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Recent research presented at the Obesity Society’s annual meeting, Obesity Week 2024, has uncovered a potentially surprising benefit of anti-obesity medications (AOMs): a decrease in alcohol consumption. The findings were based on a survey of over 14,000 participants in WeightWatchers’ telehealth weight management program and presented by Dr. Michelle I. Cardel, Chief Nutrition Officer at WeightWatchers.
The study surveyed participants who began using various classes of AOMs between January 2022 and August 2023 and followed up after a refill of the same AOM in late 2023. Results indicate that AOMs, including glucagon-like peptide 1 (GLP-1) medications, could influence drinking behaviors, with around 45% of participants who consumed alcohol reporting a reduction in drinking after starting an AOM. The findings spanned across different medication types, with reductions seen in people taking medications like metformin, bupropion/naltrexone, and both first- and second-generation GLP-1s.
Alcohol Consumption Declines, Especially Among Heavy Drinkers
The survey included 14,053 participants with an average age of 43, predominantly female (86%) and white (60%), and with a mean body mass index (BMI) of 36. Participants reported their alcohol use before starting an AOM and then again at refill. Initial drinking levels were divided into categories: non-drinkers, low/moderate drinkers, and heavy drinkers.
After starting an AOM, 24% of all participants reported decreased alcohol consumption, while 71% maintained their previous drinking levels. For those who drank heavily, reductions in alcohol use were especially notable: 76% of moderate drinkers and 91% of heavy drinkers reduced their intake. Dr. Cardel suggested this might indicate an “additional mechanism by which AOMs reduce energy intake” and may have implications for clinicians treating patients with high alcohol consumption.
Biological and Behavioral Mechanisms
According to Cardel, the decrease in drinking observed among participants may stem from both biological and behavioral factors. Users of GLP-1 medications, for example, reported diminished cravings for alcohol, while some described feeling negative physical effects after consuming alcohol. One patient noted that drinking now leads to severe hangovers, deterring further alcohol consumption.
Furthermore, Cardel pointed out that many people seeking AOMs are on a health-focused journey, aiming to reduce caloric intake, including from alcohol. This behavioral aspect could be reinforcing their commitment to overall health improvements, including drinking less.
Potential Pathways: Reward System and Caloric Intake
Obesity researcher Dr. Joseph A. Skelton from Wake Forest University, who moderated the session, highlighted potential brain pathways affected by these medications. He suggested that overlapping reward system pathways might explain the reduction in both eating and drinking behaviors, though further investigation is needed.
The study also revealed that men were more likely than women to report decreased alcohol use, and participants with higher BMI were more likely to reduce drinking than those with lower BMI.
Future Research
Cardel emphasized the need for further research to understand if AOMs could be more effective than non-pharmacological weight management methods in reducing alcohol consumption. She noted that many people on a weight loss journey often cut back on alcohol as a means to reduce calorie intake, but the potential of AOMs to contribute to these reductions presents a new avenue worth exploring.
These findings contribute to the evolving landscape of anti-obesity medications, which now appear to offer benefits beyond weight management.
