Is there such a thing as a healthy relationship with alcohol?

This is possible although many would disagree. The medical position is that there is no level of alcohol consumption that is safe. If the occasional drink brings joy then it is simply a question of balancing the pros and cons. The problem is that for many of us, those scales are not very accurate.

How much alcohol is considered too much?

There is no single threshold at which alcohol suddenly becomes harmful, but risk increases as consumption increases. In the UK, current guidelines suggest keeping intake below 14 units per week, spread over several days, as a way of limiting long-term health risks rather than guaranteeing safety.

What is Why We Drink Too Much about?

Why We Drink Too Much explores the biological, psychological, and cultural reasons humans consume alcohol. The book combines scientific research with personal insight to examine our complex relationship with drinking.

Can you be healthy and still drink alcohol?

Health exists on a spectrum, and many people who drink alcohol also engage in healthy behaviours. However, alcohol offers no health benefit of its own, and its effects need to be considered alongside sleep, diet, exercise, and mental wellbeing.

Can GLP-1 Weight-Loss Medications Treat Alcohol Use Disorder?

12 Jul

Written By Annie Knowles

Citation

Klausen M, Justesen S, Pedersen J et al.

Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial.

The Lancet. 2026;407:1687–1698.

DOI: 10.1016/S0140-6736(26)00305-3

Each month, I review an important new alcohol research paper, separating the evidence from the headlines and explaining what the findings really mean.

Why This Paper Matters

For several years, there has been growing interest in whether GLP-1 receptor agonists - better known as weight-loss medications, such as semaglutide or Wegovy, might also reduce alcohol consumption.

It may seem surprising at first. These medications do not simply reduce appetite. They also appear to influence areas of the brain involved in reward, motivation and craving.

Animal studies and early human research have suggested that they may reduce interest in alcohol. This study provides the strongest clinical evidence so far.

Study at a Glance

Who took part?
108 adults with obesity and alcohol use disorder. Their average age was 52, and approximately 85% met the criteria for severe alcohol use disorder.

Study design
A randomised, double-blind, placebo-controlled clinical trial.

What treatment did they receive?
Half received weekly semaglutide injections and half received placebo injections. All participants also received cognitive behavioural therapy.

What was the main question?
Whether semaglutide reduced the number of heavy drinking days compared with placebo.

What Did the Researchers Find?

Heavy drinking days fell

Participants receiving semaglutide reduced their heavy drinking days by 41% from the start of the study, compared with a 26% reduction in the placebo group.

Other alcohol-related measures improved

Participants taking semaglutide also showed improvements in several other measures, including overall alcohol consumption, alcohol craving, AUDIT scores and some markers of liver function. The fact that several measures moved in the same direction adds weight to the main finding.

Participants lost more weight

As expected, participants receiving semaglutide lost more weight than those receiving placebo.

Side effects were generally manageable

The medication was generally well tolerated. The most common side effects were gastrointestinal problems such as nausea and stomach upset, which are already well recognised with GLP-1 medications.

Study limitations

Although the results are encouraging, there are some important limitations.

The study only included people who had both obesity and alcohol use disorder. We therefore cannot assume that the same results would be seen in people who are not overweight.

Everyone in the study also received cognitive behavioural therapy. This means the trial tested semaglutide as an addition to psychological treatment, not as a replacement for it.

The study included 108 participants, so larger trials and longer follow-up will be needed before semaglutide could become a routine treatment for alcohol use disorder.

Why This Matters

For more than a decade, research has suggested that GLP-1 medications may affect more than appetite. They appear to influence brain systems involved in reward and motivation, the same systems that play an important role in alcohol use disorder.

This trial provides the first high-quality clinical evidence that targeting these pathways may reduce heavy drinking in people with alcohol use disorder and obesity.

Current medication options for alcohol use disorder are relatively limited and do not work equally well for everyone. If future trials confirm these findings, GLP-1 medications could become a valuable addition to existing treatments.

The study also reinforces an important principle: alcohol use disorder is not simply a failure of willpower. It involves changes in brain systems involved in learning, reward and craving, which is why treatments that act on these systems may help.

Charles's View

I discussed the growing interest in GLP-1 medications in Why We Drink Too Much, before randomised clinical trial evidence was available.

This study is an important milestone. It supports the theory that these medications can influence alcohol-related reward and craving as well as appetite.

It is still too early to consider semaglutide an established treatment for alcohol use disorder, and the results apply specifically to people with obesity. Nevertheless, I suspect this is the beginning of an important new direction in alcohol treatment research.

Key Takeaway

Semaglutide reduced heavy drinking in people with alcohol use disorder and obesity when used alongside cognitive behavioural therapy.

It is not yet a stand-alone treatment or a cure, but this trial provides the strongest evidence so far that GLP-1 medications may have a future role in alcohol treatment.

Reference

Klausen M, Justesen S, Pedersen J et al. Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial. The Lancet. 2026;407:1687–1698.

DOI: 10.1016/S0140-6736(26)00305-3

Annie Knowles