We are nearing a point of no return for GLP-1 drugs.

More than one in 10 Americans have already taken a GLP-1 agonist, be it Ozempic, Wegovy or Mounjaro. The medications, originally developed for diabetes treatment, have proven to be remarkably effective in helping people lose weight — and America is in the throes of an obesity crisis. They have shown promise in treating cardiovascular diseases, the country’s leading killer and a direct consequence of the obesity epidemic.

But the potential for these drugs seems to go far beyond weight loss. Recent small studies have provided evidence that GLP-1s may stave off dementia and Alzheimer’s disease, reduce kidney and liver problems, and may even be able to treat alcohol and drug dependence, as well as other compulsive behaviors like sex, gambling and shopping addiction.

With each additional study finding yet another application for these drugs, you might find yourself asking: Should I be taking Ozempic? Should everybody take it? Is there anything these drugs can’t do?

And indeed, right now it can seem like everyone will be taking GLP-1, sooner or later. These drugs currently require regular injections and can cost more than $1,000 out of pocket, but cheaper and more easily used versions are coming.

Eli Lilly will soon bring a pill version to the market, with a version expected to debut at a lower price than injectable Ozempic or Wegovy did.

A generic GLP-1 agonist is on track to arrive at Canadian pharmacies in 2026 and a US version will likely follow within the next decade. Some of the newer versions in development may prove to be even more effective than the first generation, which will only create more demand among doctors and patients.

Put it all together, and we can expect many, many more people taking them. GLP-1 drug prescriptions for adults with commercial insurance increased by a staggering 364 percent from 2019 to 2024, but they were still only prescribed to 4 percent of insured US adults; more than 100 million US adults — 40 percent of the population — are obese, the Wall Street Journal reported earlier this year, and as more insurers cover these drugs for weight loss, more patients will be able to access them.

These drugs’ power comes from their mysterious ability to control people’s compulsions. Patients who take an GLP-1 agonist say that the fatty ultraprocessed foods they used to find irresistible are no longer so tempting, though sometimes those old cravings for unhealthy junk come rushing back after taking the drugs for a while. Substances as habit-forming as coffee no longer hold the same sway. Others notice decreased desires that have nothing to do with their diet — to bite their nails, for example.

We are entering the Ozempic era, and even as excitement grows about the possibilities for these medications, now is the time to take seriously the possible risks from this new class of drugs.

A lot of people experience brand-new cravings, sometimes for healthier foods. “Beans — I get cravings for beans. I never really ate them before, now I crave homemade baked beans in a tomato sauce,” Sarah, a charity development worker from Scotland who has been taking a GLP-1 compound for a few months, told me by email. “It used to bother me if a cafe served beans on a cooked breakfast; now beans is the main part of my breakfast.”

Swapping salad greens for carbs sound like a clear win — in fact, it sounds almost too good to be true. In the long term, what does it mean to modulate our desire? Are we sure we can suppress the harmful compulsion to eat too much without compromising the productive ones — such as the desire to succeed or the pleasure we find in personal relationships? How might these drugs impact our experience of joy and pain? What might that do to impact the messy human experience of…simply living?

“What are the very long-term effects of these drugs? The literature will say, ‘Well, there isn’t really bad long-term effects because some people have been taking it for diabetes for 10 years, and they don’t have bad effects,’” Kent Berridge, a professor of psychology and neuroscience at the University of Michigan, told me. “And I think that’s a fair argument. But then 10 years is not 20 years or 30 years.”

We are entering the Ozempic era, and even as excitement grows about the possibilities for these medications, now is the time to take seriously the possible risks from this new class of drugs. In my conversations with some of the........

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