生物与医学2025academic.oup.com
GLP-1 疗法：其在酒精与物质使用障碍中的新兴作用
GLP-1 therapeutics: Their emerging role in alcohol and substance use disorders
进阶 · 约 35 分钟读完前置知识：GLP-1 受体激动剂基础、成瘾神经生物学、临床试验证据解读
导读
这篇综述探讨了 GLP-1 类药物（如司美格鲁肽、替尔泊肽）在酒精及物质使用障碍中的潜在治疗作用。文章梳理了相关证据，表明这类减重药物可能同时抑制对酒精、成瘾性物质的渴求，但其疗效和机制仍需更多研究确认。
HN 关注点：GLP-1 药物是否真能减少酒瘾等成瘾行为，评论区大量个人用药经历与临床证据形成对照，讨论焦点是效果的真实性与个体差异。
HN 评论精选
这几条评论里：质疑 1 补充 1 亲历 2
亲历亲历：GLP-1 药物意外消除了他的游戏成瘾冲动，停药后效果仍持续
关于 GLP 药物与各类成瘾障碍的讨论已经很多：酒精、毒品甚至赌博。就我个人经历，我曾在游戏上有些'失控'，会翘掉会议去打在线游戏，虽没成大问题但自己知道且感到难堪。开始用替尔泊肽、后来用 retatrutide 后，会议间隙想开电脑打游戏的冲动几乎归零。回头看，我多少算是'游戏成瘾'了。这肯定是药物的意外副作用（或收益），当然还有明显的减重效果。与很多人不同，我在减量停药后也没有暴食或重新沉迷游戏的冲动，保持了健康活跃的生活方式和理想体重。我知道这听起来像托儿，但我认为这些药物确实有可能彻底改变很多人的生活。
hbosch查看英文原文
Much has been said about the GLP drugs and their interactions with all kinds of addictive disorders. Alcohol, drugs, even gambling... Anecdotally, I "struggled" at times with gaming (not joking). I would find myself skipping meetings at times or ducking away to play online sometimes. It never became a real issue but I knew I did it and it was embarrassing. Once I started on tirzepatide, and then with retatrutide, the "urge" to swap over to my PC between meetings and load up a game is pretty much zeroed out. Is this an "addiction" or a form of "abuse" similar to alcohol or other drugs? I would have said no some time ago, but now I'm not sure. I definitely feel like, looking back, I was more or less "addicted" to video games. I don't want to romanticize it as some sort of "escape", it just is what it was. This was an unintended side effect (benefit?) of the drug for sure, in addition to acute weight loss of course. Unlike many others, even after titrating down and coming off the GLP's, I have not felt the urge to binge food, video games, or anything else. I maintain a healthy, active lifestyle and have kept my weight exactly where I prefer it. My relationship with my body and my time has massively improved. I feel like I am at risk of sounding like a complete shill, obviously, but in my mind these drugs can be something that absolutely has the potential to turn life around for many, many people.
质疑反例：用药数月饮酒量未减，说明效果因人而异
作为一个爱喝酒的人，服用 Zepbound 12.5mg 已数月，我的酒精摄入量并没有明显减少。
sghiassy查看英文原文
As an alcohol enthusiast on 12.5mg of Zepbound for the last several months, my ethanol consumption hasn’t diminished much
亲历亲历：司美格鲁肽让他自然失去对酒精的兴趣，两年未复发
只是一个数据点：开始用司美格鲁肽约 8 个月后，我戒酒一个月，到月底时对酒精完全失去了兴趣。至今快两年了，我不刻意坚持，偶尔在庆祝时喝一杯气泡酒，天热时喝瓶啤酒（有无醇的就选无醇）。效果很有意思。
jnsaff2查看英文原文
Just a single datapoint here. About 8 months after starting on semaglutide I took a month off alcohol and by the time the month was over had lost all interest for alcohol. Almost 2 years now. I'm not religious about it and will occasionally drink the celebratory glass of bubbles or a beer (alcohol free if available) when it's hot outside. Very interesting how it has worked.
补充质疑：英国处方门槛高，好奇美国用户如何获得药物
有意思的是 HN 评论区这么多人在用这类药——在英国，BMI 不够高是拿不到处方的。是美国更容易开药，还是大家直接在网上买原料？
crimsoneer查看英文原文
It's interesting how many people in the HN comments are on this stuff - here in the UK you can't get it unless your BMI is pretty high. Is it easier to get prescribed in the US or are people just buying the chemicals online?
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- 2025Hacker News 讨论帖254 分 · 198 评
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