- Yes, in the largest trial so far: among 108 adults with alcohol use disorder and obesity, heavy drinking days fell by 41.1 percentage points on semaglutide vs 26.4 on placebo over 26 weeks.1
- Smaller trials of semaglutide found drops in some drinking measures, such as drinks per drinking day, but not in others. An older exenatide trial missed its main goal.2,3,4
- No GLP-1 medicine is approved for alcohol use disorder, and the US labels say nothing about drinking. Talk to your prescriber about alcohol.9
Why researchers think GLP-1s might affect drinking
GLP-1 receptors are found in brain areas involved in reward, not only in the gut. A 2025 joint advisory from four US nutrition and obesity societies notes that its authors see reduced cravings for alcohol, as well as for fatty and sugary food, in many patients on these medicines.8 Animal studies and large health-record studies pointed the same way. The question was whether randomized trials would confirm it.
What the randomized trials found
| Trial | Who | Main result |
|---|---|---|
| Semaglutide 2.4 mg weekly, 26 weeks (Denmark, Lancet 2026) | 108 treatment-seeking adults with moderate to severe AUD and obesity, all also receiving therapy | Heavy drinking days fell more than with placebo (difference −13.7 points) |
| Low-dose semaglutide weekly, 9 weeks (US, JAMA Psychiatry 2025) | 48 adults with AUD not seeking treatment | Less alcohol drunk in a lab test, fewer drinks per drinking day, less craving; no change in drinking days |
| Oral semaglutide daily, 8 weeks (US, Am J Psychiatry 2026) | 50 treatment-seeking adults with moderate to severe AUD | Fewer heavy drinking days; no change in lab-measured craving or drinks per day |
| Exenatide weekly, 26 weeks (Denmark, JCI Insight 2022) | 127 treatment-seeking adults with AUD, plus therapy | No overall effect on heavy drinking days |
The largest trial: semaglutide in AUD with obesity (2026)
Researchers in Copenhagen randomly assigned 108 adults (53 women, 55 men) with moderate to severe alcohol use disorder and obesity to weekly semaglutide 2.4 mg or placebo for 26 weeks. Everyone also received cognitive behavioral therapy. 81% completed the full treatment.1
The share of heavy drinking days fell by 41.1 percentage points on semaglutide and 26.4 on placebo, an estimated difference of 13.7 points. Side effects were mostly mild to moderate stomach symptoms and were more common with semaglutide.1 Note the large placebo drop: therapy and being in a trial helped too.
The first semaglutide trial (2025)
This US trial enrolled 48 adults with alcohol use disorder who were not seeking treatment; 71% were women. They received low, gradually increasing doses of semaglutide or placebo for 9 weeks. Semaglutide reduced how much alcohol people drank in a lab session, drinks per drinking day and weekly craving. It did not change average drinks per day or the number of drinking days. Among the smokers, it also predicted larger drops in cigarettes per day.2 The authors called this initial evidence that justifies larger trials.
Oral semaglutide (2026)
In 50 treatment-seeking adults with moderate to severe alcohol use disorder, 8 weeks of oral semaglutide did not reduce craving measured in the lab or drinks per day, the main outcome. It did reduce heavy drinking days, drinks per drinking day, everyday craving and alcohol-related problems compared with placebo.3
The older exenatide trial (2022)
Exenatide is an earlier, weaker GLP-1 medicine. In 127 treatment-seeking patients given exenatide or placebo for 26 weeks alongside therapy, it did not reduce heavy drinking days overall. In an exploratory analysis, it did reduce heavy drinking days and total alcohol intake in the subgroup with a BMI over 30.4 That hint is one reason the 2026 trial focused on people with obesity.
What the large observational studies show
These studies look back at health records. They cover far more people, but they show links, not cause and effect: people who get a GLP-1 may differ in ways the researchers cannot fully adjust for.
- US health records (2024). Among 83,825 patients with obesity, semaglutide was linked to a 50–56% lower risk of both first-time and recurring alcohol use disorder over 12 months, compared with other anti-obesity medicines. Similar findings came from 598,803 patients with type 2 diabetes.5
- Sweden (2025). In 227,866 people with alcohol use disorder, each compared with themselves on and off treatment, periods on semaglutide (4,321 users) were linked to a lower risk of hospitalization for alcohol use disorder (adjusted hazard ratio 0.64), and liraglutide to 0.72. Approved AUD medicines were linked to 0.98.6
- Semaglutide vs tirzepatide (2026). In adults with type 2 diabetes, starting semaglutide (hazard ratio 0.54) or tirzepatide (0.61) was linked to fewer hospital or emergency visits for alcohol use disorder than starting an SGLT2 inhibitor. The two GLP-1 medicines did not differ from each other.7
Is tirzepatide different?
