Welcome to The Thin Line, a New York Post series on the dark side of GLP-1 drugs. Although GLP-1 agonists sold under brand names like Ozympic have helped millions of people lose weight, manage diabetes and improve other health conditions, they are not without risks. Check back for more stories about the lesser-known downsides of this wildly popular drug.
Terry Locker Stewart was ready for a change.
“For a very long time, I used food as an activity,” the 29-year-old Texan told The Post. “We don’t have mountains or the ocean here in Dallas, we just love to shop, eat and drink.”
So two years ago, he decided to break the cycle. Like millions of Americans, Luke Stewart switched to GLP-1 weight-loss drugs—and quickly saw himself shedding 60 pounds.
But the thin belt came with a curve ball that he didn’t see. “I’ve always been a very happy drinker, but when I got to Ozimpek, I wasn’t,” he admitted. “I got very emotional.”
Suddenly, the carefree nights he spent drinking with friends at the neighborhood watering hole feel anything but relaxing.
“Doing something that was once fun now makes me anxious and upset,” Luke Stewart said. “I start thinking about everything and my feelings get hurt easily.”
The next morning is even worse.
“Before I wake up at 7 a.m. after drinking and go to the gym and be productive,” Luke Stewart said. “But when I started taking GLP-1, I was down for the count until lunch.”
And that was after just one or two drinks.
For Locker-Stewart, a real estate agent who also owns Bar, Ozympic — and later Terzapatide, the active ingredient in drugs like Monjaro and Zipband — it didn’t just affect his nightlife; It’s also taken a bit from business.
“Overall in Dallas, we’ve seen a 35% drop in alcohol sales across the board, and I think a lot of that has to do with GLP-1s.” “I know I’m not the only one who feels this way when they go out.”
Doctors say he is suffering from something.
“The reality is that GLP-1 agonists change your reward system,” said Dr. James J. Chow, co-founder and chief medical officer of VedaNu Wellness, which works with patients.
“When you drink, that warm, comfortable glow you feel after a few hits may not be there,” he explained. “It can feel awful. It can feel like nothing.”
To understand why, it helps to understand what this blockbuster obesity and diabetes treatment does to the body.
GLP-1s work by mimicking the hormones your gut normally releases after a meal. These hormones help control blood sugar, regulate appetite and quiet appetite – which is why the drug can be so effective for weight loss.
But they don’t just act on the stomach. They also affect the brain.
A key target is a small, pea-sized region known as the habenula, which plays a major role in how we experience reward, motivation and aversion.
“When hibenula is going on, it causes all kinds of problems, including cravings and withdrawal symptoms,” said Dr. Kira Bobinette, MD, a neuroscientist and behavioral therapist. “It really encourages us to use it.”
Drugs like Ozympic seem to dial this system down. When the drugs reach the brain and bind to receptors in the habinula, they reduce the compulsive stress behind behaviors such as overeating – often described by patients as “eating noise”.
This is one reason why GLP-1s are now being studied as potential tools for treating or preventing substance use disorders. Researchers suspect they may curb reward-seeking behavior and reduce cravings for people struggling with alcohol, nicotine and opioids — though we’re still years away from them being covered by insurance.
“Am I sad about it? A little, because I drink a lot, but it’s good for my health.”
Terry Locker-Stewart
But the effects may not be limited to addicts. Even regular drinkers like Luke Stewart may change their relationship with alcohol while taking GLP-1s, experts say.
“When the normal pleasure driven by dopamine is reduced, the emotional effects of alcohol can feel very different – more debilitating, more introspective, or even dysphoric or a sad drunk,” said Dr. Fernando Uval Jr., a dual board-certified plastic surgeon and obesity medicine specialist.
The drug may also explain why Luke Stewart now rates so high in the morning.
“GLP-1 slows down gastric emptying, which changes how alcohol is absorbed,” said Owl. “This can make addiction feel delayed, prolonged, and in some cases, people feel ‘off’ the next day.”
There is also a fundamental but often overlooked factor: people on GLP-1s eat and drink less.
“Alcohol consumed in a relatively dehydrated, fueled state, especially with a low protein intake, can cause severe damage and produce a severe hangover,” Orville said. “That alone could explain the severe symptoms the next day.”
And for most patients, their tolerance naturally decreases with the number on the scale.
“Some people lose significantly more weight than when they start taking GLP-1s, which contributes to lower alcohol tolerance,” Chow noted.
At one point, Locker-Stewart stopped taking weight loss pills for six months, satisfied with the pounds she shed.
His appetite and desire for food returned – but his previous experience with drinking did not.
“I expected the side effects of alcohol to work the same way as food, but it never really went away,” he said. “Am I sad about it? A little, because I drink a lot, but it’s good for my health.”
Experts say there is currently no strong evidence that GLP-1s permanently change how the body processes alcohol or alter users’ brain chemistry over the long term. But Bobinette suspects that the Locker-Stewart brain’s reward system may still be organized.
“The habinula is a part of the nervous system that adapts to your lifestyle,” she said. “It may still receive signals like it was in GLP-1.”
A Novo Nordisk spokesperson noted that there are “many studies” that have discovered a link between GLP-1 use and a reduction in behaviors sometimes associated with addiction.
“GLP-1 receptor agonists affect areas of the brain associated with the control of hunger and satiety and are also home to the brain’s reward system,” the spokesperson said in a statement shared with The Post.
These days, Locker-Stewart takes a maintenance dose of terzapatide once a month to help her lose weight. His low tolerance for alcohol — and the rough mornings that come with it — stuck around.
“It definitely changed something in me,” he said.
Still, Locker-Stewart believes the trade deal is worth it.
“I wouldn’t have lost 60 pounds any other way,” he said. “I’ve been going to the gym my whole life and nothing has given me the results I’ve gotten from GLP-1, and ultimately, this is what I want.”
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