GLP-1 receptor agonists
DESCRIPTION:
GLP-1 agonists are all the rage: weight-loss injections such as semaglutide, initially intended for type 2 diabetes; their mechanisms of action, effects on GLP-1, and the psychology of their use in obesity.
The hype surrounding Wegovy and other weight loss injections: Why GLP-1 receptor agonists such as semaglutide change more than just your body weight or a medical condition – understanding the benefits and risks
The hype surrounding "weight loss injections" is everywhere. GLP-1 receptor agonists such as semaglutide (Wegovy, Ozempic) are revolutionising the treatment of obesity and type 2 diabetes. But here's where it gets strange: people are not only reporting weight loss –they are suddenly no longer interested in wine, cigarettes stay in the drawer, and even compulsive shopping stops. "I feel... empty," said one woman. "Shouldn't I be happy?"
Why does this liberation from desire feel so different from what Buddhist monks have been talking about for centuries?
What it's all about:
· the mechanisms of action of GLP-1 receptor agonists,
· benefits and risks, and
· Why the "middle way" between chemical suppression and conscious living could be the key.
Spoiler: The connections are more complicated than expected, and so is the solution to the problem.
What medication: What are GLP-1 receptor agonists – and do they kill all desires?
The hype is real, and you've probably heard of them: GLP-1 receptor agonists such as semaglutide (Wegovy, Ozempic), tirzepatide and liraglutide are the fastest-growing group of drugs in recent years. These "weight loss injections" were initially developed for the treatment of type 2 diabetes, but their effects go far beyond blood sugar control. This class of substances mimics the body's own hormone glucagon-like peptide-1 (GLP-1) – a messenger substance that signals "I'm full!" after eating. That's the simple explanation you got from your doctor.
But then something strange happens. People report: "I just don't feel like having wine in the evening anymore." Or: "The cigarettes have been sitting untouched in the drawer for weeks." If you have struggled with eating disorders or obesity for years, you may suddenly find that you don't care about the chocolate in the fridge. Compulsive Amazon shopping? Gone. You still know the desire – but it no longer screams.
The explanation lies in the mechanisms of action that make these antidiabetic drugs so special: the GLP-1 receptor is not only found in the digestive tract, where it delays gastric emptying and curbs your appetite. These receptors are also located deep in the brain – in the reward centre, where they modulate dopamine release. Studies in people with obesity show an average weight loss of 10–15% of body weight. But is that the whole story? These drugs also change your relationship to desires themselves. And new therapeutic applications are being discovered every day, from cardiovascular effects to possible uses in addiction treatment.
How does semaglutide actually work? The mechanisms of action in obesity are explained.
To understand why semaglutide and other GLP-1 receptor agonists can do so much more than "just" help you lose weight, we need to take a quick look inside your brain. The glucagon-like peptide-1 receptor (GLP-1 receptor agonists) is like a molecular switch on your cells. In people with type 2 diabetes and obesity, the body often does not produce enough of this hormone. Subcutaneous injections of semaglutide, tirzepatide or liraglutide step in and compensate for this deficiency.
The drug works on several levels at once – and that is what makes this class of substances so effective: firstly, it helps with diabetes by stimulating the insulin-dependent uptake of sugar into your cells. Secondly, it slows the rate at which your stomach empties – you feel full for longer. Thirdly, it acts directly on your hypothalamus, the part of your brain that cries "Hunger!" or "Enough!" These complex mechanisms of action explain why the FDA and the European Medicines Agency have approved these drugs for people with a body mass index (BMI) above 30 kg/m² – or even as low as 27 kg/m² if you have additional health problems.
But here's where it gets exciting: the GLP-1 receptor is not only found in your digestive system. It is also found in regions of the brain that control what you crave and what motivates you. When the agonist binds to this receptor, it dampens dopamine release—the "I want this NOW!" feeling. That's why it's not just your eating habits that change. Clinically controlled studies have shown other positive effects – fewer heart attacks and fewer strokes in overweight people. The drug is having a profound impact on what drives us as humans.
The truth about benefits and risks: what you should know
Let's be honest: the figures are impressive. In studies, people taking semaglutide lost an average of 15% of their body weight, while the placebo group lost only 2–3%. If you have diabetes mellitus or obesity, this means that your blood sugar levels will normalise, your blood pressure will drop, and your risk of heart attack and stroke will be reduced. These are the benefits everyone is talking about.
