Weight-loss and diabetes drug Wegovy (semaglutide) may also help heavy drinkers cut down on their alcohol intake, a randomised controlled trial has found.
A US study in 48 people with alcohol use disorder found that the weekly GLP-1 receptor agonist medication led to reduced alcohol craving, drinking quantity and the frequency of heavy drinking days, compared with placebo.
The findings back what some users of GLP-1 weight-loss drugs like Wegovy – also marketed as Ozempic – had reported anecdotally, that a side effect of treatment was a loss of desire to drink alcohol.
Other studies have suggested the treatment may be beneficial in alcohol-use disorder but this is the first randomised controlled trial to test the theory.
Those taking part in the study met the criteria for alcohol-use disorder – defined as the inability to stop or control their drinking despite negative consequences – but were not actively seeking treatment.
In the past month, they had more than seven (for women) or more than 14 (for men) standard drinks in a week as well as two or more heavy drinking episodes (four or more drinks for women and five or more for men).
A week before the first injection, they were invited to drink their preferred alcoholic beverages over a two-hour period in a comfortable, lab setting, with instructions to delay drinking if they wished.
This was followed by weekly, low-dose injections of Ozempic or a placebo for nine weeks, during which time their weekly drinking patterns were also measured. The laboratory drinking test was also repeated at the end.
Researchers measured both grams of alcohol consumed and breath alcohol concentration and found that semaglutide injections reduced weekly alcohol craving, reduced average drinks on drinking days, and led to greater reductions in heavy drinking days, compared to placebo.
And the magnitude of effect was greater than often seen with existing medications used to reduce alcohol craving, the researchers reported in JAMA Psychiatry.
In the last month of treatment, those in the semaglutide group had significantly reduced their number of heavy drinking days.
Almost 40% of people in the semaglutide group reported no heavy drinking days in the last month of treatment, compared to 20% in the placebo group.
There was no difference in the number of days people drank.
Researcher Dr Klara Klein, assistant professor of medicine at the University of North Carolina, said: ‘These data suggest the potential of semaglutide and similar drugs to fill an unmet need for the treatment of alcohol-use disorder.
‘Larger and longer studies in broader populations are needed to fully understand the safety and efficacy in people with alcohol use disorder, but these initial findings are promising.’
Professor Matt Field, professor of psychology at the University of Sheffield, said the study overcame some of the issues with previous observational research suggesting that semaglutide may reduce alcohol consumption.
He added that while small with a short follow up the results were important: ‘Although the semaglutide and placebo groups did not differ in how often they drank alcohol during the study period (outside the lab), on days when they did drink alcohol the semaglutide group drank less alcohol than the placebo group.’
It demonstrates for the first time ‘a causal effect of semaglutide on the amount of alcohol that people drink’.
‘This study will hopefully serve as a springboard for further research.
‘Furthermore, the nature of the semaglutide effect (reducing the amount of alcohol consumed, whilst having no effect on the number of days that people drank alcohol) is consistent with the idea that semaglutide reduces the reward or pleasure that people get from drinking alcohol, which is why they drink less.’
Dr Stephen Burgess, group leader at the MRC Biostatistics Unit at the University of Cambridge, said: ‘This is a small study, but an exciting one. It provides evidence that semaglutide treatment can reduce alcohol consumption, similar to how it has been shown to reduce food consumption and consequently body weight. The likely mechanistic pathway is by dampening brain cues that prompt an individual to crave both food and alcohol.’
He added that the limitations of the study did include ‘the small sample size and limited length of follow-up’.
‘A key difference between weight loss and alcohol use is that the aim of weight-loss treatment is to lose weight and then maintain a healthy weight. Individuals will continue to eat food during and after treatment, and they will maintain a healthy weight if they maintain a calorie balance post treatment. Whereas the aim with alcohol use disorder treatment is to reduce alcohol consumption, in many cases to zero, and then to maintain low or zero consumption.
‘It is currently unclear whether individuals who discontinue treatment will maintain healthy alcohol status post treatment. Investigating this question will require larger and longer studies. However, this study serves as an initial indication that semaglutide and similar weight loss drugs may be beneficial for treating alcohol-use disorder, at least in the short term.’
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