Revisiting food addiction in the era of GLP-1–based obesity pharmacotherapy via neural reward pathways linking feeding and substance use

Obesity rates, once thought to be on an inevitable rise with limited treatment options, have recently stabilized and begun to decline in the US, a trend that coincides with the increased use of GLP-1 receptor agonist medications for weight management. Accumulating evidence indicates that GLP-1 receptor agonists influence feeding behavior through central neural pathways that also regulate compulsive and reward-driven actions. GLP-1 receptor agonists not only reduce appetite but also reshape food preferences, shedding light on the neural mechanisms underlying compulsive consumption and offering potential therapeutic avenues for metabolic and behavioral disorders. As such, GLP-1 receptor agonists have the potential to reinforce the concept of obesity as a treatable medical condition. As these pharmacotherapies reshape household grocery expenditures and inspire new food product lines tailored to users' nutritional needs, they are catalyzing broader economic and social transformations. Furthermore, ongoing innovations in these therapies hold promise for expanded clinical applications and improved health outcomes. This review reconsiders the debated concept of 'food addiction' in light of these pharmacological advances, drawing on neurobiological, societal, and emerging clinical perspectives.