Almost half of weight loss participants reduced their alcohol intake after starting anti-obesity drugs

Antiobesity drugs are associated with reduced alcohol use, likely due to their effects on craving and reward systems, and behavioral strategies also play a role.

study: Alcohol use and treatment with anti-obesity drugs. Image credit: PeopleImages.com – Yuri A / Shutterstock.com

In a recent study published in JAMA network open, Researchers evaluated changes in alcohol use among individuals enrolled in a telemedicine weight management program after initiation of antiobesity medications (AOM).

How does AOM affect alcohol use?

AOM etc. glucagonPeptide-1 receptor agonists (GLP-1 RAs) are effective in achieving significant weight loss. Of note, GLP-1 RAs are also associated with reduced incidence and relapse of alcohol use disorder, suggesting a potential dual benefit of these agents.

Investigating the effects of different AOMs on alcohol consumption provides valuable insight into their broader behavioral effects. Comparative studies of different AOMs and their effects on alcohol use are essential to better understand their therapeutic scope and mechanisms. Therefore, further research is needed to investigate these interactions and provide better approaches in weight management and addiction treatment.

About research

In the current study, participants were recruited from the WeightWatchers (WW) Clinic's telemedicine medical weight management program. Eligibility criteria includes individuals who started an AOM between January 2022 and August 2023 and refilled the same AOM between October and November 2023.

The Henry Ford Health Institutional Review Board approved this study. Informed consent was removed as the data were collected as part of clinical care and subsequently anonymized. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

AOMs were classified as first-generation GLP-1 RAs such as bupropion, metformin, naltrexone, liraglutide and dulaglutide, or second-generation GLP-1 RAs such as tirzepatide and dulaglutide. Semaglutide. Individuals using AOM prior to enrollment or with a history of bariatric surgery due to a different risk profile for alcohol use disorder were excluded from the analysis.

The baseline survey collected demographic data including age, sex at birth, race, ethnicity, height, weight, and weekly alcohol intake. Body mass index (BMI) was calculated from reported height and weight measurements.

All study participants completed a follow-up survey reporting alcohol use at the time of AOM refill. Statistical analyzes utilized multivariate logistic regression to assess changes in alcohol use while incorporating covariates related to body weight and alcohol consumption. Analyzes were performed using R software.

Research results

Data were obtained from a total of 14,053 people, of whom 86% were women. The average age of the participants was 43.2 years, and the average BMI was 36. Approximately 0.8% of study participants were unable to complete follow-up.

More than 86% of the study cohort was prescribed a second-generation GLP-1 RA, while a smaller group received a first-generation GLP-1 RA, bupropion/naltrexone, or metformin. The study cohort included individuals from a wide range of obesity classes, of which 41.3% were classified as obesity class I, 26% as class II, and 21% as class III.

At baseline, 53.3% of study participants reported consuming alcohol, of which 45.3% reduced their alcohol intake after starting AOM. Meanwhile, 52.4% of these participants reported no change in their drinking habits, while 2.3% reported an increase in their drinking.

24.2% of all participants experienced a decrease in alcohol intake. People with higher levels of obesity and higher baseline alcohol intake were more likely to report decreased alcohol use.

Participants given bupropion/naltrexone were more likely to reduce alcohol intake compared to participants prescribed metformin. However, this association loses statistical significance when adjusted for weight loss, suggesting that the observed reduction in alcohol use is partially mediated by weight loss itself rather than a specific effect of bupropion/naltrexone. It has been suggested that this is possible.

The average time from initiation of AOM to follow-up was 224.6 days, during which time participants experienced a mean weight loss of 12.7% of their initial body weight.

conclusion

Almost half of those who consumed alcohol at baseline reduced their alcohol intake after starting AOM. Potential mechanisms for this association include pharmacological effects, such as the ability of naltrexone to reduce alcohol craving, and the influence of GLP-1 RAs on attenuating the beneficial effects of alcohol use.

Reduced alcohol use among metformin users may reflect behavioral changes associated with weight management programs in which alcohol restriction is encouraged to reduce caloric intake and enhance cognitive inhibition. Motivated participation in health behavior interventions may have contributed to these findings.