Researchers at Henry Ford Health, collaborating with WeightWatchers International, report that more than 40% of individuals using popular weight loss medications while participating in a WeightWatchers clinic decreased their alcohol use.
Examining alcohol use among individuals using various medications for weight loss could offer insights into behavioral versus medication effects on alcohol reduction.
After statistically adjusting for weight loss, the significance of bupropion and naltrexone’s effect disappeared, suggesting the reduction may be mediated by weight loss rather than the medication itself.
If AOMs reduce alcohol use partly by promoting weight loss, adjusting for weight loss could obscure this effect.
If anti-obesity medications reduce alcohol use partly by promoting weight loss, adjusting for weight loss might minimize the apparent role of the medications.
Over 40% of people taking common weight-loss drugs while attending a WeightWatchers clinic reported cutting back on alcohol consumption, according to research from Henry Ford Health in partnership with WeightWatchers International.
Certain drugs have previously been linked to a decreased prevalence of alcohol use disorder. Reduced alcohol consumption is also associated with health-conscious behavioral changes in weight-management programs. Analyzing alcohol consumption in people taking different weight-loss drugs may provide information about how medication and behavior affect alcohol consumption.
Participants in the WeightWatchers telehealth weight management program from January 2022 to November 2023 provided data for the study “Alcohol Use and Antiobesity Medication Treatment,” which was published in JAMA Network Open.
The participants’ mean body mass index (BMI) was 35.97, and their mean age was 43.17 years. Of them, 86.0 percent were female. Glucagon-like peptide-1 receptor agonists of the second generation (GLP-1 RAs) were prescribed to the majority of participants (86–2%). At baseline, about half (53.3%) reported using alcohol.
Among the drugs were metformin, semaglutide (Ozempic, Rybelsus), dulaglutide (Trulicity), liraglutide (Saxenda), tirzepatide (Zepbound), and bupropion plus naltrexone (Contrave). Several of the medications used in the study were not approved by the FDA for weight loss, and others were not approved at the time of the study.
The authors describe how joining the WeightWatchers telehealth weight management program and starting what they call anti-obesity medication (AOM) caused 52.4% of the 7,491 participants who reported alcohol use at baseline to report no change, 45.3% to report a decrease in their consumption, and 2.3% to report an increase. Individuals who had higher baseline alcohol use and obesity levels were more likely to cut back on their alcohol intake.
People on bupropion and naltrexone were most likely to reduce their alcohol consumption when compared to people on other medications. Because it lessens rewarding effects and cravings, naltrexone is FDA-approved for the treatment of alcohol dependence.
When bupropion is taken with alcohol, there are known risks, such as an increased risk of seizures and adverse behavioral effects. Patients who were given the combined version would have been informed of these interactions by their doctor or pharmacist.
The effect of bupropion and naltrexone was no longer statistically significant after controlling for weight loss, indicating that weight loss rather than the drug itself may have mediated the reduction. Given the known pharmacological effects of naltrexone in other study settings, this is an impressive finding.
For example, weight loss may be a mediator of alcohol use reduction rather than a confounding factor if GLP-1 RAs decrease the rewarding effects of both food and alcohol through comparable neural mechanisms. Adjusting for weight loss in this instance may minimize the role that AOMs play in changes in alcohol consumption.
Given that they were all enrolled in the same program, it is possible that participation in the weight management program and related behavioral strategies that encourage reduced alcohol intake have contributed to the lowest reported decrease in alcohol use among metformin users.
troublesome elements of the research design.
The interpretation of the study’s results is impacted by a number of limitations. Isolating the effects of medication from behavioral interventions is challenging when there is no control group taking anti-obesity medications as part of the weight management program. Such a group’s inclusion might have made it clearer whether behavioral modifications by themselves have an impact on alcohol reduction.
There are possible conflicts of interest because a number of the authors work for WeightWatchers International, which offers the weight-loss program and markets a drug that the study found to be beneficial. This relationship might lead to biased reporting of results that are favorable to the company’s initiatives and goods.
Distinguishing the impact of behavioral interventions and medication on alcohol consumption requires more investigation.
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