From obesity to addiction? GLP-1s show promise

Clinical takeaway: For patients with alcohol use disorder who also have obesity or type 2 diabetes and are candidates for a GLP-1 receptor agonist, this study suggests that semaglutide or tirzepatide may offer an additional benefit.

Alcohol use disorder remains substantially undertreated, and currently approved medications have modest uptake because of adherence and tolerability challenges. Growing evidence has suggested that GLP-1 receptor agonists may reduce alcohol craving and consumption, raising interest in whether they could also improve clinically meaningful alcohol-related outcomes.

In this target trial emulation study, researchers analyzed electronic health record data from 40,703 adults with alcohol use disorder and either type 2 diabetes or obesity who initiated semaglutide or tirzepatide between 2018 and 2024.

Compared with other diabetes medications, newer GLP-1 receptor agonists were associated with a 26% lower risk of alcohol-related emergency department visits or hospitalizations. Compared with other anti-obesity medications, the risk was 32% lower.

Newer GLP-1 receptor agonists were associated with even lower observed risks of alcohol-related hospitalization than acamprosate, disulfiram, or naltrexone among patients with alcohol use disorder. However, the authors cautioned that these comparisons were more susceptible to residual confounding because GLP-1 users also experienced fewer non-alcohol-related hospitalizations, suggesting differences between treatment groups beyond the medications themselves.

"Initiation of newer GLP-1 receptor agonists among patients with alcohol use disorder was associated with a lower observed risk of alcohol-related hospitalization, with similar associations across populations with type 2 diabetes and obesity. These findings may suggest a potential role for GLP-1 receptor agonists in the context of alcohol use disorder," the study authors concluded.

Source: Rodriguez PJ, et al. (2026 Jul 21) BMJ Open. Association between GLP-1 receptor agonists and alcohol-related hospitalisations among adults with alcohol use disorder: multi-target trial emulation study