Episode #192: Alcohol and GLP’s: Why You Suddenly May Not Want to Drink
Have you noticed that alcohol suddenly doesn’t sound as appealing since starting a GLP-1 medication? Maybe you used to look forward to a glass of wine at the end of the day, but now you barely think about it. Or perhaps you’ve tried drinking and discovered that you can’t finish your usual drink, or that alcohol leaves you feeling nauseated, overly full, or just plain awful. These are experiences I hear about frequently from patients taking medications like Wegovy, Ozempic, Zepbound, and Mounjaro.
In this episode of Conquer Your Weight, we’re talking about the relationship between GLP-1 medications and alcohol. We’ll explore why alcohol cravings may decrease, why some people suddenly lose interest in drinking altogether, and why alcohol may be harder to tolerate while taking these medications. We’ll also talk about the emerging research looking at GLP-1 medications and alcohol use, including the fascinating possibility that the same pathways that quiet “food noise” may also quiet what we might call “drinking noise.”
Finally, we’ll answer one of the most common questions I hear: Is it safe to drink alcohol while taking a GLP-1 medication? We’ll discuss why there isn’t one answer that applies to everyone, what factors you should consider before drinking, and why your previous alcohol tolerance may not be the same after starting a GLP-1. Whether alcohol has completely lost its appeal or you’re simply wondering how an occasional drink fits into your treatment, this episode will help you understand what may be happening and what we’re learning about the broader effects of these medications on cravings and reward.
Ready to get started on your weight loss journey? We’re now enrolling patients for in-person visits in Charlottesville, Virginia and for telemedicine throughout the states of Illinois, Tennessee, and Virginia. Learn more and get started today at https://www.sarahstombaughmd.com
If you’re looking for support during your GLP journey, check out The GLP Guide. This on-demand video program will give you answers to the questions you have! Get started today at https://www.sarahstombaughmd.com/glp
Transcript
Dr. Sarah Stombaugh:
This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight Podcast.
Announcer:
Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here’s your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh.
Dr. Sarah Stombaugh:
One of the things that really surprises people when they start a GLP medication is realizing that alcohol just doesn’t taste the same as it did before they started their GLP. And so today, that’s exactly what we’re going to be talking about, recognizing that alcohol and GLP medications, do they mix, do they not mix? And what is the role of how those two things interact? We’re going to talk about why alcohol might be suddenly unappealing while some people feel really sick when they’re drinking. What is the role that GLP medications have in reducing cravings, particularly for alcohol? Is it even safe to drink when you’re on a GLP medication? And is there potentially a role for these medications in the future for substance use disorders, especially alcohol use disorder? So this is something we are going to dive into. I am Dr. Sarah Stombaugh, board certified obesity medicine physician.
And genuinely, I think this is one of the biggest surprises. I don’t actually always warn my patients that this effect might come up or at least we’re not talking about it in a very in-depth way and it catches people off guard. Sometimes people notice that alcohol just doesn’t taste the same anymore. So they’ve been poured a glass of wine, maybe their favorite wine or their favorite beer, and they taste it and it just doesn’t quite have the same taste or the same appeal that it did before they still had their GLP medication. Or sometimes that they get poured at that beverage, it’s sitting in front of them, they have a few sips, but they realize they leave half the glass behind, that they’re not actually desiring or finishing their beverages. Or on the other hand, sometimes we’re just in habits, we drink as much as we usually would, and then afterwards people realize, oh my gosh, I feel pretty miserable and it surprised me.
So these are not all the exact same mechanism. And let’s talk about how alcohol and GLPs interact. So I think one of the things we’ve been hearing a lot with the GLP medications is the description of food noise where we’re thinking about food all of the time, almost even intrusive thoughts where before a meal, after a meal, thinking about vacation, what’s for dinner tonight? Are there snacks in my pantry? We’re thinking about food all of the time. Very commonly, this comes up actually in the same way with alcohol where people, especially maybe in the afternoons, in the evenings when they’re going out, when they might typically be having alcohol, that they start thinking about it, oh, I have that bottle of wine in the refrigerator. Oh, I bet that would taste really good with this dinner, that they have this desire, this food noise also experiences alcohol noise.
