Return-Path: Received: from [2607:fb90:e214:dabd::f0:ffff] ([2607:fb90:e214:dabd:a498:7c45:d08e:651b]) by smtp.gmail.com with ESMTPSA id 00721157ae682-7bd6688c99bsm10725937b3.45.2026.05.01.06.18.27 for (version=TLS1_2 cipher=ECDHE-ECDSA-AES128-GCM-SHA256 bits=128/128); Fri, 01 May 2026 06:18:27 -0700 (PDT) Date: Fri, 1 May 2026 09:18:21 -0400 From: tjphuhs@gmail.com To: "=?utf-8?Q?oc.tjphuhs=40gmail.com?=" Message-ID: In-Reply-To: <20260501113147.3.b534ca94b959b059@mg2.substack.com> References: <20260501113147.3.b534ca94b959b059@mg2.substack.com> Subject: Fwd: Semaglutide and Alcohol: A New Study in The Lancet is Worthy of Attention X-Readdle-Message-ID: c8c79b25-984f-44dd-80fc-a9bcf3bc2181@Spark MIME-Version: 1.0 Content-Type: multipart/alternative; boundary="69f4a822_d2dec81_ba01" --69f4a822_d2dec81_ba01 Content-Type: text/plain; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Disposition: inline ---------- =46orwarded message ---------- =46rom: Dave Knapp from On The Pen Date: May 1, 2026 at 7:34=E2=80=AFAM -0400 To: tjphuhs=40gmail.com Subject: Semaglutide and Alcohol: A New Study in The Lancet is Worthy of = Attention > Anecdotes are slowly becoming science > =CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0= =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2= =AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2= =A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87= =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F= =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80= =87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD= =8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2= =80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD= =CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0= =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 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=C2=AD=CD=8F =C2=A0= =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2= =AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2= =A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87= =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F= =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80= =87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD= =8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2= =80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD= =CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0= =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2= =AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2= =A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87= =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F= =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80= =87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD= =8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2= =80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD= =CD=8F =C2=A0 =E2=80=87 =C2=AD=CD=8F =C2=A0 =E2=80=87 =C2=AD > =46orwarded this email=3F Subscribe here for more > Semaglutide and Alcohol: A New Study in The Lancet is Worthy of Attenti= on > Anecdotes are slowly becoming science > On The Pen GLP-1 News > May 1 > > READ IN APP > > There=E2=80=99s a particular kind of exhaustion that comes with alcohol= use disorder. Not just the physical kind, though that=E2=80=99s real too= . I=E2=80=99m talking the kind that settles into your bones after years o= f trying, having minimal success, and trying again. After being told, in = ways spoken and unspoken, that the problem was really just a lack of will= power. That if you really wanted it badly enough, you=E2=80=99d find your= way out eventually. Sound familiar=3F > If you=E2=80=99ve lived inside the obesity fight, you know this cycle a= ll too well. The same cycle of white knuckle effort and utter disappointm= ent. The same medical shrug. The same story that put the weight of a biol= ogical condition squarely on the shoulders of the person carrying it. Two= different diagnoses. The same long loneliness. This week, the condition = that has been waiting even longer for a real pharmacological answer got s= ome news. And the drug at the center of it is one you already well know. > Researchers in Copenhagen just published a randomized controlled trial = in The Lancet, one of the most respected medical journals in the world, t= esting whether semaglutide, the active ingredient in Wegovy and Ozempic, = could reduce heavy drinking in people with alcohol use disorder. The resu= lts were clear enough that they=E2=80=99ll be difficult for the medical c= ommunity to set aside. People in the study who received weekly semaglutid= e injections reduced their heavy drinking days by 41% over six months. Pe= ople who received a placebo, a salt water injection, reduced theirs by 26= %. That gap, roughly 14 percentage points, is statistically robust and cl= inically meaningful. Semaglutide didn=E2=80=99t just help a little. It he= lped in a way that showed up clearly against a control group that was als= o receiving therapy and weekly