Weight Loss Drugs and Alcohol: A Surprising Link Found in WeightWatchers Program
A groundbreaking new study, published in JAMA Network Open, suggests a fascinating connection between weight loss medications and alcohol consumption habits. Researchers, in collaboration with WeightWatchers International, analyzed data from over 7,000 participants in the company’s telehealth weight management program between January 2022 and November 2023. The results point to a surprising trend: more than 40% of individuals using popular weight loss medications while participating in the WeightWatchers program reported a decrease in their alcohol intake.
"Previous studies have hinted at possible links between certain medications and lower levels of alcohol use disorder," explained researchers. "We also know that making healthy lifestyle changes through programs like WeightWatchers can often lead to reduced alcohol consumption. This study aims to shed further light on whether these changes are driven by the medications themselves or by the behavioral modifications associated with weight management programs."
The study participants, with an average age of 43 and a mean BMI of 35.97, were prescribed a variety of weight loss medications, including metformin, bupropion combined with naltrexone (Contrave), liraglutide (Saxenda), dulaglutide (Trulicity), tirzepatide (Zepbound), and semaglutide (Ozempic, Rybelsus).
Interestingly, participants taking bupropion and naltrexone experienced the highest rates of alcohol reduction. Naltrexone, already FDA-approved for treating alcohol dependence due to its ability to decrease cravings and lessen the pleasurable effects of alcohol, wasn’t surprisingly effective in this context. Bupropion, however, carries known risks when combined with alcohol (increased seizure risk and negative behavioral effects), and patients on this combination would have received warnings from medical professionals.
The surprise came when researchers adjusted for weight loss in their statistical analysis. The effectiveness of bupropion and naltrexone in decreasing alcohol use disappeared, suggesting that the reduction might be primarily mediated by weight loss, not the medication itself.
This finding raises important questions: If weight loss medications are effective in reducing alcohol use in part because they promote weight loss, wouldn’t adjusting for weight loss obscure this very effect?
The researchers warn that could indeed be the case. They propose that if medications like GLP-1 receptor agonists (GLP-1 RAs), which are believed to reduce the rewarding effects of both food and alcohol through similar neural pathways, promote weight loss as a primary mechanism for alcohol reduction, then adjusting for weight loss could downplay the drugs’ true impact.
While participants using metformin showed the least decrease in alcohol use, researchers believe this could be attributed to the WeightWatchers program itself and its emphasis on behavioral changes that discourage alcohol consumption. This pattern held true for all participants in the study.
Cautionary Notes:
The study is not without its limitations. The lack of a control group not receiving weight loss medication makes it challenging to isolate the effects of the medications from the broader behavioral interventions in the WeightWatchers program.
Moreover, potential conflicts of interest exist, as several authors are employees of WeightWatchers International, which both provides the program and sells a medication viewed favorably in the study. This connection could potentially introduce bias.
Further research is essential to disentangle the complex relationship between weight loss medications, behavioral interventions, and alcohol consumption. Only then can we fully understand the role these drugs play in addressing alcohol-related issues.
Photo: Beyond the Stone