And what’s really fascinating is that gets turned down significantly. It’s the exact same pathway, whether we’re talking about food noise, whether we’re talking about alcohol noise, that gets turned down really significantly. And this is really thought to be because of the role that GLP has in the brain in the reward, the dopaminergic centers of our brain. So that gets turned down really significantly and those cravings and thoughts just aren’t there in the same way that they were before. We also see, you’ve probably heard some conversations about people using medications like the GLPs for the treatments of substance use disorders and alcohol use disorders. And actually last year in JAMA Psychiatry, they published, it was a really small trial. There were 48 participants and they were randomized to take semaglutide. So that’s the active ingredient in Ozempic or Wegovy versus placebo to see what effect did that have on alcohol intake during that time.
And these were people who had alcohol use disorder and they were looking at how many days of the week did they drink, when they did drink, how much did they have, what were their cravings and desires? And what’s really interesting was that they observed that patients, even though they actually drank a very similar number of days, when they did drink, they had much lower alcohol cravings when they did drink. So on those days that they were drinking, there were fewer drinks that were consumed and there were greater reductions in heavy drinking over time. So this gives us this really interesting proof of concept that these medications can have effects beyond just the use of metabolic disease like obesity or diabetes. And there’s been a lot of conversation about using medications in this way. Now, even if people don’t feel like they have a problem with alcohol, they might be thinking or recognizing, okay, that is calories that my body doesn’t necessarily need, or do I need as much alcohol as I’m currently consuming?
And it can be really surprising when this starts dialing back. And so people recognizing that maybe I’m drinking less often. When I am drinking, I’m drinking a smaller amount. And some people recognize that when they’re drinking, it actually just makes them feel pretty badly. So we talked about the effect of the GLP medication in the brain. There is of course an effect of these medications in the GI system as well. One well-known effect of these medications is they can cause things like nausea. They can cause things like slowed gastric emptying. And you can think about, especially if you’ve had maybe a heavy meal, if you add alcohol on top of that, you’re already dealing with a little bit of nausea, you’re dealing with that feeling of over fullness, or things like alcohol, for example, can really just worsen that. So I have a lot of times people feel like their effects of their GLP or their side effects rather of their GLP are much more significant or very commonly people recognizing that because of the way that the GLP is making them eat or making them drink just regular hydration, maybe they’re eating less food, they’re having less water, they’re consuming a lot less in that sense, that having alcohol on top of that, it hits them a lot harder.
So sometimes people realize, “Oh my gosh, I got tipsy or I got even drunk after just a couple of drinks.” And so I’m always telling people to be mindful of the amount of alcohol that they consume, especially if that’s an amount that they feel like they’ve tolerated in the past. That same amount might hit them a little bit harder. They may recognize that they get drunk or tipsy sooner. So especially want to be careful in work settings or any settings, you don’t want to embarrass yourself, but also recognizing there’s that potential for worsening of some of those GI side effects. So people ask, “Well, okay. Okay, Dr. Stombaugh, but can I drink?” The short answer is probably yes. Most people can drink when they’re on a GLP medication, but you want to be really mindful of your consumption of alcohol. Make sure you’re mindful of are you adequately hydrated?
Are you pairing your alcohol with a meal? Are you mindful of the side effects that you’re having already? Are you being careful not to over-consume? But yes, it is safe to have some alcohol alongside a GLP medication for most people. Now, there may be people who have health issues like gallbladder disease or pancreatitis for whom that is not a good idea anyway. So I definitely encourage you to have this conversation one-on-one with your individual physician. But the short answer is most people can drink, just do it intentionally because it might hit you a little bit harder than it otherwise would have and might exacerbate some of those GI side effects. But if you are someone who realizes alcohol has become part of your daily routine, maybe you’re having a nightly glass of wine or recognize that when you’re out to dinner you have two, three, or four beverages without really meaning or intending to, it can be incredibly powerful to see the role of GLP medications for these patients.
And alongside some of the reductions in the amount of food or the types of food that they’re eating, seeing some of those reductions in alcohol as well can be a really powerful way to help support their weight loss goals. If you are looking for a physician to support you in this way, I would love to be that person. I see patients in person in Charlottesville, Virginia and throughout the states of Illinois, Tennessee, and Virginia by telemedicine. To learn more, visit www.sarahstombaughmd.com. Thank you for joining us for this week’s episode. See you all next time.