A daily pill best known for helping people lose weight may also reduce heavy drinking and quiet alcohol cravings, according to new research.
Scientists found that people taking oral semaglutide – the active ingredient used in Wegovy – experienced fewer heavy-drinking days, consumed fewer drinks when they did drink and reported weaker everyday cravings than those given a placebo.
The eight-week randomised clinical trial involved 50 adults with moderate-to-severe alcohol use disorder who wanted help reducing their drinking.
Participants received either a daily placebo or three milligrams of oral semaglutide for four weeks, followed by seven milligrams for another four weeks.
Abdal Alvi, chief clinical officer at Simple Online Pharmacy, said the findings offered an intriguing glimpse into how GLP-1 medicines may affect more than appetite alone. Prior to joining Simple Online Pharmacy, Mr Alvi worked in community pharmacy across the Glasgow area, specialising in the treatment of substance misuse.
He said: “GLP-1 medicines are designed to regulate appetite and help people feel fuller, but researchers are increasingly interested in whether they may also influence the brain’s reward pathways.
“This could potentially help explain why some patients report feeling less interested in things they previously found difficult to resist, including alcohol.”
What did the study find?
Those taking semaglutide recorded significantly fewer heavy-drinking days and fewer drinks per drinking day during the final four weeks.
They also reported reduced everyday alcohol cravings, fewer alcohol-related negative consequences and were more likely to move down at least one World Health Organisation drinking-risk level.
However, the medication did not significantly reduce the study’s primary measure of alcohol craving when participants were exposed to alcohol-related cues in a laboratory. Nor did it significantly reduce the overall number of drinks consumed per day compared with the placebo.
Alvi said: “The results are encouraging, but it is important to understand exactly what the study did and did not find.
“Semaglutide appeared to improve several real-world drinking outcomes, but it did not produce a significant improvement in every measure researchers examined. This was also a small and relatively short trial, so we cannot draw firm conclusions yet.”
Researchers do not yet fully understand why the treatment may affect drinking. GLP-1 receptors are present in areas of the brain involved in motivation and reward, raising the possibility that the medication may alter the “reward value” attached to alcohol as well as food.
Alvi said: “People often describe GLP-1 treatment as turning down ‘food noise’. One theory is that a similar process could reduce the pull of alcohol, although the biology is complex and considerably more research is needed.”
Not a treatment for alcohol dependence
Despite the findings, semaglutide is not licensed in the UK to treat alcohol dependence, and the study does not mean weight-loss medication should be used to control drinking.
Alvi said: “Nobody should start taking a GLP-1 medicine, increase their dose or change how they use it because they are worried about their alcohol intake.
“These are prescription medicines with potential side effects and specific eligibility requirements. They should only be used for an approved purpose following a proper clinical assessment.”
Semaglutide commonly causes digestive side effects such as nausea, vomiting, diarrhoea and constipation. Alcohol may worsen nausea or dehydration for some patients, particularly while their dose is being increased.
The researchers said larger and more diverse trials are now needed to establish whether the apparent benefits are sustained, which patients may respond and what dose would be appropriate. The injectable format of semaglutide has also been used to research the link between these medications and alcohol and tobacco consumption, as well as gambling.
Alvi added: “This research is exciting because it may eventually broaden our understanding of how GLP-1 medicines affect cravings and compulsive behaviour.
“But for now, anyone concerned about their drinking should seek appropriate support from their GP or an alcohol service rather than viewing weight-loss medication as a solution.”
