SAN ANTONIO — Several types of anti-obesity medications (AOMs), including glucagon-like peptides 1 (GLP-1), are associated with reduced alcohol consumption, new research suggests.

The findings, from surveys of more than 14,000 participants in WeightWatchers’ telehealth weight management program, were presented Nov. 6 at the Obesity Society conference. Obesity Week 2024 meeting by the company’s Director of Nutrition, Michelle I. Cardel, PhD, RD, based in Gainesville, Florida.

Similar reductions in alcohol consumption were observed among people taking different classes of AOMs, suggesting “an additional mechanism by which AOMs reduce energy intake, and also point to a potential role for these medications in reducing alcohol consumption,” Cardel said, adding that “clinicians treating individuals for obesity may consider anti-obesity medications, particularly in those who report higher alcohol consumption.

Asked to comment, session moderator and obesity researcher Joseph A. Skelton, MD, professor of pediatrics at Wake Forest University School of Medicine, Winston-Salem, North Carolina, said: Medscape Medical News“I think there are overlapping pathways, maybe a reward system or something like that in the brain. I don’t think we know exactly what the end result will be in terms of potential use of medications But there is one signal that needs to be studied further.

Cardel noted that there had been a great precedent cohort study finding that semaglutide was associated with a lower risk of alcohol use disorders, and another study which analyzed social media threads of people saying they would stop drinking after starting a GLP-1 drug. But this new study is the first to examine the relationship with different classes of AOM and to quantify the amount of alcohol consumed.

About half reported reduced alcohol consumption, regardless of AOM class

The study included 14,053 participants in the WeightWatchers telehealth program who initiated an AOM between January 2022 and August 2023 and renewed the same AOM between October and November 2023. Those who had previously used AOMs before joining the program or who had undergone bariatric surgery were excluded.

Participants had a mean age of 43 years, were 86% female, 60% Caucasian, and had a mean body mass index of 36. They were asked about their weekly alcohol consumption before the start of AOM and again at the time of renewal of the AOM.

Initially, they were divided into category 0 (no alcohol consumption; n = 6,562), category 1 (one to three drinks for women and one to six for men; n = 5,948), category 2 (4 to 6 for women and 7-14 for men; n = 1,216) and category 3 (≥ 7 for women and ≥ 15 for men; n = 327).

In the second survey, 24% reported a decrease in their alcohol consumption after starting AOM, 71% reported no change, and 4% reported an increase in their alcohol consumption (P. < 0.0001). But when only the 7,491 people who reported alcohol use at baseline were included, 45% reported a decrease in their alcohol use after the onset of AOM, 52% reported no change, and only 2% reported an increase in their alcohol consumption.

The decrease in alcohol consumption with AOM consumption increased with greater alcohol consumption at baseline, from 37% for category 1, 76% for category 2 and 91% for category 3. Proportions reporting an increase in alcohol consumption were only 3%, 1% and 0.%, respectively. The adjusted odds ratios (OR) for decreased alcohol consumption were 5.97 for category 2 (P. < .0001) and 19.18 for category 3 (P. < 0.0001) compared to category 1.

The proportions reporting a reduction in alcohol consumption were similar across AOM classes: 51% for metformin, 46% for bupropion/naltrexone, 46% for first generation GLP-1s (Saxenda, Trulicity and Victoza) and 45% for second generation GLP. -1 medications (Mounjaro, Ozempic, Rybelsus, Wegovy and Zepbound). All were statistically significant at P. < 0.0001.

The highest proportion reporting increased use was 4% for bupropion/naltrexone. Compared to women, men were significantly more likely to report a reduction in alcohol consumption when using AOM (adjusted OR: 0.74; P. < 0.001), but there were no differences by race/ethnicity or age.

Compared to those who were overweight, those in obesity classes I, II, and III were all more likely to reduce their alcohol consumption when consuming AOM, with adjusted ORs of 1.26 (P. = 0.0045), 1.49 (P. < 0.001) and 1.63 (P. < 0.001), respectively.

The mechanisms appear to be both biological and behavioral

During the discussion, Cardel said that participants’ qualitative assessments suggest that there are at least two mechanisms behind this phenomenon: one biological and one intentional.

“What we hear from them is twofold: First, particularly among people taking GLP-1 medications, we hear that physiologically they feel different on the medications, that their cravings for alcohol are diminished, and that when they choose to drink that there is often very negative reinforcement… A patient told me: “I used to drink two or three margaritas, and maybe I didn’t feel as although never.” in the morning, but I was fine. And now if I drink two or three drinks, I’ll throw up for 5 hours, and it’s the worst hangover I’ve ever had in my life. And so that really creates this negative reinforcement loop.

But at the same time, “the people who come to us and are looking for these medications are largely on a health-focused journey. That’s what they tell us. The majority of our patients are here to improve their health. We rarely hear about vanity or aesthetics. This may be because in terms of improving their health, they are also trying to reduce their alcohol consumption, either simply for their overall health or also in an attempt to decrease their overall calorie consumption.

As part of future research, Cardel said: “We want to examine whether anti-obesity medications are more successful in reducing alcohol consumption than non-pharmacological weight management interventions, because we know that people often reduce their consumption of alcohol as part of a weight management journey. a way to prioritize their calories for food and decrease calories from alcohol.

Cardel and all co-authors of the study were employees and shareholders of WeightWatchers at the time the research was conducted. Skelton is editor-in-chief of the magazine Childhood obesity.

Miriam E. Tucker is a freelance journalist based in the Washington, DC area. She is a regular contributor to Medscape Medical News, and other work appears in the Washington Post, NPR’s Shots blog, and Diatribe. She’s on X: @MiriamETucker.