Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity

Abstract

Alcohol Use Disorder (AUD) contributes significantly to global mortality. GLP-1 (Glucagon-like peptide-1) and GLP-1/GIP (Glucose-dependent Insulinotropic Polypeptide) agonists, FDA-approved for managing type 2 diabetes and obesity, where the former has shown to effectively reduce the consumption of alcohol in animal models but no reports exist on the latter. In this report, we conducted two studies. In the first study, we conducted an analysis of abundant social media texts. Specifically, a machine-learning based attribution mapping of ~ 68,250 posts related to GLP-1 or GLP-1/GIP agonists on the Reddit platform. Secondly, we recruited participants (n = 153; current alcohol drinkers; BMI ≥ 30) who self-reported either taking Semaglutide (GLP-1 agonist), Tirzepatide (the GLP-1/GIP combination) for ≥ 30 days or, as a control group; no medication to manage diabetes or weight loss for a within and between subject remote study. In the social media study, we report 8 major themes including effects of medications (30%); diabetes (21%); and Weight loss and obesity (19%). Among the alcohol-related posts (n = 1580), 71% were identified as craving reduction, decreased desire to drink, and other negative effects. In the remote study, we observe a significantly lower self-reported intake of alcohol, drinks per drinking episode, binge drinking odds, Alcohol Use Disorders Identification Test (AUDIT) scores, and stimulating, and sedative effects in the Semaglutide or Tirzepatide group when compared to prior to starting medication timepoint (within-subjects) and the control group (between-subjects). In summary, we provide initial real-world evidence of reduced alcohol consumption in people with obesity taking Semaglutide or Tirzepatide medications, suggesting potential efficacy for treatment in AUD comorbid with obesity.

Figure 1

Final optimized clusters. Shown are the final optimized clusters obtained for our sample. (A) a scatterplot visualized by the UMAP model, we see the two UMAP components denoted as UMAPx and UMAPy represent the x and y axis of the scatter plot, with different colors to show the different clusters. (B) the distribution of posts into each of these clusters with corresponding colors.

Figure 2

Underlying features obtained by training a supervised learning-based Random forest binary classifier. All clusters are identified by unique underlying features, as evident by the output (A–H).

Figure 3

Alcohol related word tree. Prefixes from effects of medications cluster generated for the keyword “alcohol”. Any phrases related to a decrease/change in alcohol consumption or effects on alcohol are highlighted with red. It is evident that most alcohol-related posts point towards reduced alcohol usage.

Figure 4

Alcohol related word tree. Suffixes from effects of medications cluster generated for the keyword “alcohol”. Any phrases related to a decrease/change in alcohol consumption or effects on alcohol are highlighted with red. It is evident that most alcohol-related posts point towards reduced alcohol usage.

Figure 5

Optimum clusters full order partial correlation matrix with p values. Figure shows 8 unique GLP-1 post themes. Green arrows indicate a positive correlation between themes while a red arrow indicates a negative correlation between themes. The background color represents the p value, ranging from 0: white, to 1: dark blue.

Figure 6

The remote study provides strong converging evidence of reduced alcohol use. (A) Incidence Rate Ratio of Average drinks calculated from the past 30 days Timeline Follow Back, as calculated by the lme4 package using the poisson distribution. (B) Odds Ratio of binge drinking over the past 30 days (binomial distribution, 0; no binge, 1; binge) Males (> 5 drinks), Females (> 4 drinks). (A, B) Grey diamonds represent the estimated incidence rate or odds ratio and the error bars are 95% confidence intervals. Findings are significant, since the 95% CI do not encompass 1. Comparison of (C) average drinks per episode of use (D) AUDIT scores (E) Sedative effects and (F) Stimulative effects of alcohol within and between groups. A significant reduction is seen both within (Before and after starting medications) and between (control vs. medication) groups for all four measures. Solid circles represent mean and the error bars are standard error of means. Significantly different points are denoted by different letters.

Figure 7

Data exploration and finalization. (A) Distribution of posts and users across top 25 subreddits. (B) Time-series of daily post count and cumulative post count between 2009 and 2023. Overall, we observe a large influx of posts in recent years, with most posts coming from January 2022 to July 2023. These posts largely came from the top 25 subreddits (89% of total posts), notably from subreddits with a focus specifically on GLP-1 and Tirzepatide.