Ozempic New Uses: Alzheimer's, Addiction, Liver and Kidneys

Short answer: semaglutide, the drug in Ozempic, has proven benefits beyond blood sugar in only some of the areas where it was tested. For adults with type 2 diabetes, it lowers the risk of heart attack, stroke and cardiovascular death, and since January 2025 it has had an FDA-approved kidney indication based on the FLOW trial. In fatty liver disease with scarring (MASH), the higher-dose semaglutide brand Wegovy received accelerated FDA approval in 2025. Alzheimer's disease was the biggest hope, and it failed: two large phase 3 trials reported in November 2025 found no slowing of the disease. For alcohol use disorder, the first randomized trials show less heavy drinking, but they are small and the drug is not approved for it. Depression, other addictions, cancer and aging remain early-stage research.

Below is what scientists expected when Ozempic's popularity exploded in 2023, and what the evidence shows as of October 2026.

Proven or still being studied: the 2026 scorecard

Ozempic itself is FDA-approved only for adults with type 2 diabetes, with heart and kidney outcome claims for that population. Everything else below is either a benefit shown in people with diabetes or an open research question.

Area	Key trial	Result	Status, October 2026
Heart (type 2 diabetes)	SUSTAIN-6, 3,297 people	Heart attack, stroke or CV death 6.6% vs 8.9% on placebo (26% lower)	Proven; on the Ozempic label
Kidneys (type 2 diabetes with CKD)	FLOW, 3,533 people	24% lower risk of major kidney outcomes and CV death	Proven; FDA indication January 2025
Leg artery disease (type 2 diabetes)	STRIDE, 792 people	Maximum walking distance 13% greater than placebo at 52 weeks	Positive trial; not on the U.S. label we reviewed
Heart (obesity without diabetes)	SELECT, 17,604 people, semaglutide 2.4 mg	Major CV events 6.5% vs 8.0%	Proven for Wegovy, not Ozempic
Liver (MASH with moderate to advanced fibrosis)	ESSENCE, semaglutide 2.4 mg	MASH resolved without worse scarring in 62.9% vs 34.3%	Wegovy accelerated approval 2025; Ozempic not approved for liver disease
Alzheimer's disease	evoke and evoke+, 3,808 people	No slowing of disease progression	Failed; extension stopped
Alcohol use disorder	JAMA Psychiatry 2025 (48 people); Lancet 2026 (108 people)	Less heavy drinking and craving	Under study; not approved
Smoking, other addictions	Secondary analyses, animal studies	Early signals	Under study
Depression, schizophrenia-related weight gain, cancer, aging	Small pilot and early-phase studies	Too little data	Under study

Where the hopes came from

Ozempic was launched as a type 2 diabetes medicine and became famous for something else: weight loss, often off-label, celebrity rumors included. The story of that boom is in Ozempic for weight loss. As millions of people started semaglutide, many reported changes that had nothing obvious to do with food. They said they wanted less alcohol, smoked fewer cigarettes, and felt fewer urges to shop, gamble or bite their nails. Researchers who study addiction took notice, and so did those working on the brain, the liver and the heart.

How semaglutide might act on the brain

Semaglutide mimics GLP-1, a gut hormone that boosts insulin release when blood sugar is high, slows stomach emptying and reduces appetite. GLP-1 receptors also exist in the brain. The leading hypothesis is that drugs like semaglutide damp down the brain's reward signaling, the dopamine-driven system that makes eating, drinking and other pleasurable behaviors feel worth repeating. If that signal is weaker, alcohol or nicotine may simply become less rewarding. That idea is what the addiction trials are testing.

Ozempic and addiction: from patient stories to clinical trials

What researchers said in 2023

Addiction researchers, including clinical psychologist Christian Hendershot, then at the University of North Carolina at Chapel Hill, pointed out that most addiction treatments target one substance, while semaglutide and its relatives might act more broadly across addictive behaviors. Clinicians in addiction medicine described patients on semaglutide for weight loss who reported reduced cravings for alcohol, which matched earlier findings in animals. Studies in rodents with GLP-1 drugs also suggested less drug-seeking behavior with substances such as cocaine.