But no one likes to talk about the downsides. And there are some: gastrointestinal complaints such as nausea affect 20–40% of people who take these drugs, especially at the beginning and when the dosage is increased. You may be familiar with this: constant nausea that won't go away. And then it gets more serious: there are reports of an increased risk of suicidal thoughts and thoughts of self-harm. The European Medicines Agency is currently investigating whether the active ingredient is directly responsible or whether people who suddenly lose their usual "coping mechanisms" (eating, drinking for comfort) fall into an existential crisis. If you already live with a mental illness or an eating disorder, special caution is advised.
And here comes the most significant problem: weight gain after discontinuation. Without fundamental changes in your diet and exercise, the kilos come back – often more than before. The injection is not a miracle pill. You need a comprehensive approach – behavioural changes, possibly psychological care, and definitely medical supervision. The optimal dosage varies from person to person and must be carefully adjusted. The hype surrounding "Wegovy and Co" often fails to mention that these are actually neurological interventions, not harmless lifestyle products for weight control.
Why your medicinal "liberation" feels so strangely empty
"If Buddhism has been teaching for centuries that liberation from desire leads to enlightenment," asked journalist Shayla Love in 2024, "why does the medicinal version through semaglutide and other GLP-1 agonists feel so... disappointing?" Perhaps you've experienced this yourself: the pounds are falling off, your lab results are improving, and your doctor is thrilled. But somehow you don't feel liberated. More like empty. Why?
The difference lies in the speed of change—and in what is lost in the process. Buddhist practice means years, sometimes decades, of observing your desires. You gradually understand why you reach for food when you are sad. You recognise the patterns. You develop new ways of dealing with stress. Your self grows in parallel with the change. You learn who you are when desire no longer rules your life.
GLP-1 receptor agonists skip this whole process. In weeks or months, the drug changes your brain chemistry without giving your psyche time to catch up. When you are suddenly freed from intense feelings of desire, you have to rediscover what drives you completely. Imagine: your entire adult life, you were "the bon vivant," "the foodie," "the party animal." Now there's chocolate in front of you – and you feel... nothing. Who are you without your desires? This is not a theoretical question. It is an existential crisis that many users of the weight-loss injection struggle with.
The "Middle Way": Why you don't have to be an ascetic or a helpless victim of your desires
In his first sermon, Buddha described the "Middle Way" (Majjhima Patipada) – and the concept fits amazingly well with what you might experience with GLP-1 receptor agonists. Buddha warned against two extremes: indulging in all pleasures (uncontrolled obesity, addictive behaviour) and denying yourself everything (extreme diets, self-mortification). Both extremes lead to suffering.
The Middle Way does not mean that you have to give up all pleasures. On the contrary, Buddhism encourages enjoying the moment. What you can learn: enjoy consciously without being obsessed. You can love delicious food without it controlling you. You can look forward to things without being emotionally dependent. Applied to your situation with semaglutide: the drug can reduce your body weight and improve your blood values. But the optimal treatment of type 2 diabetes and obesity requires more changes in diet and exercise, possibly psychological support, and awareness of what you really need.
And this is where it gets interesting: some people on GLP-1 drugs find their own "middle way" after months. "I had to learn more about what desire is, how it works," one user said. Do you see the parallel? Medication to curb desires becomes a starting point for self-exploration. You suddenly have space – space to ask: what do I actually want? Who am I? What gives my life meaning when it's no longer about chasing the next desire? This is more than weight loss. It's a new therapeutic possibility—if you're willing to do the work.
What the weight loss injection does to your reward system (and why it's more than you thought)
To understand why these drugs change you so much, we need to talk about dopamine. The mesolimbic reward system – your "I want that!" centre – is why you get up in the morning, look forward to dates, and why chocolate is so tempting. The hype surrounding "weight loss injections" is based on the discovery that these drugs do more than reduce your appetite. They change how your brain creates desires.
Here's the most critical point: dopamine is not a "happiness hormone." That's a myth. Dopamine is an "anticipation hormone." It doesn't say, "This feels good," but rather, "This is worth striving for!" When you see chocolate and your dopamine rises, it doesn't create joy – it creates desire. The glucagon-like peptide-1 receptor in your brain modulates precisely this dopamine release. That's why you don't just lose your interest in food. Suddenly, you're no longer interested in alcohol, you put down your cigarettes, and your compulsive shopping stops.
