Glucagon-like peptide-1 receptor agonist use and violent crime among US adults

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a class of medications widely prescribed for diabetes and obesity, have exhibited emerging effects on substance use, reward processing, and impulse control. This study examines whether current GLP-1 RA use moderates established behavioral pathways to violent crime from impulsivity and alcohol use. Data come from a 2025 nationally representative US survey (n = 7521; 821 lifetime GLP-1 RA users). Negative binomial regression models with overlap weighting compared current (n = 597) and former (n = 224) users on self-reported violent criminal behavior in the past year. Although impulsivity and alcohol use were strongly associated with violent criminality, these associations were significantly weaker among current GLP-1 RA users (GLP-1 RA × impulsivity incidence rate ratio (IRR) = 0.38, p = 0.002; GLP-1 RA × alcohol use IRR = 0.48, p = 0.023). Robustness checks consistently supported the GLP-1 RA × impulsivity interaction, whereas less consistent support was found for the alcohol interaction. Results suggest that GLP-1 RAs may attenuate widely documented behavioral risk mechanisms like impulsivity linked to aggression, pointing to novel biosocial hypotheses regarding pharmacological influences on violent criminality. Future longitudinal and experimental research should confirm these findings and test causal mechanisms.