• A sense that nothing feels pleasurable anymore

That’s why working closely with your healthcare provider is so important, especially if you notice big shifts in your mood or sense of joy.

And if it turns out that this medication isn’t a good fit for you? That’s totally okay. There are other options. The goal is never to tough it out—it’s to find the path that supports both your physical and emotional health.

Why Building a Life Beyond Food Matters First

One of the most helpful things you can do before starting a GLP-1 is to build a life that doesn't revolve around food.

That might sound simple, but for many of us—especially those juggling work, caregiving, and other pressures—there may not be many built-in sources of pleasure or relaxation outside of eating. When I work with patients, one of my first questions is: "What do you like to do in life? What brings you joy? What are your hobbies?" 99% of people can't answer this question.

Think of this as an opportunity to intentionally create a richer routine. Explore hobbies, revisit old interests, or introduce low-pressure movement like walking or swimming that brings joy. These aren't just distractions—they're new dopamine sources that help fill the emotional gap. This is why therapy, coaching, or regular physician appointments become so important during this transition.

When the Shift Feels Positive

While much of the conversation centers on what might be lost, there's another side to this story: what can be gained.

Many people report feeling better than ever once their body becomes more capable. Physical activity becomes easier. Long walks become possible and enjoyable. Hiking, swimming, and other activities open up. Energy levels rise dramatically, and travel feels less restrictive.

Life experiences expand in remarkable ways. Patients go on cruises and actually do the excursions. Amusement park rides become an option. Swimming with dolphins or other adventure activities become possible. Daily life improves across the board—airplane seats fit comfortably, clothing shopping becomes enjoyable, and there's reduced discrimination and bias.

Instead of missing food rewards, patients often describe a new sense of freedom, confidence, and excitement about what their body can do. The narrative moves from deprivation to expansion—more possibility, more strength, more connection with life.

Changing your relationship with food is necessary for long-term weight management, whether you're on medication or not. The difference is that GLP-1 medications can make this transition easier by reducing the physical and psychological pull of food.

Success requires working through emotional eating patterns, developing non-food coping strategies, building meaningful activities and hobbies, and addressing underlying mental health needs.

Support Is Everything

GLP-1 medications are powerful tools, but they're not magic pills. They require a full-picture approach that includes medical supervision, emotional awareness, and a willingness to reshape your routines.

The key is not to go it alone. Work with a medical team that will monitor you closely. Be honest about your current coping mechanisms. Start building hobbies and interests now. Have a plan for addressing emotional eating. And remember that if this approach doesn't work for you, there are other options.

With the right support system, many people find that their relationship with food changes—but what opens up in its place is far more rewarding. The goal isn't just weight loss. It's building a life where you feel capable, energetic, and engaged with the world around you.

Always consult with your healthcare provider before starting any new medication. This information is for educational purposes and should not replace professional medical advice.

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance. 

