Men prescribed semaglutide for obesity saw a dramatic reduction in alcohol consumption over 10 months, adding new real-world evidence to the idea that GLP-1 drugs can help curb alcohol cravings and highlighting the need for better screening in primary care.
Case study: The role of glucagon-like peptide-1 receptor agonists in promoting meaningful improvement in alcohol use disorder. Image credit: Love Employee / Shutterstock
In a recent study published in Primary Care and Community Health Journalresearchers detail a 10-month case report of a 34-year-old man with comorbid class 2 obesity and alcohol use disorder (AUD).
This case study revealed that after administering semaglutide, patients’ Alcohol Use Disorders Identification Test (AUDIT) scores decreased by 20 points and their alcohol use, including binge drinking episodes, decreased significantly.
These findings add to a growing body of evidence suggesting that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may modulate the human reward system by interacting with receptors in brain regions associated with dopamine signaling.
background
Alcohol use disorder (AUD) is an increasingly prevalent global public health challenge. According to U.S. government records, the condition affects about 29 million Americans, out of about 133 million alcohol consumers in the country. Despite more than 60 million Americans reporting binge drinking, data studies highlight that access to treatment remains sociodemographically uneven and geographically dispersed.
Current statistics show that less than 10% of people diagnosed with AUD receive any treatment, and only 2% utilize evidence-based medications. Previous studies investigating the limitations of conventional AUD treatments have highlighted that a major barrier to pharmacological efficacy is the need for intensive behavioral involvement, which is frequently observed to impede long-term adherence.
At the same time, a growing body of evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) can cross the blood-brain barrier (BBB) and interact with reward and dopamine signaling regions of the brain, leading researchers to hypothesize that these originally weight management-centered drugs could be used to address addictive behaviors, particularly with regard to inhibition of ethanol-seeking induction.
About research
This study is a detailed case study description of a 34-year-old man who was referred to a family medicine clinic for pharmacotherapeutic management of class 2 obesity and hypogonadism. Clinical evaluation of the patient revealed that his clinical profile was complicated by several comorbidities, including bipolar disorder, generalized anxiety disorder, and obstructive sleep apnea (OSA). Additionally, the patient’s baseline assessment revealed that she met 9 of the 11 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for AUD.
The primary screening tool used in this evaluation was the Alcohol Use Disorders Identification Test (AUDIT, patient baseline score = 27). It is a validated 10-item instrument used to assess several alcohol dependence-specific indicators, including drinking frequency, binge eating patterns, and alcohol-related consequences.
The pharmacological intervention in this case study was the administration of semaglutide following a standard titration protocol. Patients first received 0.25 mg subcutaneously once weekly in August 2024. By May 2025, the dose was systematically increased to a maintenance level of 2.4 mg weekly. He was also started on testosterone 100 mg intramuscularly once a week for hypogonadism.
The primary outcomes of interest in this study (monitored over a 10-month follow-up period) included change from baseline in body mass index (BMI), AUDIT score, and qualitative reports on craving.
Research results
A 10-month follow-up revealed clinically meaningful improvements in both metabolic and behavioral indicators. The patient’s BMI was observed to decrease from 37.0 to 28.6. What’s even more remarkable is that his alcohol intake has decreased significantly. At baseline, he consumed approximately 15 alcoholic drinks each week, but frequent binge drinking (9 or more drinks at a time) occurred.
After titrating semaglutide to 2.4 mg, his intake was reduced to approximately 0.5 beers per month, a nearly 100% reduction in volume. In addition, the patient’s AUDIT score improved from high-risk 27 to 7, a clinically significant 20-point reduction.
Of note, the clinicians noted that if his current intake pattern persisted for a full year, his predicted AUDIT score would drop to 1, indicating low risk. Most importantly, the patient reported a complete absence of alcohol withdrawal symptoms and a complete absence of “cravings to drink.”
Additionally, stabilization of his alcohol use was found to correlate with improved management of the patient’s bipolar disorder. These psychiatric improvements may reflect both reduced alcohol use and the possibility that improved mood also contributed to reduced drinking.
The paper notes that in bipolar disorder, AUD often worsens mood symptoms and increases suicide risk, but reductions in blood ethanol levels and suicide risk have not been directly measured in these patients.
conclusion
The present case study suggests the potential anti-addiction effects of semaglutide, with the drug associated with significant reductions in AUD-related craving and clinically meaningful reductions in patients’ alcohol consumption. However, while these results are convincing, the authors emphasize that this is a single-subject observation and emphasize the need for large randomized clinical trials to validate semaglutide and similar GLP-1 RAs as first-line treatments for AUD.
The authors also note that patients may not initially disclose alcohol use due to guilt and stigma, highlighting the need to strengthen AUD screening and diagnosis efforts within family medicine clinics.
Reference magazines:
- Meilinger, A., Campbell, M.A. Jr., Reynolds, H.M., and Chavez, A.S. (2026). The role of glucagon-like peptide-1 receptor agonists in promoting meaningful improvement in alcohol use disorder. Journal of Primary Care & Community Health, 17. DOI – 10.1177/21501319261437615, https://journals.sagepub.com/doi/10.1177/21501319261437615
