GLP-1 RA Medication Associations With Hazardous Alcohol Drinking Reductions in Patients With Overweight or Obesity: A Prospective Observational Study.

PURPOSE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) approved for type 2 diabetes and overweight or obesity may affect alcohol drinking behavior. The present prospective observational study investigated hazardous alcohol drinking in patients at the University of Chicago Weight Loss Clinic. They received GLP-1 RA therapy and underwent body weight and hazardous drinking assessments before and during treatment. METHODS: Fourteen patients were prescribed a GLP-1 RA for overweight or obesity (liraglutide [n=1], semaglutide [n=8], and tirzepatide [n=5]), along with standard care dietary counseling and physical activity recommendations. All but one patient met the body mass index (BMI) cutoff for obesity in the United States (n=13, BMI ≥30 kg/m 2 ; n=1, BMI=29.50 kg/m 2 ). Patients screened positive for hazardous drinking on the Alcohol Use Disorders Identification Test (AUDIT; score ≥8) and were categorized into subgroups of high (score 8-14) and very high AUDIT (score ≥15). The AUDIT was readministered on average 9.6 (±4.8) months after medication initiation. RESULTS: There were significant reductions in BMI and AUDIT scores over time, with patients in the very high AUDIT group reporting more pronounced reductions in AUDIT scores compared with those in the high AUDIT group. Effect sizes were large, indicating a high magnitude of the effect of GLP-1 RA medications on reducing hazardous drinking scores. CONCLUSIONS: These findings support the association between GLP-1 RA treatment and reduced alcohol consumption, particularly for individuals with very hazardous alcohol drinking levels. A better understanding of the acute mechanisms underlying GLP-1 RA therapies and randomized clinical trials may aid in the development of pharmacotherapies for hazardous drinking beyond patients with diabetes and/or obesity.