Welcome back to another episode of the podcast. How are you all doing? I am finding that it's may timeframe around when I'm recording this, so this might there might be like a little bit of a delay for from when it comes out, but I am in full summer prep mode. So every year our kids get outta school end of May, and then they actually go back either the end of July or right the beginning of August. It's insanity. We have a little bit of like a rolling calendar in Indiana. Basically there's only one month when they're truly not ever in school, but the rest of the time, they might have a two week break in fall or spring, things like that. But it's basically this nonsense where they're constantly in school, and I say that because there's these long periods of time, you're like, what am I gonna do With a five or 6-year-old for two weeks when I'm not off right. Any working parents here know what I'm talking about. But anyway, back to the plot. I am planning summertime because I find that if I don't get really intentional with it, and I'm just talking, saying, alright, I wanna see if we can get, we like to go to a lot of the state parks around us. They'll have different lakes that you can swim at and. We get that$50 pass for the year. We have to see if they up the price this year. But you can go to all these parks. I cannot recommend this enough. It's not sponsored. But seriously, I feel that we really need to support the things that we have around us. We get that. We go to all these different places. You'd be shocked how many are probably around you that you don't even know exists. I wanna do hiking, swimming and I like to kind of make, if you would sort of like a summer bingo list and say, all right, we're gonna go here once, we're gonna do this three times, because otherwise the end of the summer hits and you feel like you've done nothing. Am I the only one? You're like, wait, what happened? Did anything happen? I like from the beginning to lay it out, decide what time I'm gonna take off, all that kind of stuff. So I've been deep in that and I got a good fan mail question here, and so I decided, hey, let's do a fan mail response for this episode, and this is something that I have not really dug into a lot, which is that with these GLP 1 medications, GLP 1 slash G, so whether you're thinking semaglutide or tirzepatide, again that's, Wago, Ozempic or Manjaro zep bound these medications for some people. They notice that, of course, just as the response to food is blunted, it's also other areas can be decreased as well. And so let me read this question and then I wanna talk a little bit about it. I wanna, for the 900th time, remind you that I am a physician, but I'm likely not your physician. And so if I'm not directly in a visit with you, nothing here is medical advice. This is just. A general conversation and educational exploration. Right. Okay. But talk to your medical team. What's right for you. This person said they're seriously considering going ahead with Wegovy. I just had a couple of small questions. What happens when I actually want to go out with friends and drink socially? If it shuts down the reward part of your brain, is it only for food or does everything else seem to just be blah as well? Question mark. If I've been using food and alcohol to cope slash fall asleep, et cetera. What am I gonna do then when that's all gone? I'm a little bit worried about depression as well., I feel fine now than being stressed out about not losing weight. Okay. So this person, if I'm reading this right, they're feeling fine now, but they're just stressed out with not losing weight. Alright? So I wanna just start out with this. These medications are not perfect, there are actually a lot of things that I wanted to address in this question. The first thing that I really wanna address here that's really significant is that this person is really cluing into that they've been using potentially food and alcohol to cope or fall asleep, things like that. So you're using tools maybe in a way that they were not intended, definitely with alcohol, know that I'm not a fan of alcohol and I don't ever judge whatever your habits are. The problem with alcohol is, number one, we know that it's known to cause different cancers and things like that. And I mean, like, this is like well established at this point, but thing number two, that's a lot more significant when it comes to the metabolic health and the, uh, weight management area. It's that. When you use alcohol, you actually get less really deep REM restorative sleep. And so you usually, typically struggle more with food. And it's this tricky thing because you're thinking, I'm using it to sleep, but your sleep is actually crappier and crappier. And so it's tricky because you keep thinking that you're using it for that reason, but you actually keep shooting yourself in the foot. So thing number one, if you're doing that, you really need to. Talk to your medical team about what strategies do they have for you. And again, I don't ever know to what extent someone's doing this, so it's really hard to make a comment heads or tails'cause everybody's different with this. So again, these are my beliefs and how I typically work through things with people. But that's definitely. Something that I would really wanna work through first. And then also, some people really do use food as like a soothing mechanism. They find if they have carbohydrates at night, it kind of calms them down and helps them with sleep. And so there's a reality to all of this happening. The one thing though, that I wanna address that I see happens, so yes. A lot of the time, food does not hit in the same way anymore. People don't get that same dopamine hit. They're not having the same reward when they're having the food. And I have noticed this so much, even myself, that sometimes you say, oh, you used to really like when you ate that brownie, how it tasted, how it made you feel, all of that. And it just doesn't do that anymore. Now, again, I've always told you I've not been someone where. All the food was suddenly didn't want to eat anything and all of that. But you really do have a different relationship and this is why I am such a fan of, if you need therapy, if you need coaching, if you need regular physician's appointments, what do you need so that you can work through this? A big thing that I work through with patients, and we go through this on the first visit, I will always say, so what do you like to do in life? What brings you joy? What are your hobbies? 