Strongest evidence yet that Ozempic and Wegovy reduce alcohol intake

Semaglutide really does seem to help people who are addicted to alcohol reduce their intake, according to the first randomised clinical trial of the drug for this purpose.

Sold under brand names including Wegovy and Ozempic, semaglutide works by mimicking a gut hormone called glucagon-like peptide-1 (GLP-1), hence the technical term for it is a GLP-1 receptor agonist. The drug was first used to treat type 2 diabetes, but because it reduces appetite, Wegovy has now also been licensed for weight loss in eight countries. Semaglutide has also shown hints of helping an extraordinary number of medical conditions.

When it comes to alcohol use, a 2024 study of 84,000 people linked injecting Ozempic or Wegovy with a lower risk of alcoholism. Promising as that result was, it showed correlation rather than causation.

But now, Christian Hendershot at the University of Southern California and his colleagues have completed the first randomised clinical trial of semaglutide’s effect on alcohol use disorder, a type of study that can tease out causation.

Their trial involved 48 people in the US who had been diagnosed with the condition, of whom 34 were women and 14 were men. Half received weekly low-dose injections of semaglutide for nine weeks and the rest had placebo injections.

Those on semaglutide consumed fewer drinks per drinking session and had reduced weekly alcohol cravings compared with those on placebo.

“We didn’t have any evidence of significant adverse effects or safety concerns with the medication in this population and we found overall that across several different drinking outcomes it reduced the quantity of alcohol that people consumed,” says Hendershot.

“The results are promising,” says Rong Xu at Case Western Reserve University School of Medicine in Ohio. “Despite the small sample size, this randomised clinical trial highlights the therapeutic potential of semaglutide in treating alcohol use disorder.”

Ziyad Al-Aly at Washington University in St Louis, Missouri, says the study adds “yet another piece of evidence that GLP-1RAs [GLP-1 receptor agonists] may be helpful in addiction disorders”.

Larger studies are needed to corroborate the work, he says, and to answer questions about whether people increase their drinking if they come off semaglutide and what its longer-term effects might be, especially given concerns around loss of bone and muscle mass.

The study should be treated as promising initial evidence, says Hendershot, but more research is needed. People shouldn’t start taking semaglutide for alcohol problems, he says.

“This is the first study like this and people are excited about it, but we do have approved and effective medication for alcohol use disorder, so until more research has been done, people are advised to pursue existing medications that are out there and approved right now,” says Hendershot.