What the first randomized trials found

• JAMA Psychiatry, 2025 (Hendershot and colleagues). 48 adults with alcohol use disorder who were not seeking treatment received semaglutide (0.25 mg for four weeks, 0.5 mg for four weeks, then 1 mg for one week) or placebo for nine weeks. In a lab session where they could drink freely, the semaglutide group drank less and reached lower breath alcohol levels. Drinks per drinking day and weekly craving fell; the number of drinking days and average daily drinks did not change significantly, but heavy drinking declined more over time than with placebo. Among smokers, cigarettes per day fell more on semaglutide.
• The Lancet, 2026 (Klausen and colleagues, Denmark). 108 treatment-seeking adults with moderate to severe alcohol use disorder and obesity received semaglutide 2.4 mg weekly or placebo for 26 weeks, plus cognitive behavioral therapy. Heavy drinking days fell by 41.1 percentage points with semaglutide versus 26.4 with placebo. Side effects were mostly transient, mild to moderate stomach complaints.
• American Journal of Psychiatry, 2026 (University of Colorado). In an eight-week trial of 50 treatment-seeking adults, oral semaglutide reduced heavy drinking days, alcohol consumed per occasion and daily cravings, and also cannabis use days.

What it means: the signal is consistent, but the trials are small and short. Semaglutide is not FDA-approved for alcohol use disorder, and it does not replace counseling or approved addiction medicines. Day-to-day advice on drinking while taking Ozempic is in Ozempic and alcohol.

Why results may differ

Researchers caution that responses vary between people and that long-term effects are not known. Semaglutide has been on the market only since 2017, and its effects fade when it is stopped, so any benefit for addiction would likely require ongoing treatment, with ongoing side effects and costs. Some addiction specialists already prescribe it off-label to selected patients; that is a clinical judgment, not an approved use.

Kidneys: the strongest new evidence

When Ozempic first became famous, kidneys were barely part of the conversation. They have since produced some of the clearest results. FLOW enrolled 3,533 adults with type 2 diabetes and chronic kidney disease. Adding Ozempic 1 mg weekly to standard care:

• lowered the risk of the main outcome (a sustained 50% drop in kidney function, kidney failure, or death from kidney or cardiovascular causes) by 24%: 18.7% versus 23.2% with placebo;
• lowered major cardiovascular events by 18% and death from any cause by 20%;
• slowed the yearly decline in kidney function.

In January 2025 the FDA approved Ozempic to reduce the risk of kidney function decline, kidney failure and cardiovascular death in adults with type 2 diabetes and chronic kidney disease. It is an approved use only in people who have type 2 diabetes, not a treatment for kidney disease in general. More in Ozempic for type 2 diabetes.

Heart and blood vessels: from worry to proven benefit

Early on there was concern because semaglutide raises resting heart rate slightly, by 2 to 3 beats per minute on average. Outcome trials settled the question for people with diabetes. In SUSTAIN-6, among 3,297 adults with type 2 diabetes at high cardiovascular risk, heart attack, stroke or cardiovascular death occurred in 6.6% on Ozempic versus 8.9% on placebo, about 26% lower. Weight loss and better blood pressure and blood sugar likely contribute.

The largest heart trial, SELECT, enrolled 17,604 adults with cardiovascular disease and overweight or obesity but no diabetes. Semaglutide 2.4 mg (Wegovy's dose) reduced major cardiovascular events to 6.5% from 8.0% on placebo. That result supports Wegovy's cardiovascular indication, not Ozempic's.

A newer area is peripheral artery disease, where narrowed leg arteries cause pain when walking. In STRIDE, 792 adults with type 2 diabetes and this condition received Ozempic 1 mg or placebo for 52 weeks; maximum walking distance on a treadmill improved 13% more with semaglutide. The FDA label we reviewed, revised October 2025, does not include this use.

The liver: from NASH research to an approved treatment

In 2023, researchers were testing whether semaglutide could improve the liver condition then called NASH, alone and in combination with newer liver drugs. The condition has since been renamed metabolic dysfunction-associated steatohepatitis (MASH).

The phase 3 ESSENCE trial, published in 2025, enrolled adults with biopsy-confirmed MASH and moderate or advanced fibrosis (stage 2 or 3). In the first 800 patients analyzed at 72 weeks, on semaglutide 2.4 mg:

• MASH resolved without worsening scarring in 62.9%, versus 34.3% on placebo;
• scarring improved without worsening MASH in 36.8%, versus 22.4%;
• body weight fell 10.5%, versus 2.0%.

