Obesity drugs could help lower alcohol intake
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Key takeaways:
- Obesity medications, alongside a telehealth program, may reduce patients’ alcohol intake.
- Drinking was especially reduced among those with higher body weight and those who drank more at baseline.
SAN ANTONIO — Obesity medications, regardless of class or generation, were associated with reduced alcohol intake among individuals participating in a telehealth weight-loss program, a speaker reported.
At ObesityWeek, Michelle I. Cardel, PhD, MS, RD, FTOS, chief nutrition officer of Weight Watchers and adjunct professor at the University of Florida, presented data that showed individuals engaged with a telehealth obesity management program who were prescribed a weight-loss medication reported drinking less alcohol, especially among women, individuals with more body weight and those who reported high levels of drinking at baseline.
“Anecdotally, we were hearing from patients that they were just not interested in alcohol. Their cravings were reduced. When they did drink, it made them feel awful, and we were hearing that they were drinking a lot less than they were before they started taking anti-obesity medications. Primarily, we were hearing it from patients on GLP-1 medications like semaglutide or tirzepatide,” Cardel told Healio. “And so we were curious. This is something that we assess in our clinical protocol. We assess alcohol intake at baseline. What if we start assessing it after they’ve been on treatment and assess changes. When we looked at the data, we were really surprised to see that the majority of folks were decreasing alcohol intake. It was across all anti-obesity medications. We thought we were only going to see it in the GLP-1 medications because of the effect on the addictive centers in the brain. We were really surprised to see it even with medications like naltrexone or metformin.”
All participants in this analysis were enrolled in a telehealth weight management program and initiated an obesity medication between January 2022 and August 2023 and refilled the same medication between October and November 2023.
At baseline, 14,053 participants were surveyed on their age, sex, race, height, weight and weekly alcohol use and were resurveyed at the time of their obesity medication refill.
Overall, 4% of participants were taking metformin and 5% were on bupropion/naltrexone (Contrave, Nalpropion Pharmaceuticals); less than 7% were taking a first-generation GLP-1 receptor agonist such as liraglutide (Saxenda or Victoza, Novo Nordisk) or dulaglutide (Trulicity, Eli Lilly); and the remainder were taking a second-generation GLP-1, including 44% on tirzepatide for diabetes (Mounjaro, Eli Lilly), 13% on injectable semaglutide 0.5 mg, 1 mg or 2 mg (Ozempic, Novo Nordisk), less than 1% on oral semaglutide 7 mg or 14 mg (Rybelsus, Novo Nordisk), 28% on injectable semaglutide 2.4 mg (Wegovy, Novo Nordisk) and less than 1% on tirzepatide for weight loss (Zepbound, Eli Lilly).
Cardel and colleagues observed a significant reduction in weekly alcohol intake across all obesity medication classes, with 45% to 51% of participants reporting reduced weekly drinking (P for all < .0001).
Compared with women, men were less likely to reduce their weekly alcohol intake (adjusted OR = 0.74; 95% CI, 0.64-0.85; P < .0001), but there were no differences according to age or race/ethnicity, according to the presentation.
Compared with individuals classified as overweight, higher baseline obesity class was associated with increased likelihood to reduce alcohol intake:
- obesity class I (aOR = 1.26; 95% CI, 1.07-1.48; P = .0045);
- obesity class II (aOR = 1.49; 95% CI, 1.26-1.77; P < .0001); and
- obesity class III (aOR = 1.63; 95% CI, 1.36-1.96; P < .0001).
Moreover, compared with individuals who drank less at baseline — one to three drinks per week for women and one to six drinks per week for men — individuals who reported greater baseline alcohol intake were more likely to reduce intake while taking an obesity drug (aOR = 5.97; 95% CI, 5.17-6.91; P < .0001), especially those with the highest levels of weekly drinking (aOR for at least seven drinks per week for women and 15 drinks per week for men = 19.18; 95% CI, 13.25-28.86; P < .0001).
“We were super surprised to see that decrease across all the different anti-obesity medications,” Cardel told Healio. “It brings up the idea, is it a physiological effect of the medications alone or is it that when people are on a weight management journey, that the behavior change strategies that are incorporated to decrease their calorie intake is decreasing alcohol consumption, or is it a combination of both? We need future research to do placebo-controlled randomized trials to really be able to disentangle the effects of the medications alone vs. the strategies that people engage in when they’re trying to lose weight.”
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Cardel MI. Oral-104. Presented at: ObesityWeek; Nov. 3-6, 2024; San Antonio.
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