The Active Mechanisms Behind GLP-1s<\/p>\n
These drugs act primarily in the gut but also work on pathways in the brain that influence appetite regulation and reward processing, said Bronwyn Holmes, MD, a member of the medical advisory board at Eden<\/a>, an online weight loss clinic that prescribes GLP-1s. It\u2019s difficult to pinpoint exactly how they behave, because the mechanisms by which they work are still not exactly known.<\/p>\n \u201cThese drugs are thought to dampen dopamine<\/a>-driven reward signals, which help reduce the cravings for food and other compulsive behaviors. This can indirectly affect mood and motivation, useful for weight loss but potentially relevant to other reward-driven activities like intimacy or alcohol use<\/a>,\u201d Holmes said.<\/p>\n Emerging research suggests the medications may enhance serotonin receptors that are known to blunt sexual desire in another context, Holmes said.<\/p>\n The combination of reduced dopamine signaling and elevated serotonin could contribute to a muted reward response, she said. But, she said, definitive human trials are limited.<\/p>\n Psychiatrist Ryan S. Sultan, MD, said a closer look at current studies that show how GLP-1s may be useful in addiction<\/a> treatment highlights the effects this class of medication has on patients\u2019 brain chemistry. In this sense, he agreed with Holmes.<\/p>\n New research has shown GLP-1s could be the next treatment to reduce cravings and improve recovery in alcohol and opioid addiction<\/a>, Sultan, an assistant professor of clinical psychiatry at Columbia University\u2019s Irving Medical Center, New York City, and the founder and medical director of Integrative Psychiatry in Chelsea, New York, and Miami, said.\u00a0<\/p>\n GLP-1 receptor agonists can increase dopamine release in the mesolimbic pathway, ultimately increasing baseline dopamine levels and reducing the spike that leads to cravings, he said. Other studies have shown that GLP-1 receptor activation can lead to a drop in dopamine and food cravings. In serotonin pathways, activation of GLP-1 receptors also aids in appetite regulation.<\/p>\n As reproduction and eating are both drives that are wired into the human system by evolution, Sultan said it \u201cmakes complete biological sense\u201d that both of these needs are tied to the brain\u2019s reward pathways. An overabundance of food in Western society creates what Sultan characterized as \u201cmajor dysfunction in the reward system pathways associated with food.\u201d<\/p>\n \u201cSex is based on drive and reward as well, and many neuronal networks involved in food and sex drives overlap,\u201d he said.<\/p>\n \u201cWhen we take GLP-1s, we are essentially dampening the internal processes that drive us to address our evolutionary needs. By inhibiting the pathways that drive us towards food acquisition, we are subsequently affecting the overlapping systems that drive us to have sex.\u201d<\/p>\n Holmes said that the physical side effects that some patients experience when taking these medications, including nausea, constipation<\/a>, and fatigue, can also lead to a reduced desire for intimacy.<\/p>\n On the Upside<\/p>\n Holmes pointed out that some patients experience enhanced sexual desire as the result of weight loss and improved self-perception, so there are some benefits to the libido from taking GLP-1s \u2014 or at least, benefits are experienced by some patients.<\/p>\n \u201cThe majority of people experience better sexual desire and function after weight loss because their mood improves, together with their self-esteem and hormonal balance,\u201d she said. \u201cThe drug-induced libido reduction does not always outweigh the benefits of weight-loss improvements, which are most pronounced in menopausal women and men with low testosterone<\/a> levels.\u201d<\/p>\n Hormonal Fluctuations<\/p>\n Given that GLP-1s work on the patient\u2019s hormones, it\u2019s natural that they affect the functioning of the body\u2019s overall hormonal system. The mechanism through which they help patients with type 2 diabetes manage their blood sugar levels is predicated on stimulating insulin<\/a> release and slowing glucagon<\/a>, in addition to slowing gastric emptying.<\/p>\n Two decades after the introduction of the first medication in this class, it can be hard to remember that weight loss was originally just a side effect. As a result, a patient\u2019s hormonal changes before, during, and after taking the medication can combine with the medication\u2019s effects on libido, too.<\/p>\n![\"photo](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2025\/09\/ht-250922-bronwyn-holmes-120x156.jpg\")
Bronwyn Holmes, MD<\/p>\n![\"photo](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2025\/09\/ht-250922-ryan-sultan-120x156.jpg\")
Ryan S. Sultan, MD<\/p>\n
![\"photo](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2025\/09\/ht-250922-hayley-miller-120x156.jpg\")
Hayley Miller, MD<\/p>\n