Anti-obesity medications (AOMs) are agents used in the treatment of weight reduction including GLP-1 receptor agonists. GLP-1 receptor agonists may also reduce the incidence and recurrence of alcoholism. A comparison of different anti-obesity medications concerning their effects on alcohol consumption may provide important comparative information regarding their effects on alcohol consumption may provide important comparative information regarding their diverse AOM effects. The study was designed to examine changes in alcohol consumption of the individuals enrolled in telehealth weight management program, following the initiation of the AOM.
This cohort study was granted ethics approval by the Institutional Review Board of Henry Ford Health. A waiver of informed consent was granted and given that the information was collected during clinical care where all data were deidentified. This study has adhered to the STROBE reporting guidelines. Participants were enrolled in Weight Watchers (WW) telehealth medical weight management program. Eligibility criteria included initiating an AOM between January 2022 and August 2023 and refilling the same with an AOM between October and November 2023.
Among 14,166 individuals, only 113 (0.8%) did not refill their AOM prescription. Using multivariate logistic regression, individuals who did cut down alcohol use were compared with those who did not cut back following their enrollment into the AOM with adjustment for covariates based on weight and alcohol use associations. P values were 2-sided, and significance was set at P < 0.05. Analyses were conducted with R software version 4.4.0 (R Project for Statistical Computing) from January to May 2024. The study population comprised 14 053 participants (12 081 [86.0%] females; mean [SD] age, 43.17 [10.13] years; mean [SD] BMI, 35.97 (6.28)). Many participants (12 116 [86.2%]) were prescribed a second-generation GLP-1 RA. At baseline, 53.3% (7,491 participants) reported alcohol consumption.
Across all participants, 3395 (24.2%) had a decreased value of alcohol consumption. Among 7491 participants at baseline with alcohol consumption, 3395 (45.3%) participants decreased their alcohol consumption category, 3923 (52.4%) had no change, and 173 (2.3%) increased their usage category. Among participants reporting at baseline any alcohol use, those with a higher class of obesity and higher levels of drinking are more likely to reduce their uses. Individuals taking bupropion and naltrexone reported reductions in the amount of alcohol consumed compared to those taking metformin. However, this difference proved non-significant after adjustment for weight loss (adjusted odds ratio, 1.33; 95% CI, 0.95-1.86; P = 0.10).
Results from this cohort survey among subjects in a weight-reduction program showed that nearly half of the participants consuming alcohol at baseline reduced their consumption after initiation of AOM. It can be expected that some properties of AOMs cause a reduction in the use of alcohol. For example, naltrexone reduces alcohol cravings and GLP-1 RAs may mitigate the rewarding effects of alcohol just as for food. Unexpectedly, participants using metformin also showed reduced alcohol consumption.
This might result from joining the weight management program, where behavioral strategies could indicate the limitation of alcohol consumption due to its caloric loading and reducing the inhibition of cognition effects. Individuals enrolled in treatment courses are more likely to show increased motivation for a health behavior change compared to those individuals who do not seek treatment. Future research could benefit from a randomized trial between an AOM and a placebo-controlled or nonpharmacological weight control group.
Reference: Miller-Matero LR, Yeh HH, Ma L, et al. Alcohol Use and Antiobesity Medication Treatment. JAMA Netw Open. 2024;7(11):e2447644. doi:10.1001/jamanetworkopen.2024.47644
