Weight loss drug semaglutide may reduce alcohol cravings, heavy drinking and smoking, new study finds

Semaglutide, a medication widely used for diabetes and weight loss, may offer another unexpected benefit -- it could help people drink less alcohol.

A study published in JAMA Psychiatry enrolled 48 adults between ages 21 and 65 who had been diagnosed with alcohol use disorder but were not actively seeking treatment.

Half received semaglutide, a type of GLP-1 receptor agonist, while the other half received no treatment. Over the nine-week trial, participants taking semaglutide started at a dose of 0.25 mg per week, which gradually increased to 1.0 mg in the final week -- a much lower dose than what’s typically prescribed for weight loss.

''We found the largest effects for outcomes related to drinking quantity or heavy drinking…[semaglutide] appeared to reduce drinking quantity,'' said Christian Hendershot, PhD, the study’s lead author and director of clinical research at the USC Institute for Addiction Science, in an interview with ABC News.

In a controlled lab setting, participants taking semaglutide drank less alcohol. However, outside the lab, their overall drinking days and daily alcohol intake did not change significantly. They did, however, report fewer binge-drinking episodes and reduced alcohol cravings.

Hendershot emphasized that the participants were not actively trying to cut back on drinking or become abstinent, making the drug’s impact particularly interesting.

''The reason why semaglutide may have an effect on addictive behaviors and cravings and may play a role in treating alcohol use disorder is still not entirely clear,'' said Dr. Stephanie Widmer, an emergency medicine physician and addiction medicine expert. ''More research needs to be done in order to really get a firm grasp on what the pathophysiology is behind this,'' she added.

One possible explanation is that GLP-1 receptor agonists increase feelings of fullness, which could make alcohol less appealing, Hendershot said.

Previous animal studies suggest these medications may also affect the brain’s reward system, reducing the desire for substances like alcohol and nicotine. However, it remains unclear if the same effect holds true in humans.

Interestingly, the medication also appeared to reduce cigarette use in a small group of participants who smoked, hinting at broader effects on addictive behaviors.

''Preclinical studies indicate that GLP-1 receptor agonists reduce not just alcohol intake, but also nicotine self-administration and nicotine-related reward,'' Hendershot noted. However, no FDA-approved medications currently exist to treat both alcohol and nicotine dependence.

Another unexpected benefit was that those treated with semaglutide lost 5% of their body weight over the course of the study. While this result is consistent with previous research, Hendershot noted the need to evaluate potential side effects, particularly in individuals with lower BMIs.

The study did have several important limitations. It was small, lasted only nine weeks, and was conducted in a controlled setting that may not fully reflect real-world drinking behaviors.

Additionally, because participants were not actively trying to reduce their alcohol consumption, their motivation—or lack of it—could have influenced the results, Henderson implied.

Still, the findings suggest semaglutide could play a role in reshaping addiction treatment. According to the National Institutes of Health, only three medications are currently FDA-approved to treat alcohol dependence, and many individuals with the condition never receive any treatment.

In 2023, more than 2 million people had alcohol use disorder, yet only about 8% received treatment.

''If semaglutide proves to be a better option than the three FDA-approved drugs that are currently in use, this would be a huge breakthrough for many,'' Widmer said.

Dr. Christopher Wachuku is an internal medicine preliminary intern at Lankenau Medical Center and a member of the ABC News Medical Unit.