99% of people that I talk to, there's nothing there. They have not built out this robust life of things that they love to do. And the reason that I bring this up,'cause a lot of people think, well, I'm here for weight loss. I'm here for,, the blood sugar going down, things like that. So here's the challenge. If we don't replace that with other things, you are always going to be. Missing the food, going back to the food, trying to manipulate the food to still make it work in your world, even though you physically can't eat as much or doesn't hit the same, you will continue down that road. And so we need to build out other things that replete your dopamine, that help you to feel better, you have to build a whole new life. And so my thought to this person is. Of course, I think your alcohol use is gonna go down because people just don't want alcohol when they're on this. And in fact, these medications are really being used for addiction treatment. Again, I'm not implying that this person is in that camp, but I'm just saying that these medications are literally being used for alcohol use disorder, right? It's like we're literally taking these things and using them, and I universally across the board, see with my patients that they just say, gosh, I just don't even want anymore. Maybe they had a few beers on the weekend, they don't wanna do it anymore. It's just the desire is not there. Now other things they end up building out, but that really does go away. I actually have yet for this to really happen with any of my patients. But I will say that you rarely, I. See someone where they, it truly affects their mental health. It is incredibly rare, but it does occur. And I do see also in a lot of the forums, where other physicians are commenting and things like that every so often someone will bring up yes. That this person suddenly just. Isn't interested in anything and just every area of their life is affected, then it really might not be a medication for you, and that's why you really have to be supervised on these medications. Keep in mind, I say this a lot on the podcast, these are prescription medications. There's a reason that you can't just. Go into Walgreens and pick it up, right? Like there's a reason for it. Because there are a lot of serious potential side effects, this being one of them. The mental health aspect. When people come in my clinic, I ask about history with self-harm. I ask about all of these things because all of it might potentially play a part. And so could this happen? Yes. Is it common? Absolutely not. It's not common at all. But it does occur, and I think that this is why you really need to be followed by a team that's following you closely because these things declare themselves. And I have had a friend that literally within the first 1, 2, 3 weeks on it said it was dramatic how the mental health side, how bad it was, and they had to stop it. It was like an immediate. Contraindication for them. But that's, again, incredibly rare. But if you're noticing that, you know, now nothing's pleasurable and, and everything is just horrible, all these things, and that's not a medication for you and you stop it. So I really wanna remind people, I think people think well, they go on it and then it's as though that's my only option. No, we have other medications that are gonna come out. We have other medications in general as well, some of them that treat mental health, that help with weight loss, right? And so, again, just remember that if that occurs. Then maybe it's not a medication for you. You need to be talking to who you're working with. It's not the end of the line. There are always other options and things to do. But the other side that I think is not talked about enough is how incredibly amazing life can become. And I wanna just give some, analogies here. So there sometimes is this death that occurs where the food is now. Not the main friend, it's not the main reward giver, it's not the main thing. Right? Okay. But what does end up occurring suddenly as your weight set point is going down, your body becomes more capable. Now you're able to really do long walks. Now you're able to start hiking. Now you're able to, oh my gosh. You get on the weight machine and gosh, do I feel strong? And you're starting to do all these other things. You start to, I hear patients, they're going on cruises and they're going out and doing the excursions that they could never do. They're swimming, with dolphins. They're doing all the things. They could never do all these things before. And they're suddenly realizing, I don't care that I'm not eating these foods and doing these things because I feel so great. Their life is entirely different. So that's the part that, it's so interesting because everyone is so focused on the alcohol, the food, things like that. But what else gets to change in your life? Honestly, absolutely everything. The realities of living in a world with. Fat bias and discrimination and literally everything, like not fitting in the plain seat with the seatbelt, not fitting, not being able to go on certain amusement park rides. Like everything is stacked against you. And so sometimes when you are in a different spot where you're energy levels are up, you're physically more capable. You're not experiencing literally hardship every single day. Sometimes your life is dramatically different. And I often. I mean, pretty much there's no patient that I work with where it's not a dramatic 180 in the opposite direction as far as how they're feeling, what they're doing, everything that's happening. And so that's the part that you can stay focused on this or you could decide if that occurs. I will deal with my medical team and we will make decisions, but otherwise I might not make that be a thing that holds me back because there's a world where there's all these other things that are gonna open up for me. So that's just something I wanted to talk about today.'cause I think that we haven't really addressed that a lot. And by the way this isn't unique to just being on a medication or not. I mean, yes, this aspect of the reward center being down, but the aspect of that, your relationship with food needs to change if you long-term wanna keep a weight set point down, it just has to. And so a lot of the times, the reason I don't teach a restrictive approach, I just don't see it work long term and food is used in so many different capacities that we have to work through it. In every single scenario for this to stay off long term. Alright? So I hope that this episode was helpful for you. Also, there is no failing here if these medications don't work out for you. There are people where, I mean, okay, great, it works for some and it doesn't for others. Now we're gonna move on and find other things, so don't get too anchored in that, if that. Is your scenario, but again, there's usually a whole other world that opens up. Alright, I hope you have a great rest of the week and that you are maybe having some good weather by you. You're getting out, you're active, you are maybe getting hydrated, right? We haven't talked about that for a minute, but I hope that you have a great rest of the day and week and we'll talk soon.