For tirzepatide (Zepbound, Mounjaro), the human evidence so far is observational, like the 2026 study above. We found no published randomized trial of tirzepatide in alcohol use disorder.
Can you drink alcohol on a GLP-1? What the labels say
We checked the current US prescribing information for Wegovy, Ozempic, Zepbound and Mounjaro. None gives guidance on drinking alcohol, and none lists alcohol use disorder as an approved use.9 The labels do include warnings that may matter if you drink:
- Pancreatitis. Acute pancreatitis has been seen with GLP-1 medicines. The labels say to stop and contact a doctor if you get severe stomach pain that may spread to the back.9
- Low blood sugar. The labels warn that using these medicines with insulin or an insulin secretagogue, such as a sulfonylurea, raises the risk of hypoglycemia.9
The 2025 joint advisory adds that alcohol may worsen nausea and gastroesophageal reflux on GLP-1 therapy and should be minimized.8 See also GLP-1 nausea and stomach side effects and what to eat on a GLP-1.
Common questions
Can semaglutide reduce drinking?
In a 26-week Danish trial of 108 adults with alcohol use disorder and obesity, published in The Lancet in 2026, heavy drinking days fell by 41.1 percentage points on semaglutide 2.4 mg vs 26.4 on placebo, with everyone also getting therapy. Two smaller trials found reductions in some drinking measures but not others.
Can you drink alcohol on Ozempic or Wegovy?
The US labels for Ozempic, Wegovy, Zepbound and Mounjaro do not give guidance on drinking alcohol. A 2025 joint advisory from four US nutrition and obesity societies says alcohol may worsen nausea and reflux on GLP-1 medicines and recommends minimal intake. Whether and how much you drink is a question for your prescriber.
Does tirzepatide reduce alcohol cravings?
No randomized trial of tirzepatide (Zepbound, Mounjaro) in alcohol use disorder has been published. In a 2026 health-record study of adults with type 2 diabetes, starting tirzepatide was linked to a lower rate of alcohol-related hospital or emergency visits than an SGLT2 inhibitor (hazard ratio 0.61), but that study cannot prove cause and effect.
Are GLP-1 drugs approved for alcohol use disorder?
No. In the US, Wegovy, Ozempic, Zepbound and Mounjaro are approved for conditions such as obesity, type 2 diabetes, heart risk reduction and sleep apnea, and none of their FDA labels lists alcohol use disorder. Use for drinking is still being studied in trials.
Do GLP-1 medicines reduce alcohol cravings?
In a 9-week US trial of 48 adults with alcohol use disorder, low-dose semaglutide reduced weekly alcohol craving compared with placebo. In an 8-week trial of 50 adults, oral semaglutide reduced everyday craving but not craving measured in the lab.
Sources
- Klausen MK, Justesen SK, Pedersen JN, et al. Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial. Lancet. 2026;407(10540):1687-1698. doi:10.1016/S0140-6736(26)00305-3 · PubMed
- Hendershot CS, Bremmer MP, Paladino MB, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025;82(4):395-405. doi:10.1001/jamapsychiatry.2024.4789 · Full text (PMC)
- Schacht JP, Sakai JT, Raymond K, Shelton R. Oral Semaglutide for Alcohol Use Disorder: A Randomized Clinical Trial. Am J Psychiatry. 2026;183(9):636-645. doi:10.1176/appi.ajp.20260003 · Full text (PMC)
- Klausen MK, Jensen ME, Møller M, et al. Exenatide once weekly for alcohol use disorder investigated in a randomized, placebo-controlled clinical trial. JCI Insight. 2022;7(19):e159863. doi:10.1172/jci.insight.159863 · Full text (PMC)
- Wang W, Volkow ND, Berger NA, et al. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nat Commun. 2024;15(1):4548. doi:10.1038/s41467-024-48780-6 · Full text (PMC)
- Lähteenvuo M, Tiihonen J, Solismaa A, et al. Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder. JAMA Psychiatry. 2025;82(1):94-98. doi:10.1001/jamapsychiatry.2024.3599 · Full text (PMC)
- Tang H, Zhang B, Lu Y, et al. Semaglutide, Tirzepatide and Clinically Recorded Alcohol-Related Outcomes in Type 2 Diabetes: A Target Trial Emulation. Diabetes Obes Metab. 2026 (online ahead of print). doi:10.1111/dom.71470 · PubMed
- Mozaffarian D, Agarwal M, Aggarwal M, et al. Nutritional priorities to support GLP-1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. Obesity (Silver Spring). 2025;33(8):1475-1503. doi:10.1002/oby.24336 · Full text (PMC)
- US prescribing information: WEGOVY, OZEMPIC, ZEPBOUND and MOUNJARO (DailyMed; 2026 versions checked November 2026).
