As more people are taking weight-loss drugs, a surprising benefit has emerged – people are drinking less. Photo / Getty Images
As more people are taking weight-loss drugs, a surprising benefit has emerged – people are drinking less
Michelle Udden had become accustomed to drinking every single night.
“If I’m being honest, it was borderline becoming a habit,” says Udden, 51, who lives in New Hampshire, the United States, and works for a fintech company within higher education.
“I wasn’t getting drunk every day, but I was enjoying two to three glasses of wine each night, and definitely more on the weekend. I had not gone a week without drinking for at least the past 10 years.”
But with just a single shot of semaglutide – a medication that is marketed either as Wegovy for weight loss or Ozempic for type two diabetes – this all changed.
“It was immediate,” says Udden. “I took my first shot on a Sunday night, immediately experienced appetite suppression and didn’t have any desire to drink. At the end of that week, I poured a glass of bourbon and couldn’t finish it.”
She is far from the only one to experience this unexpected side-effect. After injecting the weight loss drug, Micha Podolsky Harmes, 52, an executive assistant who lives in Kentucky, lost her desire for alcohol almost immediately.
“I used to drink at least two or three vodka cocktails a night. Once I started semaglutide, I completely lost my taste for alcohol. I have [since] tried three drinks in five months and didn’t finish any of them.”
Over the last few months, there has been a surge of interest in the drug’s potential as a potent new treatment for alcoholics with evidence published in research studies confirming these anecdotal reports.
In July, a study from Swedish neuroscientists in the journal eBioMedicine demonstrated that semaglutide can reduce alcohol relapses in rodents, while two new research papers have described similar benefits in humans.
When researchers at the University of Oklahoma Health Sciences Centre monitored the progress of six patients with alcohol use disorder, who had been prescribed semaglutide by the university weight-loss clinic, they observed a significant reduction in their drinking.
“This is the first confirmed improvement in alcohol use disorder symptoms in humans,” says Jesse Richards, assistant professor at the University of Oklahoma Health Sciences Centre, who led the study.
“Everybody coming to see us was on the medication for weight reasons, and then we found that they had this significant reduction in their alcohol intake. Probably the most fascinating finding was that even the lowest dose [of semaglutide], the baby starter, quarter of a milligram dose, actually showed some quite significant reduction, probably about 70 per cent of the alcohol use disorder symptoms.”
Another study in which scientists remotely followed 153 people taking either semaglutide or a different weight loss drug called tirzepatide, also reported that they seemed to consume significantly less alcohol and had fewer binge drinking episodes.
So why is this? While researchers are still not entirely sure, according to Professor Joseph Schacht of the University of Colorado School of Medicine who is now leading a clinical trial specifically testing semaglutide on patients with alcohol use disorder, there are two main theories.
Both are linked to the underlying mechanisms of semaglutide, a synthetic drug that is designed to mimic the effects of a naturally occurring gut hormone called GLP-1 which is released after eating. Like GLP-1, semaglutide targets various regions in the brain to suppress appetite.
“Alcohol is a caloric substance and may be affected by GLP-1 in the same way as food,” says Schacht. “The other more exciting hypothesis is that these medications are able to affect brain pathways that regulate motivation and reward more broadly.”
He points out that semaglutide binds to a particular brain region called the hypothalamus which not only regulates hunger but is also connected to a particular network in the brain called the mesolimbic dopamine pathway.
Alcohol and other drugs like nicotine and opioids stimulate this system, flooding the brain with up to 10 times the amount of dopamine it normally receives. Connections are then formed between brain cells to associate this surge with alcohol or another substance, forming the basis for the addiction.
“Some research with animals suggests that semaglutide reduces dopamine release in the brain areas along the mesolimbic dopamine pathway,” Schacht says.
Intriguingly, the Telegraph also received responses from users who reported that semaglutide had decreased their desire to smoke or vape. Callie Ann Hastings said that before commencing weight-loss treatment with the drug, she would smoke cannabis every night to help her get to sleep.
“Sometimes I would smoke throughout the day as well. I noticed the change within days. I had zero desire to smoke anymore. I would look at my vape pen and not even want to touch it.”
Some clinics have already begun to investigate semaglutide and other so-called GLP-1 drugs for other substance addictions. In Pennsylvania, a new clinical trial has been testing liraglutide, another drug that aims to replicate the behaviour of the GLP-1 hormone, in a small group of patients with opioid use disorder. The results are expected in 2024.
But for now, most researchers are focusing on the potential applications for alcoholics. From the US to Denmark, there are five major clinical trials overall which are now testing semaglutide in people with alcohol use disorder.
According to Mette Kruse Klausen, a psychiatrist currently recruiting patients for one of these trials at the Frederiksberg Hospital in Copenhagen, the interest stems from the grave need for new addiction treatments. Research has shown that abstinence alone largely does not work, with two-thirds of patients relapsing within just one year.
“New treatments are very much needed,” she says. “According to the 2018 World Health Organisation report, 280 million people suffer from alcohol use disorder, and harmful use of alcohol is a leading cause of preventable deaths.”
While there are some existing treatments for alcoholics such as acamprosate, disulfiram, naltrexone and nalmefene, Richards says that they all come with certain limitations.
“Acamprosate and naltrexone are both approved to help decrease cravings, the issue is that acamprosate is a three times a day medication, and naltrexone is a daily medication and can’t be used in patients with severe liver disease,” he says. “If you miss a dose or two, then the cravings come back.”
But while there is considerable excitement around the potential of semaglutide, there is still much we need to understand about how it works and its durability over time. Some people told the Telegraph that the drug changed the taste of certain forms of alcohol, to the point where it actively repulsed them, something which Richards also reported in his study.
“Having an actual aversion to the taste of alcohol is an anecdote I’ve heard quite commonly,” he says. “Hopefully we’ll have an explanation for that in the near future.”
Klausen says that the trials are vital to understanding whether the drug can benefit all people with alcohol use disorder, as well as the minimum dose of semaglutide that is needed to achieve benefit. “The lower the dose, the smaller the risk of getting side-effects,” she says.
If the trials succeed, semaglutide could rapidly become available worldwide as a new therapy for alcoholics, as the drug has already been safety tested in overweight and obese individuals.
For people like Udden who have already experienced the benefits, as well as losing weight, it is easy to see just how big a difference it could make to many people’s lives.
“I am so much more focused at work,” she says. “I sleep so much better and wake without an alarm clock. I’m not sure how I feel about drinking in the future.
“When I think about social gatherings and things like an upcoming all-inclusive vacation, being the sober one isn’t much fun. But if I had to pick from being sober and drinking as much as I used to, I would stick with sober.”
These tips will help you up the intimacy in a stale relationship.