Semaglutide and tirzepatide dampen the dopamine response to reward stimuli. In practical terms, this means that chocolate no longer triggers the same "I must have this NOW!" feeling. Your brain turns down the volume. This can be a blessing when it comes to overweight or obesity as a disease, or when alcohol has destroyed your life. But it can also be a curse when suddenly nothing seems exciting anymore. Studies show positive effects—fewer heart attacks and better blood values. But in your daily experience, the change means you need support to navigate this new inner landscape. The clinical truth? Medication alone is not enough.
The paradox: why you can feel 'cured' and still feel empty
Here's the uncomfortable truth about GLP-1 receptor agonists: desire isn't just a problem – it's also a driving force. When you're struggling with obesity as a disease, the desire for food often feels overwhelming. It controls you. But desire is also what gets you out of bed in the morning, what gives you goals, what structures your life. If you suddenly lose the ability to strive intensely for things, you may also lose the feeling of being alive. This is not a theoretical problem. People taking semaglutide and other GLP-1 medications are experiencing this in real life.
Viktor Frankl, who founded logotherapy, said: The will to meaning is the primary motivating force in humans. Not pleasure, not power – meaning. When GLP-1 receptor agonists curb your desires, they don't just curb problematic desires (compulsive eating, alcohol). They may also curb what drives you: starting new projects, nurturing relationships, and taking on challenges. And then comes the feeling: "I should be happy. I've lost weight. Why does everything feel so... flat?"
Anticipation is a significant source of human well-being. Studies show that we often enjoy the anticipation of an event more than the event itself. When GLP-1 receptor agonists dampen this anticipation, they may deprive people of an important source of life satisfaction. The challenge? To develop new sources of motivation – based on values, conscious decisions, and commitments. No longer "I want this!" as motivation, but "This is important to me." That takes work. Psychological work that the drug cannot do for you. And that is precisely what is often forgotten in the current hype surrounding "Wegovy and Co."
Dopamine detox and semaglutide: two sides of the same coin?
You may have heard of it: "dopamine fasting" is the latest trend from Silicon Valley. 24 hours without social media, junk food or dopamine kicks. The idea behind it: our modern lives are a dopamine orgy. Instagram, delivery services, Netflix binges – our brains aren't made for this. We need to "reset" the system. Sound familiar?
Here's where it gets interesting: Semaglutide has a similar biochemical effect. The drug dampens the dopamine response to reward stimuli. Chocolate, wine, the latest gadget on Amazon – they no longer trigger that same "I must HAVE this!" feeling. Your brain turns down the volume. The cultural message behind this is that desire is a monster that must be tamed. Our society – with its chips optimised for "bliss points", highly processed foods that lead to overweight and obesity, and endless social media feeds – systematically makes us addicted. GLP-1 receptor agonists appear to be a technological salvation: the biochemical reset button.
But both dopamine fasting and experiences with GLP-1 receptor agonists show that the solution is more complicated. The emotional reactions to semaglutide reveal an uncomfortable truth: yes, excessive attachment to desires causes suffering (obesity as a disease, addiction, depression). But total listlessness? That's not the answer either. Desire is not your enemy. It is more complex, more nuanced. It drives you, gives you goals, and structures your life. The challenge is not to eliminate it, but to develop a conscious relationship with your desires. That is the difference between chemical suppression and genuine growth.
Your personal path: how to deal with the changing landscape of motivation
If you are taking GLP-1 receptor agonists such as semaglutide or tirzepatide and wondering, "Who am I without my desires?", you are not alone. Many people go through this disorientation. The first step: accept that a period of adjustment is normal. Your brain has changed in a matter of weeks – your psyche needs longer to catch up. That's okay.
Approaches such as acceptance and commitment therapy (ACT) can help here. The core idea is to learn to align your actions with values, not desires. Instead of waiting until you have a strong "I want!" feeling, act out of conscious commitment. You call your friend, not because you are driven by overwhelming longing, but because friendship is important to you. You go for a walk, not because you feel like it, but because exercise is one of your values. This may sound mechanical, but over time, you will develop a new kind of motivation that is more stable than impulsive desire. If you live with eating disorders or other mental illnesses, professional support is critical.
Self-awareness – straight from Buddhist traditions – helps you explore your changed inner world. When does anticipation arise? Which activities fulfil you, even without intense desire? How does deep satisfaction differ from excited anticipation? In the long term, you will learn that change is not a disaster. It is an opportunity—if you are willing to do the inner work that goes far beyond mere weight loss.
