Antiobesity Drugs May Help Curb Alcohol Consumption: Daily Dose

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Last week, we reported on findings from a study published in JAMA Network Open that examined changes in alcohol use among people enrolled in a telehealth weight management program after initiation of an antiobesity medication (AOM).

The study

Investigators analyzed data from 14 053 adults enrolled in the WeightWatchers Clinic telehealth medical weight-management program. All participants had initiated AOM therapy between January 2022 and August 2023 and refilled the same medication between October and November 2023. At baseline, participants were surveyed on their age, sex, race, height, weight, and weekly alcohol use and were resurveyed at the time of their AOM refill.

Overall, the majority (86.2%) of participants were prescribed a second-generation GLP-1RA (ie, tirzepatide, semaglutide). Beyond second-generation GLP-1RAs, 5% of people were taking a first-generation GLP-1RA (ie, liraglutide and dulaglutide), 4.8% were prescribed bupropion/naltrexone, and 4% were taking metformin.

The findings

Across all participants, 3395 (24.2%) had a decrease in alcohol use. Among the 7491 participants who reported alcohol use at baseline, 45.3% reported a decrease in use after AOM initiation, 52.4% reported no change, and 2.3% reported an increase. The data showed that decreased alcohol use was significantly more likely among women, in those with increasing obesity class, and among the heavier drinkers at baseline.

Using metformin as a reference, only bupropion/naltrexone showed a higher likelihood of reduced alcohol consumption (aOR 1.42, 95% CI, 1.01–1.99), though this association was not significant after adjusting for weight loss. Age and race/ethnicity did not significantly affect alcohol reduction outcomes.

Authors' comments

"There may be properties of AOMs that lead to reduced use. For example, naltrexone decreases cravings for alcohol and GLP-1 RAs may attenuate the rewarding effects of alcohol, similar to food...future research would benefit from a randomized trial comparing AOMs with a placebo-controlled or nonpharmacological weight management group."

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