Anti-Obesity Medications Linked to Reduced Alcohol Use: New Insights from Weight Loss Programs, Study Reveals

Anti-obesity medications, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs), are recognized for their effectiveness in promoting weight loss. Moreover, the use of GLP-1 RAs has been linked to a reduced incidence and recurrence of alcohol use disorder. Investigating different AOMs alongside variations in alcohol consumption could provide valuable comparative insights into their broader potential effects.

Against the above background, Lisa R. Miller-Matero, Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, Michigan, and colleagues aimed to evaluate shifts in alcohol consumption among individuals participating in a telehealth weight management program following the start of an AOM.

This cohort study, approved by the Henry Ford Health Institutional Review Board, analyzed deidentified data from participants in the WeightWatchers (WW) Clinic telehealth weight management program. Eligible individuals initiated and refilled an AOM between January 2022 and November 2023. AOMs included metformin, bupropion/naltrexone, and first—and second-generation GLP-1 RAs. Participants completed baseline and refill surveys reporting demographics, BMI, and weekly alcohol use. Those with prior AOM use or bariatric surgery were excluded. Alcohol use changes were analyzed using multivariate logistic regression with covariates.

The following were the key findings of the study:

• The study included 14,053 participants (86.0% female, mean age 43.17 years, mean BMI 35.97).
• Most participants (86.2%) were prescribed second-generation GLP-1 RAs.
• At baseline, 53.3% (7,491) reported consuming alcohol.
• Overall, 24.2% (3,395) reduced their alcohol use after AOM initiation.
• Among baseline drinkers, 45.3% reduced use, 52.4% reported no change and 2.3% increased use.
• Participants with higher obesity levels or heavier drinking habits were more likely to reduce alcohol use.
• Bupropion and naltrexone users initially showed greater reductions in alcohol use compared to metformin, but this effect was not significant after adjusting for weight loss.

This study found that nearly half of participants consuming alcohol at baseline reduced their intake after starting AOMs. This effect may be linked to specific AOM properties, such as naltrexone's ability to curb alcohol cravings and GLP-1 RAs' reduction of alcohol's rewarding effects.

"Unexpectedly, metformin users also reported decreased alcohol use, possibly due to behavioral changes encouraged in the weight management program. Further research, including randomized trials, is needed to explore these findings," the researchers concluded.

Reference:

Miller-Matero LR, Yeh H, Ma L, et al. Alcohol Use and Antiobesity Medication Treatment. JAMA Netw Open. 2024;7(11):e2447644. doi:10.1001/jamanetworkopen.2024.47644