GLP-1 Medications May Reduce Alcohol Cravings — Here’s What the New Research Shows

For nearly two decades, the medication cupboard for alcohol use disorder (AUD) has been mostly bare. Naltrexone has been the main option — and it helps some people, but not enough. No new medication for AUD has received FDA approval since 2006. That’s finally showing signs of changing.

A new study from researchers at the University of Colorado Anschutz — published this month in the American Journal of Psychiatry — found that oral semaglutide (the same medication sold as Wegovy for weight loss and Ozempic for diabetes) significantly reduced heavy drinking days, alcohol cravings, and alcohol-related problems in adults with moderate to severe AUD. Participants weren’t trying to quit entirely. They wanted to drink less — and the drug helped them do exactly that.

Let me walk you through what the study found and what it means for people who are looking for help.

The Study: What They Did and Who They Studied

Fifty adults with moderate to severe alcohol use disorder — people who were actively seeking help to control their drinking — were randomly assigned to receive either oral semaglutide or a placebo for eight weeks. The dose started at 3 mg daily and increased to 7 mg daily after four weeks. That’s the same formulation as the oral Wegovy pill, taken once a day on an empty stomach.

At the start of the study, participants were drinking an average of about six drinks per day and experiencing roughly five heavy drinking days per week. Almost all were classified in the highest-risk drinking categories by World Health Organization (WHO) standards.

The Results: What Actually Happened

Here are the numbers worth knowing:

Participants taking oral Wegovy cut their drinks per drinking day by roughly half, on average
81% of the semaglutide group moved to a lower World Health Organization (WHO) risk drinking category by the end of the study, compared to 54% in the placebo group
Self-reported alcohol cravings declined significantly in the treatment group
Alcohol-related problems — the kind that disrupt work, relationships, and daily life — decreased noticeably
In a small subgroup of participants who also used cannabis, marijuana use days declined as well

The drug was generally well tolerated. Participants stayed on it. Completion rates were high.

Why This Matters for Patients with Obesity

GLP-1 medications like semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) work on appetite and food cravings — but the receptors they act on are also involved in reward-seeking behavior more broadly. Alcohol activates the same reward pathways. It’s not surprising, in retrospect, that a drug quieting food cravings might also quiet alcohol cravings.

What is surprising is how consistently this effect is showing up across trials. A separate study published in The Lancet earlier this year found a 41% reduction in heavy drinking days with injectable semaglutide, compared to a 26% reduction with placebo — a meaningful gap. Earlier trials with exenatide and dulaglutide showed similar signals, particularly in patients with obesity. The CU Anschutz study is the first to demonstrate it with the oral formulation in treatment-seeking adults with AUD.

The Naltrexone Comparison

Naltrexone remains the most commonly prescribed AUD medication. It’s a good option — and significantly less expensive than GLP-1 medications. It works for some people, but it has real limitations: it reduces cravings in only a subset of patients, it can’t be used in people with liver disease (which is common in heavy drinkers), and adherence is often poor.

Oral Wegovy sidesteps several of these problems. It doesn’t harm the liver — in fact, semaglutide has been approved to treat metabolic dysfunction-associated steatohepatitis (MASH), a form of liver disease. That’s a meaningful clinical difference for a population where liver disease is prevalent.

What This Doesn’t Mean

Oral Wegovy is not a cure for AUD. Participants were not more likely to achieve complete abstinence than those on placebo, and most were not aiming for abstinence — they wanted to drink with more control, which is a different and more common goal.

We also don’t know what happens after people stop taking it. The longest study so far ran for six months. No one has done systematic follow-up after discontinuation. AUD is a chronic condition — like hypertension or diabetes — and it may require ongoing treatment. That isn’t a weakness of the approach. It’s how most chronic diseases work.

The Bottom Line

This is Phase 2 data — promising, not definitive. But it’s consistent with a growing body of evidence that GLP-1 medications have effects beyond appetite. If you or someone you know is looking to cut back on drinking and hasn’t found the right fit in existing treatments, this is a research area worth discussing with a knowledgeable physician.

At Clinical Nutrition Center, we follow the GLP-1 literature closely. We can’t prescribe for AUD specifically — that’s a different indication — but we do prescribe Wegovy, Zepbound, Foundayo, and other GLP-1 medications for weight management, and we stay current on what these medications can do.

If you’re in the Denver area and want to explore whether a GLP-1 medication is right for you, give us a call — (303) 750-9454.

Dr. Ethan Lazarus, MD, MFOMA
Clinical Nutrition Center
7780 S. Broadway, Suite 100, Greenwood Village, CO 80112
(303) 750-9454