Adults with alcohol use disorder (AUD) and comorbid obesity who took once-weekly semaglutide significantly reduced their overall alcohol consumption and heavy drinking, according to landmark trial results issued yesterday by The Lancet.Why It’s Relevant
Alcohol is a leading contributor to mortality worldwide, and there is a pressing need for new therapeutic interventions. GLP-1 receptor agonists have shown promising results in preclinical models of alcohol addiction, as well as in analyses of health registries.
By The Numbers
- Researchers randomized 108 treatment-seeking adults ages 18 to 70 with AUD and comorbid obesity (BMI of 30 or greater) to receive subcutaneous semaglutide (up to 2.4 mg/week) or placebo for six months. Both groups were also offered cognitive behavioral therapy.
- At six months, adults taking semaglutide reported five heavy drinking days in the past month (from a baseline of 17 days), compared with nine heavy drinking days among the placebo group.
- The semaglutide group also reported significantly greater reductions over placebo in total alcohol consumption, alcohol craving, drinks per drinking day, and on alcohol exposure biomarkers—along with expected greater reductions in bodyweight.
- Gastrointestinal side effects (nausea, loss of appetite, constipation, vomiting, etc.) occurred significantly more frequently with semaglutide, but the researchers noted that this was generally mild and transient.
What’s More
Based on available data, semaglutide significantly increased the likelihood of participants achieving a two-level reduction in risk drinking level (as defined by the WHO) than currently approved AUD medications such as acamprosate or naltrexone.
The Other Side
Many participants likely guessed their treatment due to the presence or absence of gastrointestinal side effects or weight loss; this led to a higher dropout rate in the placebo group and may have distorted the true treatment difference. Additional trials in non-obese patients are needed before the results can be generalized to the overall population of individuals with AUD.
Takeaway Message
The findings from this trial provide support for broadening the indication for semaglutide to AUD in patients with a BMI of 30 or higher, which could potentially benefit the 8 million individuals in the U.S. who have both obesity and high consumption of alcohol, the researchers wrote.
Related Information
Source
Mette Kruse Klausen, et al. Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomized, double-blind, placebo-controlled trial. The Lancet. Published April 30, 2026. doi: 10.17632/fr522rsvyp
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