check-ins, conditions that already tend to= move the needle on their own. In the obesity world, we call those =E2=80= =9Clifestyle modifications=E2=80=9D. > Lancet Study: Semaglutide vs Pacebo for ... > 954KB =E2=88=99 PD=46 file > Download > The trial enrolled 108 people, split evenly between the drug and placeb= o. Everyone received cognitive behavioral therapy across the 26 weeks. By= the end, the people on semaglutide were not only having fewer heavy drin= king days. They were also drinking less per drinking day, reporting signi= ficantly less craving, showing improved liver enzyme numbers, and losing = considerably more weight than the placebo group. > =46or decades, the =46DA has approved exactly three medications for alc= ohol use disorder: disulfiram, acamprosate, and naltrexone. Three medicat= ions for a condition that accounts for 5% of deaths worldwide every year.= Those medications help some people, and that certainly matters. It matte= rs in the same way that phentermine and orlistat mattered to obesity. A u= seful way to think about how well a treatment works is something called t= he number needed to treat, which captures how many people have to take th= e drug for one person to meaningfully benefit. =46or the existing approve= d medications, that number sits at 7 or higher. =46or semaglutide in this= trial, it was 4.3. That gap represents real people, and real outcomes th= at currently aren=E2=80=99t happening for them. > What makes this study harder to dismiss than a self-reported survey alo= ne is that the researchers also measured a blood biomarker called phospha= tidylethanol, which reflects actual alcohol intake independent of what pe= ople say. Drinking diaries and questionnaires are useful, but they carry = the weight of memory and motivation. The biomarker confirmed what the sel= f-reports showed, and that convergence matters. When two different kinds = of evidence point in the same direction, the signal gets stronger. > This study enrolled people who were obese, BMI of 30 or above, because = prior research suggested GLP-1 medications might work better in that popu= lation. That means we don=E2=80=99t yet know whether the same effect hold= s for people with AUD who aren=E2=80=99t carrying extra weight, and that=E2= =80=99s a meaningful gap given how many people live with alcohol use diso= rder across a wide range of body types. The trial also ran only 26 weeks,= with no follow-up data collected after it ended, so there=E2=80=99s no w= ay to know yet whether the gains hold a year out, or what happens when so= meone stops the drug. Side effects were real and worth naming honestly. M= ore than half of the people on semaglutide experienced nausea, along with= constipation, reflux, and fatigue at higher rates than the placebo group= . Most of those effects were temporary and mild to moderate, but this is = not a medication that asks nothing of your body. And it bears repeating t= hat this was one trial, 108 people, in one city in Denmark, with a study = population that was predominantly White. The researchers themselves are c= areful to say that larger, more diverse studies are needed before anyone = should consider using this drug off-label for AUD. > Upgrade to paid > This is just the beginning. Eli Lilly has a dual GLP-1/GIP co-agonist c= alled brenipatide that is being looked at for a whole host of nueralogica= l disorders. A large phase 3 trial with a potential submission for approv= al and an actual indication will begin this year. The incretin class of m= edications are serving up hope to many people fighting various addictions= . > There are an estimated 8 million Americans living with both obesity and= problematic alcohol use. =46or them, a drug already prescribed and in ma= ny cases covered for weight loss may be doing something else quietly. Des= pite several years of anecdotal evidience, science is now meaningfully ca= tching up to the potential benefits of these medications. =46or the broad= er population of people with AUD, this study adds meaningful weight to a = growing body of evidence that GLP-1 receptor agonists deserve serious inv= estigation as a treatment for addiction, not just metabolism. The door ha= s been stuck for a very long time. This research doesn=E2=80=99t fling it= open, but it moves it. And for people who have been pushing on it for ye= ars, that is not nothing. > VISIT OUR SPONSORS=21 > You=E2=80=99re currently a free subscriber to On The Pen. =46or premium= access to insider articles, upgrade to paid. > Upgrade to paid > > Share > > > Like > Comment > Restack > > =C2=A9 2026 David Knapp > On The Pen, PO Box 541, Cedar =46alls, IA 50613 > Unsubscribe --69f4a822_d2dec81_ba01 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Disposition: inline
---------- =46orwarded message ----= ------
=46rom: Dave Knapp from On The Pen <onthepen=40substack.com>=
Date: May 1, 2026 at 7:34=E2=80=AFAM -0400
To: tjphuhs=40gmail.com
Subject: Semaglutide and Alcohol: A New Study in The Lancet is Wor= thy of Attention

