ALCOHOL use disorder (AUD) is a significant global health challenge, influenced by complex neurobiological and psychosocial factors, which impair the brain’s reward system, leading to compulsive alcohol consumption. The high relapse rate associated with current treatments, such as disulfiram, naltrexone, and acamprosate, remains a significant hurdle in managing AUD effectively. Recent preclinical studies have suggested that glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as liraglutide and semaglutide, may offer a promising avenue to reduce alcohol intake by modulating the mesolimbic dopamine pathway. A recent study aimed to assess the real-world impact of GLP-1 RAs on alcohol consumption among patients treated for obesity, providing insight into their potential role in addressing co-occurring obesity and AUD.
The study was conducted as part of routine clinical care, with data collected prospectively from January 2023 to March 2024. A total of 262 adult patients with a BMI of 27 kg/m2 or higher, who began treatment with liraglutide or semaglutide, were included. Patients were categorised as non-drinkers, rare drinkers, or regular drinkers, with alcohol intake quantified for those who could report it. The primary outcome was the change in alcohol intake, while the secondary outcome assessed weight changes.
The results showed a significant reduction in alcohol intake among patients treated with GLP-1 RAs. Of the 179 regular drinkers at baseline, alcohol consumption decreased from a mean of 11.8 units/week to 4.3 units/week post-intervention (p<0.001). High consumers reduced their intake by 68%, from 23.2 units/week to 7.8 units/week, while low consumers reduced their intake from 5.5 to 2.5 units/week (p<0.001). Weight loss was also observed, with a mean reduction of 7.7 kg over approximately 4 months. The correlation between alcohol reduction and weight loss was weak but positive (r=0.24), suggesting that alcohol reduction may partially contribute to weight loss due to the high caloric content of alcohol.
In conclusion, GLP-1 RAs demonstrated a significant reduction in alcohol intake and were associated with weight loss in patients treated for obesity. These findings suggest that GLP-1 RAs could serve as a dual-purpose therapeutic option for managing obesity and alcohol use disorder. However, the study’s limitations, such as the small sample size and lack of a control group, restrict the ability to draw definitive conclusions. Future randomised controlled trials with larger, more diverse populations are needed to validate these findings.
Reference
O’ Farrell et al. Glucagon-like peptide-1 analogues reduce alcohol intake. Diabetes Obes Metab. 2025;27(3):1601-4
