Could GLP-1s Help People Drink Less?

Taking anti-obesity medications such as Wegovy or Zepbound might help people cut back on their alcohol consumption, new research has found.

The study, published in JAMA Network Open on November 26, raises new questions about the potential benefits of these drugs beyond just weight loss.

This is especially true for glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which are primarily used to treat obesity and type 2 diabetes. Semaglutide, the active ingredient in Wegovy and Ozempic, has already been linked to improvements in kidney health, a lower risk of colorectal cancer and dementia, and other benefits.

It’s probably too soon to add substance use treatment to that list of benefits, said study author Lisa Miller-Matero, PhD, associate scientist in the Center for Health Policy and Health Services Research at Henry Ford Health.

“But I do think this work is promising and suggests that medications to treat obesity could possibly also have an impact on reducing substance use,” Miller-Matero told Health. “These findings warrant further research into the use of anti-obesity medications, including GLP-1 RAs, for reducing alcohol use.”

Here, experts explain why these medications could help people cut back on drinking and how they might contribute to the addiction medicine landscape in the future.

For years, scientists posited that GLP-1 RAs might be able to help people reduce alcohol consumption. More recently, there have been cases documenting the phenomenon—a 2023 study from Oklahoma State University researchers found six patients with alcohol use disorder (AUD) saw improvements in symptoms after taking semaglutide. And there have been plenty of other anecdotal reports as drugs such as Ozempic become more popular in the U.S.

Miller-Matero and her team conducted this latest study to add more context to the conversation.

“We partnered with colleagues at WeightWatchers [WW International] on this project after they began receiving reports from their members [taking anti-obesity drugs] that they noticed a reduced desire for alcohol,” Miller-Matero said. “Though there has been some research conducted in animal studies, research in humans has been lacking, especially examining changes in alcohol use.”

The researchers analyzed data from over 14,053 WeightWatchers members, all of whom were taking an anti-obesity medication. Over 86% were prescribed either tirzepatide or semaglutide, but the rest were taking other anti-obesity medications, including metformin, bupropion, and naltrexone, or first-generation GLP-1 RAs (liraglutide or dulaglutide).

The team surveyed participants on their weekly alcohol intake before starting the medication and then again when they got their prescription refilled.

Miller-Matero and her colleagues found that, of the participants who reported drinking alcohol at baseline, about 45% reduced their weekly consumption.

“This was found in all classes of anti-obesity medications, [and] this reduction was most pronounced in those who drank more and those with higher classes of obesity,” Leslie Heinberg, PhD, vice chair for psychology and director of behavioral services for the Bariatric and Metabolic Institute at the Cleveland Clinic, told Health.

The majority of people taking these anti-obesity drugs reported no change in the amount of weekly drinks they had, while just 2.3% reported drinking more after starting their medication.

Addiction medicine specialists said the new study will help experts learn more about the potential benefits of anti-obesity medications, but investigations are just beginning.

“GLP-1s are very intriguing drugs for our field,” Timothy Brennan, MD, MPH, chief of clinical services at the Addiction Institute of Mount Sinai, told Health. “Studies in rodents and non-human primates have demonstrated that GLP-1s cause a reduction in alcohol and drug use, but we still don’t know whether this can be definitively proven in humans…To be clear, though, these are very exciting times in our field.”

Experts aren’t completely sure why GLP-1 drugs seem to help people decrease their drinking habits. However, there are a few theories.

Some experts believe that the answer lies in how GLP-1 drugs affect the brain, explained Harith Rajagopalan, MD, PhD, a cardiologist, obesity researcher, and CEO of therapeutics company Fractyl Health. Ozempic and other weight loss drugs seem to be able to help quiet “food noise,” and similarly, they could reduce cravings for addictive substances such as alcohol.

However, the actual mechanism isn’t understood yet.

“People do not know if this decline in alcohol use is because people make lifestyle changes when they enroll in such weight loss programs, or if it’s the GLP-1 drug itself that is having effects on the brain’s sense of reward that may be driving both weight loss and reduced alcohol use,” Rajagopalan told Health.

Another potential explanation is that, for some people, anti-obesity medications could change their tolerance for alcohol.

“There isn’t something specific about this class of drug that reduces tolerance,” Heinberg said. “But as people lose weight—independent of obesity intervention—they will have a lower tolerance.”

Though people may experience changes to their drinking habits after starting a GLP-1 medication, experts don’t recommend using it as a treatment for addiction or to expressly curb the amount of alcohol you consume.

“It is still too early to know,” said Brennan. Even though there is some kind of relationship, “we don’t yet know exactly how these drugs affect drinking,” he said.

If you’re taking Ozempic, Wegovy, or a similar drug, you don’t necessarily need to stop drinking alcohol. However, experts agreed starting a new medication could be a good time to re-evaluate your drinking habits, especially since scaling back will likely be beneficial for your health.

“Although there isn’t a specific contra-indication, alcohol use isn’t recommended on these medications,” Heinberg said. “It could make side effects [such as] nausea and low blood sugar more pronounced, and because it is calorically dense, it could reduce the benefit of the medication on weight loss.”