The blockbuster drug semaglutide, better known as Ozempic for diabetes and Wegovy for obesity, could also help people cut down on their alcohol intake, according to new research led by a USC investigator.

The findings, published in JAMA Psychiatry, showed that weekly injections of semaglutide — compared with placebo injections — reduced alcohol craving, drinking quantity and the frequency of heavy drinking days in adults with symptoms of alcohol use disorder.

The discovery could help address an important treatment gap: An estimated 178,000 U.S. deaths per year can be attributed to alcohol, which is linked to liver disease, cardiovascular disease and is a known cause of cancer, as noted recently by the U.S. surgeon general. Nearly a third of American adults have met criteria for problem drinking at some point in their lives, yet very few seek or receive treatment.

The study affirms a common observation by many patients and doctors since Ozempic and drugs like it exploded in popularity: People begin weekly injections of semaglutide for obesity or diabetes — and suddenly lose their desire for alcohol.

This is the first randomized, placebo-controlled clinical trial of semaglutide designed to study the phenomenon, said Christian Hendershot, first author of the study and director of clinical research at USC’s Institute for Addiction Science.

The drugs currently approved to treat alcohol use disorder aren’t widely used. The popularity of semaglutide and other GLP-1 receptor agonists increases the chances of broad adoption of these treatments for alcohol use disorder, if approved for this indication, said Hendershot, a professor of population and public health sciences at the Keck School of Medicine of USC.

These results justify larger studies of GLP-1 receptor agonists for alcohol use disorder, Hendershot added.

The experiment

For the trial, researchers recruited 48 adults with alcohol use disorder who weren’t actively seeking treatment. Alcohol use disorder is defined by a range of possible symptoms, including the inability to stop or control one’s drinking despite negative consequences.

Participants had a past-month drinking history of more than seven (for women) or more than 14 (for men) standard drinks in a week as well as two or more heavy drinking episodes (four or more drinks for women and five or more for men).

One week prior to the first injection, researchers invited participants to drink their preferred alcoholic beverage over a two-hour period in a comfortable, lab setting, with instructions to delay drinking if they wished. Researchers documented the amount of alcohol consumed.

Participants were then randomly assigned to receive weekly, low-dose injections of Ozempic or a placebo for nine weeks, during which time their weekly drinking patterns were also measured. Afterward, participants and researchers returned to the drinking lab to repeat the process and see what changed.

What changed?

Results, measured by grams of alcohol consumed and breath alcohol concentration, indicated that semaglutide injections reduced weekly alcohol craving, reduced average drinks on drinking days and led to greater reductions in heavy drinking days, relative to the placebo. A key finding was that the magnitude of semaglutide’s effects on several drinking outcomes appeared greater than is often seen with existing medications to reduce alcohol cravings, even though semaglutide was only administered at the lowest clinical doses.

Medication effects also appeared stronger with increasing doses. By the second month of treatment, those in the semaglutide group had reduced the quantify of alcohol consumed on drinking days by an average of nearly 30%, compared to an average reduction of about 2% in the placebo group. Also, nearly 40% of people in the semaglutide group reported no heavy drinking days in the second month of treatment, compared to 20% in the placebo group.

Among a small subgroup of participants who smoked cigarettes at baseline, those treated with semaglutide had significantly greater reductions in average cigarettes per day compared to those in the placebo group, suggesting that semaglutide might reduce both alcohol and nicotine use.

“These data suggest the potential of semaglutide and similar drugs to fill an unmet need for the treatment of alcohol use disorder,” said senior author Klara Klein of the University of North Carolina School of Medicine. “Larger and longer studies in broader populations are needed to fully understand the safety and efficacy in people with alcohol use disorder, but these initial findings are promising.”

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About this study: In addition to Hendershot and Klein, other authors of the study are Michael Bremmer, Michael Paladino, Georgios Kostantinis, Thomas Gilmore, Neil Sullivan, Amanda Tow and Robyn Jordan, all of University of North Carolina at Chapel Hill; Sarah S. Dermody of Toronto Metropolitan University; Mark Prince of Keck School of Medicine; Sherry A. McKee of Yale University School of Medicine; Paul J. Fletcher of University of Toronto; and Eric D. Claus of  The Pennsylvania State University.

This research was supported by National Institute on Alcohol Abuse and Alcoholism grant R21AA026931.

An artificial right heart atrium that could save the lives of children with a rare disease. An AI-powered method to prevent blindness from glaucoma. These are early-stage innovations that were awarded the NEMO Prize through USC’s Office of Health Affairs.

