Weight-Loss Drug Semaglutide Linked to Lower Alcohol Intake in New Trial

A weight-loss medicine widely known for its role in obesity treatment has been linked to reduced alcohol consumption in a new clinical trial.

Researchers found that once-weekly semaglutide 2.4mg injections reduced heavy drinking days in people with both alcohol use disorder and obesity. The placebo-controlled trial was published in The Lancet and involved researchers from Denmark and the USA.

What Did the Study Look At?

The study included 108 treatment-seeking patients with alcohol use disorder and obesity, defined as a BMI of 30 or above. Half of the participants received semaglutide, while the other half received a placebo. All participants also received cognitive behavioural therapy to support alcohol reduction.

The main aim was to see whether semaglutide could reduce the number of heavy drinking days over 26 weeks. Heavy drinking was defined as more than 60g of alcohol per day for men and more than 48g per day for women.

What Were the Results?

By the end of the trial, heavy drinking days were reduced by 41% in the semaglutide group, compared with 26% in the placebo group. Semaglutide also performed better than placebo in several other measures, including total alcohol consumed, drinks per drinking day, alcohol craving scores and alcohol-use-disorder assessment scores.

Experts said the results are promising because they go beyond previous observational studies and provide stronger evidence that GLP-1 medicines may help some people reduce alcohol consumption.

Why Might a Weight-Loss Drug Affect Alcohol Intake?

Semaglutide belongs to a group of medicines called GLP-1 receptor agonists. These medicines are best known for helping regulate appetite, fullness and food intake.

Researchers are now exploring whether the same pathways involved in appetite and reward may also influence cravings for alcohol. This does not mean semaglutide is currently an alcohol-dependence treatment, but the findings suggest it may have potential in this area for certain groups of patients.

Are There Any Limitations?

Although the results are encouraging, experts have warned that the study was relatively small and only included people with obesity. This means the findings may not apply to everyone with alcohol use disorder.

Another important point is that all participants received cognitive behavioural therapy alongside the trial treatment. This likely helped both groups reduce drinking, meaning the results show the added effect of semaglutide on top of behavioural support.

There was also no follow-up after the 26-week treatment period, so it is not yet clear whether reductions in alcohol intake would continue after stopping semaglutide.

What About Side Effects?

More side effects were reported in the semaglutide group, but these were mainly mild-to-moderate gastrointestinal symptoms such as nausea, constipation and reflux. These side effects were generally described as temporary.

As with any prescription medicine, semaglutide should only be used after clinical assessment and under the guidance of a qualified healthcare professional.

What Treatments Are Currently Used for Alcohol Use Disorder?

In the UK, treatment for alcohol use disorder may include talking therapies, medical help for withdrawal symptoms and medicines to help prevent relapse. NHS guidance lists acamprosate and naltrexone as medicines that can help reduce alcohol cravings, while disulfiram causes unpleasant effects when alcohol is consumed.

The NHS also advises people to get medical help before stopping or reducing alcohol if they experience withdrawal symptoms. Severe withdrawal symptoms, such as seizures, confusion or hallucinations, require urgent medical attention.

Why This Study Matters

Alcohol dependence remains a major public health concern. Estimates produced by the University of Sheffield suggest there were 608,416 adults with alcohol dependence in England in 2019 to 2020, which was higher than estimates from 2015 to 2016.

A medicine that could reduce alcohol intake in people who also have obesity may offer an important new direction for research. However, larger and longer-term studies are still needed before semaglutide could be considered for routine use in alcohol-use-disorder treatment.

Final Thoughts

This new trial suggests that semaglutide may help reduce heavy drinking in people living with both obesity and alcohol use disorder. The results are promising, but they do not mean semaglutide should be used as a standalone treatment for alcohol problems.

For now, anyone concerned about their drinking should speak to a GP, pharmacist or specialist alcohol support service. Safe treatment should always involve proper clinical guidance, especially where alcohol dependence or withdrawal symptoms may be present.