By now, most Australians have heard of Ozempic. The weekly injectable medication – originally developed for type 2 diabetes and then found to dramatically reduce weight – has become one of the most talked-about drugs in the world. But a major new study published today in The Lancet suggests the medication may be doing something else entirely that nobody expected: significantly reducing the urge to drink heavily.
And for the millions of Australians – and hundreds of millions of people worldwide – whose relationship with alcohol has become a source of genuine concern, that is a finding worth understanding.
The trial, conducted at a mental health centre in Denmark, involved 108 adults who were seeking treatment for alcohol use disorder and who also had obesity.
All participants were offered cognitive behavioural therapy sessions as part of their treatment. Half received a weekly injection of semaglutide – the active ingredient in Ozempic and Wegovy – and half received a placebo injection, over a period of 26 weeks.
The results were striking.
At the start of the trial, participants had on average 17 heavy drinking days in the past 30 days – more than half the month spent drinking heavily. After six months, those receiving semaglutide averaged roughly five heavy drinking days over the previous 30 days. Those receiving the placebo averaged nine heavy drinking days.
Put simply: the semaglutide group had 50 per cent fewer heavy drinking days than the placebo group.
The reduction in total alcohol consumed was equally dramatic. At the start of the trial, participants were consuming approximately 2,200 grams of alcohol per month. After six months, the semaglutide group had reduced to around 650 grams per month. The placebo group had reduced to approximately 1,175 grams – meaningful in itself, but less than half the reduction achieved with the medication.
The study also found that semaglutide reduced alcohol cravings, drinks per drinking day, and overall alcohol consumption – and participants were more likely to achieve a clinically meaningful reduction in their drinking category overall.
Alcohol use disorder is one of the most common and most under-treated health conditions in the world. It accounts for approximately 5 per cent of deaths worldwide annually, and there is an urgent need for new treatments. In Australia, alcohol-related harm costs the community billions of dollars each year and contributes to a wide range of conditions from liver disease to cardiovascular disease, mental illness, family breakdown and workplace injury.
Despite the scale of the problem, very few medications are approved for treating alcohol use disorder – and those that exist are dramatically underused. In the United States, fewer than 2 per cent of people with alcohol use disorder receive medication-based treatment. In many parts of the world, approved medications are simply not available.
The reason semaglutide might help with alcohol – beyond its well-known effects on appetite and weight – appears to lie in how GLP-1 receptor agonists interact with the brain’s reward system. The same pathways that regulate hunger and satiety are deeply connected to the pathways that drive craving, compulsive behaviour and the neurological basis of addiction. Early research suggests that semaglutide may be dampening those reward signals – reducing not just the desire to eat, but the desire to drink.
Anecdotally, many people taking Ozempic for weight loss had already noticed a reduced interest in alcohol before the formal research began. This trial is the first randomised controlled trial in treatment-seeking patients with both alcohol use disorder and obesity to put that observation to a proper scientific test.
The researchers are careful to flag the limitations of the study. The trial involved 108 participants – a meaningful number for an early-stage trial, but small by the standards of the evidence base needed for regulatory approval. The participants were predominantly White, conducted at a single centre in Denmark, and all had both obesity and alcohol use disorder – meaning the results may not immediately translate to people without obesity, or to different populations and healthcare settings.
Crucially, there was no follow-up after the six-month trial ended, so it is not yet known whether the drinking reductions were maintained once the medication stopped, or whether a rebound effect occurred.
But the findings are described in the accompanying commentary in The Lancet as providing “reason for cautious optimism” – and the number of clinical trials now underway internationally testing GLP-1 medications for alcohol and substance use disorders has expanded dramatically. Eight drugs in the incretin class are now under investigation for alcohol use disorder or alcohol-related liver disease – an astounding number given that only three alcohol use disorder medications have been FDA-approved in the past 75 years.
For the Starts at 60 audience, this research is relevant on several levels.
Alcohol consumption patterns in Australia change significantly in the 60-plus age group. Retirement can alter drinking habits – for some people, reduced routine, increased social time or changing relationships with stress lead to higher consumption than in their working years. At the same time, older bodies process alcohol less efficiently, medications interact with alcohol more significantly, and the health consequences of heavy drinking accumulate more quickly.
Many older Australians will also have family members – adult children, siblings, partners – for whom alcohol has become a significant concern, and who have found the existing treatment options limited or inaccessible.
The prospect of a medication that is already widely prescribed, already has an established safety record, and may significantly reduce both alcohol craving and consumption – potentially delivered through a GP rather than a specialist addiction service – represents a genuine advance in how society might be able to address one of its most persistent and damaging health problems.
This article is general in nature and does not constitute medical advice. If you are concerned about your own or a loved one’s alcohol consumption, please speak to your GP.