Launched in 2023 through a gift from Shelly and Ofer Nemirovsky, the annual NEMO Prize competition supports collaborations between researchers at the USC Viterbi School of Engineering and the university’s constellation of health sciences schools. In particular, this prize focuses on projects that do not yet qualify for support by federal agencies and are not yet mature enough for private investment.

“A lot of things get funded by the National Institutes of Health when they already know it’s going to work,” said Shelly Nemirovsky, a USC trustee and 1985 graduate of the university. “But I think if you get in at the early stages of research and you gain some traction, you can really move the needle.”

“I love the technology that we’ve seen,” added Ofer Nemirovsky, who has a business and engineering degree from the University of Pennsylvania, where he started the original NEMO Prize. “These proposals represent solutions for both ailments that affect a very specific number of people and broader conditions that affect many more people.”

Each prize-winning partnership exemplifies a multidisciplinary effort to tackle a complex medical issue with creative thinking and execution from experts in the engineering, science, medical and computer science fields.

To help prevent blindness, the ATLAS (AI + Teleophthalmology in Los Angeles) Initiative collaborators Benjamin Xu, chief of the glaucoma division and associate professor of clinical ophthalmology at the USC Roski Eye Institute; Carl Kesselman, director of the informatics systems research division at the USC Information Sciences Institute; and Jose-Luis Ambite, an associate research professor of computer science at USC Viterbi, partnered with Lauren Daskivich, director of ophthalmic services and eye health programs for the L.A. County Department of Health Services, to use artificial intelligence to develop a more efficient system to detect glaucoma.

To tackle a rare, life-threatening heart defect, Aerospace and Mechanical Engineering Assistant Professor Niema Pahlevan of USC Viterbi; Andrew Cheng, an associate professor of clinical pediatrics at the Keck School of Medicine of USC; and cardiac surgeon Cynthia Herrington, the Ryan Winston Family Chair in Transplant Cardiology at Children’s Hospital Los Angeles, teamed up to design an innovative device that could give young patients their best chances at survival.

Using artificial intelligence to diagnose glaucoma

When researchers Kesselman, Xu, Ambite and Daskivich joined forces for the ATLAS project, they first had to learn how to speak the same language. “With multidisciplinary collaboration, it’s not about sticking a bunch of people in the room,” said Kesselman, a William M. Keck Professor of Engineering at USC Viterbi. “It’s about learning culture. It’s about learning the way a computer scientist looks at this problem and the way an engineer looks at this problem and coming to a level of understanding.”

With the NEMO Prize and other support and funding from USC, the ATLAS project is combining disparate disciplines for the shared goal of an innovative solution to diagnosing and treating a common ailment.

Glaucoma is the leading cause of irreversible blindness worldwide — it’s also one of the major drivers of preventable blindness, Xu said.  Unfortunately, glaucoma detection usually requires specialized equipment and the expertise of a trained ophthalmologist or optometrist — and they’re in limited and decreasing supply. An aging population and an increase in the prevalence of glaucoma has also led to a growing demand for better methods of detection, especially in underserved populations. As a result, the team says more than half of glaucoma cases in the United States go undetected and untreated.

An innovative solution for a common problem

Ophthalmologists can use a fundus camera to examine the back of the eye when screening for eye diseases such as glaucoma. Because fundus photography of the retina is considered the standard of care for diabetes patients, the ATLAS team leveraged the large volume of eye images from Daskivich’s L.A. County diabetic retinopathy screening program. With the addition of eye images from the USC Roski Eye Institute, the ATLAS team had access to a robust dataset to address the central question of their project: How do you harness artificial intelligence to identify the growing number of people who are likely to have glaucoma and connect them with a limited number of specialists for diagnosis and treatment?

“There’s a high degree of variability in glaucoma screenings, and you need considerable skill to do this,” said Daskivich, who emphasized the limited number of ophthalmologists available to patients. “So, the question became: Can you actually create AI algorithms that will look at these pictures and make a recommendation as to whether somebody should come in and get looked at in more detail?”

The way forward came in 2022, in the form of a collaboration that leveraged Xu’s clinical knowledge of glaucoma, Ambite’s expertise in leading-edge AI technology, Daskivich’s expertise in healthcare implementation and Kesselman’s computing platform that allows the team to organize its huge dataset.

“This is a real team effort in that each member of the ATLAS Initiative brings a different domain of expertise,” Xu said. “It required getting many people in the same room who don’t normally talk to each other. This is a huge barrier to implementation science that we’ve been able to overcome with this multidisciplinary group.”