The bigger questions: between miracle pills and two-tier healthcare
Imagine a future in which "desire management" is as standard as drinking coffee is today. A drug for binge eating, one for shopping addiction, and one for better impulse control. Sounds like science fiction? We're already there. The use of GLP-1 receptor agonists has long gone beyond their original indication for diabetes. People without obesity use semaglutide for weight control, discover the psychological effects, and suddenly they no longer smoke or drink. FDA approvals for ever-new areas of application are accelerating.
But here come the uncomfortable questions: Who are you when an administered drug alters your neurochemistry? Is the version of semaglutide more "authentic" than the one with intense desires? Or are you... ...malleable? Dependent on biochemical conditions? There are no easy answers to these questions. But they become more pressing the more people use these drugs.
And then there is the question of fairness, which no one likes to voice aloud: one month of Wegovy costs £1,200–1,500. Health insurance companies often only pay if you have a BMI over 30 and comorbidities. In practical terms, this means that privileged people have access to "chemical liberation" from desires. In contrast, others continue to struggle with junk food that leads to obesity, with stress from precarious jobs, without access to healthy food, therapy or even psychological care.
The hype surrounding "weight loss injections" distracts from more critical questions: Why is our environment designed in such a way that it systematically promotes addictive behaviour? Why do food companies optimise products for maximum addictive potential? Why is healthy eating a luxury? Should we change the structures—or distribute individual pharmacological patches? Soon, perhaps: GLP-1 drugs for alcoholism, nicotine addiction, and gambling addiction. The European Medicines Agency is reviewing them, and the drug group is growing. The question is: do we want a world in which desire itself becomes an illness that needs to be treated? Or do we want to understand why so many people are overwhelmed by their desires?
To put it bluntly: do we want to be fattened by high-calorie junk food and then use vitamins, minerals and weight-loss injections to combat the consequences of poor nutrition and lack of exercise?
12 insights from the laboratory and about life
The most important points for you:
· Desire is life, not neurobiology: Semaglutide, tirzepatide, and liraglutide show us that your struggle with food or alcohol is not "weakness of will" – it is neurochemistry. The glucagon-like peptide-1 receptor modulates dopamine release, thereby influencing your "I want that!" feeling. This frees you from guilt.
· The consequences are psychological, not just physical: yes, the weight loss is real. But the real challenge? What motivates you when the desires subside? How do you fill the void when food, drink or shopping are no longer available as comfort? These questions need answers.
· Quick fixes don't always help in the long term: Buddhist practice over many years enables psychological integration. Semaglutide changes your neurochemistry in weeks—your psyche lags. You may need therapeutic support. That's not a weakness, it's reality.
· The numbers are impressive – but so are the risks: 15% weight reduction, better blood values, lower BMI. But: gastrointestinal complaints such as nausea in many, suicidal thoughts and weight gain after discontinuation without fundamental lifestyle changes.
· The "middle way" is not a compromise, but the goal: neither uncontrolled desires (obesity as a disease) nor emotional emptiness leads to well-being. The best treatment for type 2 diabetes and obesity combines medication with dietary changes, exercise and psychological support.
· Dopamine is anticipation, not happiness: the GLP-1 receptor agonist class of substances does not dampen your joy, but your anticipation. People say, "I can enjoy things when I do them – but I no longer crave them." Do you understand this difference? It explains a lot.
· If you have an eating disorder, be careful: the injection can be both a blessing and a curse for eating disorders. Compulsive eating disappears – but so does your sense of hunger and satiety. Close monitoring is essential.
· Your identity needs to be redefined: "Who am I without my desires?" is not a rhetorical question. If you have defined yourself as a "bon vivant" or "foodie" for decades, you need to reconstruct your identity. That takes work – and you shouldn't have to do it alone.
· Self-awareness as a research laboratory: don't see the situation as a loss, but as an opportunity for self-exploration. What really motivates you? What do you need for a fulfilling life? Curbing your desires creates space for these questions.
· Social structures remain important: The hype surrounding Wegovy and Co. should not distract us. Why do we produce foods that are optimised for maximum addictiveness? Why is healthy eating a luxury? Individual pharmacological solutions are no substitute for social prevention.
· Integration, not elimination: The goal is not to eliminate your desires – that would be an emotional lobotomy. The goal is a conscious, flexible relationship with your desires. The "middle way" between hype and honest consideration: GLP-1 receptor agonists as a tool in a comprehensive concept, not as a substitute for psychological work.
Perhaps that is the real value of these drugs – not the suppression of desires, but the space that this creates. Space for questions. Space for growth. Space for conscious living. Chemical liberation is only the beginning. The real work – understanding who you are without your desires and who you want to become.
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