Based on these interim results, the FDA granted Wegovy accelerated approval in 2025 for adults with MASH and moderate to advanced fibrosis. The trial continues to a total of 240 weeks to see whether treatment reduces cirrhosis, transplants and deaths. Ozempic is not approved to treat liver disease, and its doses are lower than those studied.

Alzheimer's disease: the biggest hope that did not pan out

What was expected

Semaglutide was tested as a treatment for early Alzheimer's disease in two large phase 3 trials run by Novo Nordisk. The rationale: in animals, GLP-1 drugs reduced brain inflammation and supported the connections between nerve cells involved in memory and learning, and diabetes drugs in general have been studied for their effects on brain metabolism. Novo Nordisk executives said at the time that an answer would come in about two years.

What happened

The answer arrived on November 24, 2025, and it was negative. The evoke and evoke+ trials enrolled 3,808 people aged 55 to 85 with mild cognitive impairment or mild dementia due to Alzheimer's disease and confirmed amyloid in the brain. They took oral semaglutide 14 mg daily or placebo on top of usual care.

• After 104 weeks, semaglutide did not slow progression on the CDR-SB, a scale that measures thinking and everyday functioning.
• Alzheimer's-related biomarkers improved, but that did not translate into slower decline.
• Safety was consistent with earlier semaglutide studies.
• The planned one-year extension was stopped.

Why observational studies looked more promising

Hope had been fueled by large record-based studies. A 2024 analysis of U.S. electronic health records from more than a million people with type 2 diabetes found that semaglutide users were 40% to 70% less likely to receive a first Alzheimer's diagnosis over three years than people on other diabetes drugs, with the biggest difference compared with insulin and the smallest compared with other GLP-1 drugs. Studies like that compare different groups of patients and cannot fully separate the drug's effect from differences between those groups, which is why randomized trials are needed. In people who already had early disease, the randomized trials found no benefit. Whether semaglutide could help prevent Alzheimer's before symptoms appear remains an open question.

Mental health: depression and schizophrenia

Small studies are examining whether semaglutide could help with major depression, partly because of its effects on the brain and partly because obesity and depression often occur together. As of October 2026, semaglutide is not approved anywhere for depression. In schizophrenia, the interest is different: many antipsychotic medicines cause significant weight gain, which raises the risk of heart disease. Researchers are testing whether adding semaglutide helps people on these medicines keep a healthier weight. Mood changes on GLP-1 drugs are discussed in Ozempic side effects; for anxiety symptoms, see anxiety chest tightness.

Cancer and aging: early hypotheses

People with obesity have a higher risk of several cancers, partly because their natural killer (NK) cells, immune cells that destroy abnormal cells, tend to work less well. In a small 2023 study from Ireland, 20 people with obesity who took weekly semaglutide for six months showed improved NK cell function, an effect that appeared independent of how much weight they lost. That is a laboratory finding, not evidence that semaglutide prevents cancer.

Some researchers also suspect GLP-1 drugs may have broader effects on age-related disease, such as lowering chronic inflammation. That idea is at an early stage and has not been tested in outcome trials in people. The Alzheimer's result is a reminder that promising laboratory mechanisms do not always hold up in patients.

What this means if you take Ozempic or are considering it

• Ozempic is for type 2 diabetes. Its heart and kidney benefits are proven in people with type 2 diabetes; see Ozempic for type 2 diabetes.
• Other uses are not approved for Ozempic. It did not help Alzheimer's disease; addiction and mental health uses are under study; the approved liver indication belongs to Wegovy at a higher dose.
• The benefits come with side effects. Nausea, diarrhea, gallstones and, rarely, pancreatitis; see Ozempic side effects.
• Do not self-treat. If you hope semaglutide might help with drinking or another condition, talk with a clinician who can weigh benefits and risks. Unapproved "semaglutide" from online sellers or research-chemical sites is not a safe shortcut; see how to get Ozempic.

How Ozempic compares with tirzepatide on these outcomes is in semaglutide vs tirzepatide. The complete guide starts at Ozempic. This article is general information, not medical advice.