With support from the NEMO Prize and future funding, the team hopes to evaluate algorithm effectiveness and equity; demonstrate the feasibility of integrating AI algorithms into existing screening workflows; and develop multimodal AI algorithms that can detect glaucoma while accounting for multiple factors such as age, race and family history.

A rare opportunity to save young lives

Pahlevan and Cheng met each other earlier in their careers at Caltech in Pasadena. A joint research project directed their attention to young patients who had received the Fontan procedure, a palliative surgery for hypoplastic left heart syndrome, a rare and life-threatening congenital defect where the left side of the heart is underdeveloped. With this surgery, young patients can function with only one ventricle of the heart, instead of two. Unfortunately, that single-ventricle circulation eventually fails, leaving the patient in need of a heart transplant.

A colleague at CHLA connected Pahlevan and Cheng with Herrington, who was seeking a collaboration with engineers and mechanicians to create an artificial right atrium (ARA) to improve mechanical circulatory support for patients with failing Fontan circulation. Nine years into this collaboration, the trio is closer than ever to developing an ARA that could transform the lives of their young patients — with help from the NEMO Prize.

The Fontan surgery was first proposed by surgeons in 1968; by the 1990s, practitioners considered the procedure a routine line of treatment for young patients with single-valve heart defects, giving many children the opportunity to reach adulthood. Due to advancements to the Fontan procedure and improvements in peri- and post-operative care, the team projects that the population of patients with Fontan circulation will double in the next 20 years.

Despite these advances, most Fontan patients will eventually experience myriad health challenges as the circulation begins to fail, including issues with the brain, kidneys, liver, lungs and lymphatic system. Without a heart transplant — a solution where demand far exceeds supply — Fontan patients face a progressively higher risk of heart failure and premature death.

Typically, ventricular assist devices (VADs) are used for heart failure patients, who number roughly 26 million worldwide, allowing them to survive in the hopes of an eventual heart transplant. For the 70,000 people around the world living with the inevitable decline in Fontan circulation, VADs are rarely an option due to their unique heart anatomy — but an ARA could change that.

According to the team, no other group of researchers and engineers has successfully tried to create an ARA. Others have attempted to build a customized VAD from scratch, which Cheng said takes far too much time to be a practical solution. By creating an ARA device that hospitals can use to augment existing VADs, Cheng, Herrington and Pahlevan seek to decrease the time it takes for their product to have real-life implications for their young patients hoping to live long enough to receive a heart transplant.

The team says the NEMO Prize funding will be instrumental in helping them finalize the design of their device and move toward production and testing with conventional VADs.

For Pahlevan, the project represents an opportunity he didn’t think he would experience in his field of study. “It’s rare for engineers to be in the position to make a real contribution to patient well-being,” he said. “For me, that was very important.”

For Cheng, this project is impactful on two fronts. As an electrical engineering major who decided to go to medical school, he has always wanted the opportunity to solve a medical problem with an engineering lens. “From another perspective, these families are patients that I take care of all the time,” said Cheng, who is the director of CHLA’s Fontan clinic. “To be able to offer something tangible to them that will greatly increase the likelihood of a good outcome is really important to me.”

“Winning the NEMO Prize makes all the difference in the world at a very pivotal point in this device’s creation,” Herrington said. “My colleagues in the transplant world are excited that this thing could be hitting the shelf sometime in their career and lifetime. I can’t thank the team from NEMO enough.”

For the Nemirovskys, their support for collaborations like ARA and ATLAS is endlessly rewarding.

“I am so excited to see what next year’s slate holds, because I feel like since the first prize launched, and the word has gotten out there, we’ve received more applicants, more stories, more everything,” Shelly Nemirovsky said. “The potential is limitless.”

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The Request for Applications for this year’s NEMO Prize will be released in March.

Jennifer* had obesity, diabetes, severe acne and excess facial hair — the result of a hormonal disorder called polycystic ovary syndrome, or PCOS. PCOS is linked to infertility and a host of other issues.

Her doctor, Katie Page, an endocrinologist and associate professor of medicine at the Keck School of Medicine of USC, knew that typical treatment — insulin, daily exercise and dietary changes — offered modest improvement, at best. For Jennifer, Page wanted to try something else: the anti-diabetes drug Ozempic.

In just six months, Jennifer lost 70 pounds. Her diabetes went into remission, and problems with acne and excess facial hair disappeared.

“Patients love it because it’s only administered once a week and the effects are just amazing,” Page says. “It has been so great just to have something that works.”

Thanks to its use by celebrities and its ability to cause rapid weight loss, Ozempic and similar drugs like Wegovy, Zepbound and Mounjaro are a pop culture phenomenon — the subject of tabloid speculation, podcasts and late-night TV jokes.

