Can weight loss drugs help in reducing risk of alcohol use disorder?

How does semaglutide reduce alcohol craving?

Semaglutide belongs to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RA) which reduce the release of the pleasure hormone dopamine. “They don’t just work on the stomach, they touch every organ, from the heart to the brain. We have known for a long time that dopamine is the ‘pleasure’ hormone that becomes overly activated in addiction, be it addiction to food, alcohol or even video games. GLP-1 medications reduce the release of dopamine, making previously ‘rewarding’ behaviours, like drinking in excess, far less enjoyable,” says Dr KP Singh, Director, Endocrinology, Fortis Hospital, Mohali, and former professor, PGIMER, Chandigarh.

According to Dr Sandeep Chhatwal, Internal Medicine Specialist, Omni Hospital, Chandigarh, the receptors on which Ozempic acts are also found in areas of the brain involved in both reward-processing and addiction. Activation of these receptors may modulate neurotransmitter activity related to craving and reward-seeking behaviour. “The drug while working on regulating glucose may act by preventing mood swings leading to addiction,” he says.

What is alcohol use disorder?

It is a medical term used to describe excessive consumption of alcohol. People struggling with alcoholism are often unable to quit the habit or end up relapsing later. “The study shows that among 83,825 patients with obesity, who had never been diagnosed with alcohol abuse disorder in the past, those using injectable semaglutide had a 50 per cent lesser risk of developing alcohol use disorder over one year. Similarly, a 56 per cent lesser risk of relapse was shown in 4,324 patients who had been diagnosed with this disorder in the past.

And since these improve secretion of insulin from the pancreas in response to food intake, thus helping in the management of both obesity and Type 2 diabetes, the drugs seem to have many effects,” says Dr Akanksha Gautam, DM, Endocrinology, PGIMER, and Consultant, Endocrinologist, IVY Hospital, Mohali.

Why is this study significant for other addictive behaviour?

This human study confirms the animal study where researchers had shown reduced drinking and relapse rates in alcohol-dependent rodents.

Singh believes current studies have a limited number of patients and are of short duration. Hence, evidence in many more patients would be needed before declaring success and recommending this as the sole treatment. “Nobody should recommend semaglutide for alcohol abuse disorder in isolation, but if a patient has obesity and diabetes with over-drinking as an issue, it could work there. We would also watch out for more long-term data on pancreatitis and retinopathy with these therapies before giving our final verdict,” he sums up. If results are convincing, he sees them being used to treat other ‘OCD-like tendencies’ including nail biting, online shopping, smoking, or vaping.