Since weight-loss drugs that target the hormone GLP-1 have surged in popularity, some additional health benefits have emerged. Beyond helping people shed pounds, they also lower the risk of heart disease and sleep apnea—and the U.S. Food and Drug Administration has acknowledged these benefits by approving changes to the drugs’ labels.
Now, one type of weight-loss medication is proving helpful with another health issue. In a study published Feb. 12 in JAMA Psychiatry, researchers report that semaglutide, better known as Ozempic or Wegovy, helped people with alcohol addiction reduce their craving and drink less.
The trial involved 48 people with alcohol-use disorder, which for men means consuming more than 14 drinks a week, with two or more heavy-drinking events during the week; for women, it means consuming more than seven drinks weekly with two or more of these drinking episodes. No one in the study was receiving treatment for their drinking, and most were overweight or obese.
Researchers divided people into two groups and compared weekly injections of semaglutide to placebo, while tracking differences in the amount of alcohol people drank and how often they drank over 2.5 months. The study was uniquely constructed: Participants came into a lab designed to look like a living room, where they could relax, watch TV, and drink as much of their favorite alcoholic beverages as they desired for about two hours. The researchers recorded how much they drank at the beginning of the study—before they received any medication or placebo—and then again at the end of the study. In between, participants came in for weekly visits to receive their injections and answer detailed questions about their alcohol consumption over the previous week.
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While people taking the drug didn’t drink any fewer number of days than people in the control group, they did drink less alcohol at the end of the study, says Christian Hendershot, professor of population and public health science and director of clinical research at the USC Institute for Addiction Science, and the lead researcher of the study. This suggests that the rewarding and addictive appeal of alcohol might have been diminished for them—similar to the way food is less enticing for those taking semaglutide for weight loss. “These medications don’t make people stop eating altogether, but reduce the urge to eat so there is appetite reduction and satiety,” he says. “I think this is very much analogous.”
Hendershot says he expected to see an effect of semaglutide on alcohol-use disorder, but not to this extent. Drugs like semaglutide affect the GLP-1 hormone, which works on the reward and satiety regions of the brain. Previous studies, mostly in animals, showed that these drugs could dampen addiction and cravings for substances including alcohol. Non-scientific, anecdotal reports from people taking semaglutide to treat diabetes or for weight loss also suggested that the medications curbed the desire to drink.
“The magnitude of the effect, specifically at these doses, was somewhat surprising,” Hendershot says. People in the study receive the two lowest doses of semaglutide; the dose used for weight loss is about four fold higher.
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The reduction in craving that people reported, and the reduction in the amount they drank in the living-room lab at the beginning of the study vs. the end, is similar to the effect of existing prescription treatments for alcohol-use disorder, such as naltrexone, Hendershot says. But while the FDA has approved three such treatments, they are “underutilized” for reasons including stigma and a lack of awareness, he says.
That’s where GLP-1 medications could have an advantage, since they are widely popular and familiar to many people in both the public and in the medical community. But while his small study is encouraging, Hendershot says it’s too early to use GLP-1 drugs off label to treat alcohol-use disorder. “We know people are prescribing GLP-1 receptor agonists off label for this purpose, but it’s best to recommend instead that they use FDA-approved treatments that are already available,” he says. “We really would need a handful of larger clinical trials to address that question, and we are still pretty far out from that level of conclusiveness.”
More questions remain about the best dose of these medications to potentially treat alcohol addiction, as well as whether drugs that target multiple weight-loss-related hormones—like tirzepatide, sold as Mounjaro and Zepbound—could have even better results. Hendershot’s team is researching these questions.
“Right now, this data points to a fairly consistent picture across animal studies, and now early human findings, of GLP-1’s effect on alcohol-use disorder,” he says. “The next task is to generate more human data from larger clinical trials.”
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