An FDA review in 2026 found no increased risk of suicidal thoughts or behavior with GLP-1 medications, and the warning was removed from weight-management labels. Early research on alcohol cravings is promising but small, and a large Alzheimer's trial was negative.
GLP-1 medications change hunger and cravings, not only digestion, which is why researchers are studying their effects on mood, substance use and memory. The clearest answer so far concerns safety: in January 2026 the FDA reported that its review found no increased risk of suicidal thoughts or behavior, and it asked for that warning to be removed from the weight-management labels. Research on alcohol and other cravings is early and promising but based on small trials, and a large trial in early Alzheimer's disease found no benefit.
Trials have shown that GLP-1 medications change hunger, cravings and food preferences, and earlier animal and observational research suggested they might also affect alcohol intake. That raised two kinds of questions. One was a safety question: could these drugs affect mood in harmful ways? The other was a possibility: if they change food reward, could they also affect other cravings or brain health? Both have now been studied, with very different levels of evidence.
When Saxenda, Wegovy and Zepbound were first approved for weight management, their labels included a warning about suicidal behavior and ideation. According to the FDA, that language reflected reports of such events with a variety of older medicines used or studied for weight loss. GLP-1 labels for type 2 diabetes do not include it.
In its January 2026 Drug Safety Communication, the FDA described two analyses:
The agency concluded that the evidence does not support a causal relationship and requested removal of the warning from the Warnings and Precautions sections of the Saxenda, Wegovy and Zepbound labels. The current Wegovy label lists that section as removed in February 2026.
The FDA's advice to patients is practical: keep taking your medication as prescribed, and tell your health care professional if you experience new or worsening depression or other mood changes. If you are having thoughts of harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911 in an emergency.
A 2017 trial in Diabetes, Obesity and Metabolism looked closely at how semaglutide changes eating. Thirty adults with obesity took weekly semaglutide or placebo for 12 weeks each, in random order. With semaglutide, energy intake across self-selected meals over a day was about 24 percent lower. Participants reported less hunger, fewer food cravings and better control of eating, and showed a lower preference for high-fat foods. Resting metabolic rate adjusted for lean mass did not differ, which suggests the main effect was on intake rather than on metabolism.
This was a small mechanism study, not a long-term outcome trial, and individual experiences differ. For more on the everyday experience of appetite, see Food Noise and Appetite.
Animal and observational research suggested GLP-1 medications might reduce alcohol intake. The first randomized trial of semaglutide for this question was published in JAMA Psychiatry in 2025. Researchers randomized 48 adults with alcohol use disorder who were not seeking treatment to low-dose semaglutide or placebo for 9 weeks.
The authors described this as initial evidence that justifies larger trials. Semaglutide is not approved to treat alcohol use disorder, and using it for that purpose would be off-label.
A large 2025 analysis in Nature Medicine of US Veterans Affairs health records adds a broader, but observational, view. It compared 215,970 people with diabetes who started a GLP-1 medication against several comparison groups across 175 health outcomes. Compared with usual care, GLP-1 use was associated with lower risks of substance use disorders and psychotic disorders, among other outcomes. It was also associated with higher risks of gastrointestinal disorders, low blood pressure, fainting, kidney stones and drug-induced pancreatitis. Observational associations like these generate hypotheses; they do not prove cause and effect.
The same Nature Medicine study found GLP-1 use was associated with a lower risk of neurocognitive disorders, including Alzheimer's disease and dementia. Findings like that, along with animal research, led to a direct test.
The evoke and evoke+ trials, published in The Lancet in 2026, randomized 3,808 adults aged 55 to 85 with early Alzheimer's disease (mild cognitive impairment or mild dementia, with confirmed amyloid) to daily oral semaglutide or placebo across 566 sites in 40 countries. After 104 weeks, the change in the main measure of clinical decline was essentially the same in both groups. The authors concluded that oral semaglutide was not efficacious in slowing clinical progression in early Alzheimer's disease, and safety was consistent with other studies.
That result does not settle every question, since it tested one drug in people who already had symptoms. But it is a useful reminder that observational links do not always hold up in randomized trials.
The FDA's 2026 review of 91 placebo-controlled trials and a large observational study did not find an increased risk of suicidal thoughts or behavior, or of psychiatric events such as depression or anxiety. The FDA still recommends telling your health care professional about new or worsening depression. If you are in crisis, call or text 988.
A 2025 randomized trial of 48 adults with alcohol use disorder found semaglutide reduced weekly craving and some drinking measures over 9 weeks. The study was small and short, and semaglutide is not approved for this use. The authors called for larger trials.
Observational studies have linked GLP-1 use with lower dementia risk, but the evoke and evoke+ trials found oral semaglutide did not slow progression in people with early Alzheimer's disease. Whether there is any preventive effect in people without symptoms is not known.
In a 2017 trial, semaglutide reduced hunger and food cravings and improved control of eating compared with placebo, along with a lower preference for high-fat foods. Experiences vary, and very low intake should be discussed with your provider.
Changes in mood, appetite or drinking patterns are worth mentioning to your provider whether or not they seem connected to your medication. A licensed provider can help interpret what you notice and adjust your care. This article is educational and does not determine eligibility for any treatment.
Written by the NewDay Wellness editorial team from the sources above and checked against them before publication, and medically reviewed by Dr. Sean Arora and Dr. Shannon Arora of Arora Health & Aesthetics; see our editorial standards. This article is educational and does not diagnose conditions, establish eligibility for any medication, or replace care from a licensed provider. Compounded medications are not FDA-approved.
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