But behind the hype is a medication that could catalyze profound changes in public health. With 75% of Americans now classified as overweight or obese, according to a recent study in The Lancet, obesity is one of the biggest health challenges facing the country.

“These medications not only benefit patients in terms of the weight loss itself but also clearly improve metabolic function and either ameliorate or even eliminate diabetes,” says Pinchas Cohen, dean of the USC Leonard Davis School of Gerontology. “We are now in a completely new era of managing these conditions.”

The economic toll of obesity

By lowering the nation’s staggering obesity burden — as well as rates of associated illness that increase disability and reduce the quality of life — anti-obesity drugs have the potential to reduce future health care spending significantly.

“Obesity is a complicated issue, and one that we, as a society, need to address,” says Anne Peters, a professor of medicine at the Keck School of Medicine and one of the world’s leading diabetes expert and advocates for new care guidelines for the disease. “It can lead to many illnesses in addition to diabetes, such as increases in cancer and heart disease, sleep apnea, joint disease, back pain and huge numbers of other problems. Our bodies aren’t meant to carry that much weight.”

A USC Schaeffer Center for Health Policy & Economics white paper that chief scientific officer Darius Lakdawalla and colleagues contributed to estimates that Medicare coverage for new obesity treatments could save $175 billion in health care costs in the first 10 years alone. A Goldman Sachs forecast predicts widespread use of the drugs in the United States could boost gross domestic product by 1% as lower obesity-related complications increase workplace efficiency.

“Obesity is a leading risk factor for mortality in the U.S.,” Lakdawalla says. “Our modeling shows that new treatments generate substantial benefits to Medicare and its beneficiaries. Developing strategies for unlocking that value should be a priority for policymakers.”

Experience for patients

Semaglutide, the active ingredient in Ozempic and Wegovy, mimics a hormone, GLP-1, released in the gastrointestinal tract in response to eating. Tirzepatide, the active ingredient in Zepbound and Mounjaro, also mimics GLP-1 plus another gut hormone known as GIP. They help lower blood sugar by helping the pancreas make more insulin. Patients say the drugs reduce cravings and quiet the brain’s constant “chatter” about food and eating.

Peters says she initially starts patients off with a low dose of weight-loss drugs before increasing slowly because patients tend to experience gastrointestinal side effects early on, such as nausea, diarrhea, vomiting and constipation.

Weight loss is slow, she says, but patients start feeling full long before they’ve actually lost a lot of weight. Peters advises them to not only eat less but also healthier, with high-quality protein to avoid a loss of muscle mass. She gave an example of a patient who, despite loss of appetite and eating significantly less, maintained the same weight and blood sugar due to an unchanged, unhealthy diet.

“I work with people on healthy nutrition to go along with the fact that they’re not going to feel like eating as much,” Peters says. “It’s all about watching your body, listening to your response and then talking to your health care provider.”

Broad access to the drugs is essential

Christopher Scannell, a physician and postdoctoral researcher at the USC Schaeffer Center for Health Policy & Economics, says that the intense focus on semaglutide’s anti-obesity effect obscures that the drug is also hugely important for treating diabetes.

“It’s the reason why I’ve been able to get some of my patients off insulin,” Scannell says.

In 2024, Scannell and Dima Qato, an associate professor at the USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences and senior scholar at the USC Schaeffer Center for Health Policy & Economics, published research about potential inequities in access to the drugs.

Their study, which examined prescription data, found that the vast majority of Ozempic and Wegovy prescriptions were going to people with private insurance — and far fewer going to people on Medicaid or Medicare Part D. Obesity disproportionately affects lower-income communities of color.

“If only certain patient populations get access to these medications — those primarily with private insurance, more generous health plans — then a huge percentage of the U.S. population isn’t getting access to these medications,” Scannell says. “That brings up a very significant equity issue.”

Big-picture solutions

 Kayla de la Haye, director of the Institute for Food System Equity at USC Dornsife Center for Economic and Social Research, sees immense promise in Ozempic and other drugs like it. But it’s still important to address underlying problems fueling the obesity epidemic.

“For people living in unhealthy food environments — where unhealthy foods are cheap, convenient and accessible, while healthy options are not — their food environment is stacked against them,” says de la Haye, who studies the impact of low-quality food environments on overall health. “We need strong investment to make our food environments healthier.

“These drugs are expensive, and most people will transition off from them at some point. So, we also need to ramp up our investment in big-picture solutions that make it easier for people to start and sustain healthy eating habits.”

*not her real name