Ozempic and Wegovy May Reduce the Risk of Problem Drinking

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The popular GLP-1 drugs Ozempic and Wegovy may reduce cravings for more than just food. A new study suggests these medicines might also play a role in curbing the desire to drink alcohol.For the study, researchers followed people with obesity for one year after they began taking semaglutide — the active ingredient in Ozempic and Wegovy — or other weight loss medicines that weren’t GLP-1 drugs. At the start of the study, 83,825 participants had no history of alcohol use disorder, while 4,254 participants had been previously diagnosed with this condition.Very few people without a history of alcohol use disorder got diagnosed with this condition by the end of the study — just 0.37 percent of participants on semaglutide and 0.73 percent of people taking other weight loss drugs, according to study results published in Nature Communications. But this translated into a 50 percent lower likelihood of alcohol use disorder for the semaglutide group.[1]Among participants with a history of alcohol use disorder, relapsing was less common with semaglutide, occurring for 22.6 percent of participants on this drug compared with 43.0 percent of people taking other weight loss medicines. This translated into a 56 percent lower risk of relapse with semaglutide.Interestingly, the effects of semaglutide on drinking were stronger than two older anti-addiction drugs that are also used for weight loss: naltrexone and topiramate. Study participants without a history of alcohol use disorder were 56 percent less likely to develop the condition with semaglutide than with naltrexone or topiramate. And, people with a history of alcohol use disorder were 75 percent less likely to relapse with semaglutide.How Semaglutide May Decrease Drinking“Semaglutide may prevent alcohol from being rewarding, and thereby cause a reduction in alcohol drinking,” says Elisabet Jerlhag, a professor of pharmacology at the University of Gothenburg in Sweden who wasn’t involved in the new study.Semaglutide is in a family of medicines known as GLP-1 receptor agonists, which interrupt signals in the brain that control our desire for rewards, helping to reduce food cravings. This same brain circuitry can fuel addiction to alcohol and other drugs, and may also be impacted by semaglutide, says W. Kyle Simmons, PhD, a professor of pharmacology and physiology at the Oklahoma State University Center for Health Sciences in Tulsa, who wasn’t involved in the new study.“It makes sense that a medication that reduces the motivation to eat might also reduce the motivation to drink alcohol,” Dr. Simmons says. This might also explain why the study found semaglutide better at reducing the risk of alcohol use disorder than naltrexone or topiramate, Simmons adds.Semaglutide May Target Both Food and Alcohol CravingsSome preliminary research in animals has found that delivering GLP-1 drugs directly to the brain region involved in rewards reduces alcohol consumption, says Alexandra DiFeliceantonio, PhD, an assistant professor at the Fralin Biomedical Research Institute at Virginia Tech University in Roanoke, who wasn’t involved in the new study.In addition, drugs like semaglutide may curb drinking because they alter digestion, Dr. DiFeliceantonio says. “Alcohol is an ingested drug whose metabolism and effects are altered when digestion is altered,” DiFeliceantonio says. “Think of how you feel drinking on an empty stomach versus after a full meal.”But the study wasn’t a controlled experiment designed to prove whether or how semaglutide might directly prevent alcohol misuse.A lot more research is still needed before it makes sense to consider giving semaglutide to people without obesity or diabetes who are looking to manage problem drinking, says the senior study author Rong Xu, PhD, a professor and the director of the Center for AI in Drug Discovery at Case Western Reserve University in Cleveland.“Our study provides evidence that semaglutide may be better than other medications in managing diabetes or obesity while mitigating alcohol use,” Dr. Xu says. “We could not yet recommend prescribing semaglutide to treat alcohol use.”

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