3D=22=22
Anecdotes are slowly becoming science
=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23= 160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80= =87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD= =CD=8F &=23160; =E2=80=87 =C2=AD=CD=8F &=23160; =E2=80=87 =C2=AD
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S= emaglutide and Alcohol: A New Study in The Lancet is Worthy of Attention<= /a>

Anecdotes are slowly becoming science

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There=E2=80=99s a particular kind of exhaustion that c= omes with alcohol use disorder. Not just the physical kind, though that=E2= =80=99s real too. I=E2=80=99m talking the kind that settles into your bon= es after years of trying, having minimal success, and trying again. After= being told, in ways spoken and unspoken, that the problem was really jus= t a lack of willpower. That if you really wanted it badly enough, you=E2=80= =99d find your way out eventually. Sound familiar=3F

If you=E2=80=99ve lived inside the obesity fight, you = know this cycle all too well. The same cycle of white knuckle effort and = utter disappointment. The same medical shrug. The same story that put the= weight of a biological condition squarely on the shoulders of the person= carrying it. Two different diagnoses. The same long loneliness. This wee= k, the condition that has been waiting even longer for a real pharmacolog= ical answer got some news. And the drug at the center of it is one you al= ready well know.

Researchers in Copenhagen just published a rando= mized controlled trial in The Lancet, one of the most respected medi= cal journals in the world, testing whether semaglutide, the active ingred= ient in Wegovy and Ozempic, could reduce heavy drinking in people with al= cohol use disorder. The results were clear enough that they=E2=80=99ll be= difficult for the medical community to set aside. People in the study wh= o received weekly semaglutide injections reduced their heavy drinking day= s by 41% over six months. People who received a placebo, a salt water inj= ection, reduced theirs by 26%. That gap, roughly 14 percentage points, is= statistically robust and clinically meaningful. Semaglutide didn=E2=80=99= t just help a little. It helped in a way that showed up clearly against a= control group that was also receiving therapy and weekly check-ins, cond= itions that already tend to move the needle on their own. In the obesity = world, we call those =E2=80=9Clifestyle modifications=E2=80=9D.
Lancet Study: Semaglutide vs Pacebo for ...
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The trial enrolled 108 people, split evenly between th= e drug and placebo. Everyone received cognitive behavioral therapy across= the 26 weeks. By the end, the people on semaglutide were not only having= fewer heavy drinking days. They were also drinking less per drinking day= , reporting significantly less craving, showing improved liver enzyme num= bers, and losing considerably more weight than the placebo group.

=46or decades, the =46DA has approved exactly three me= dications for alcohol use disorder: disulfiram, acamprosate, and naltrexo= ne. Three medications for a condition that accounts for 5% of deaths worl= dwide every year. Those medications help some people, and that certainly = matters. It matters in the same way that phentermine and orlistat mattere= d to obesity. A useful way to think about how well a treatment works is s= omething called the number needed to treat, which captures how many peopl= e have to take the drug for one person to meaningfully benefit. =46or the= existing approved medications, that number sits at 7 or higher. =46or se= maglutide in this trial, it was 4.3. That gap represents real people, and= real outcomes that currently aren=E2=80=99t happening for them.

What makes this study harder to dismiss than a self-re= ported survey alone is that the researchers also measured a blood biomark= er called phosphatidylethanol, which reflects actual alcohol intake indep= endent of what people say. Drinking diaries and questionnaires are useful= , but they carry the weight of memory and motivation. The biomarker confi= rmed what the self-reports showed, and that convergence matters. When two= different kinds of evidence point in the same direction, the signal gets= stronger.

This study enrolled people who were obese, BMI of 30 o= r above, because prior research suggested GLP-1 medications might work be= tter in that population. That means we don=E2=80=99t yet know whether the= same effect holds for people with AUD who aren=E2=80=99t carrying extra = weight, and that=E2=80=99s a meaningful gap given how many people live wi= th alcohol use disorder across a wide range of body types. The trial also= ran only 26 weeks, with no follow-up data collected after it ended, so t= here=E2=80=99s no way to know yet whether the gains hold a year out, or w= hat happens when someone stops the drug. Side effects were real and worth= naming honestly. More than half of the people on semaglutide experienced= nausea, along with constipation, reflux, and fatigue at higher rates tha= n the placebo group. Most of those effects were temporary and mild to mod= erate, but this is not a medication that asks nothing of your body. And i= t bears repeating that this was one trial, 108 people, in one city in Den= mark, with a study population that was predominantly White. The researche= rs themselves are careful to say that larger, more diverse studies are ne= eded before anyone should consider using this drug off-label for AUD.

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This is just the beginning. Eli Lilly has a dual GLP-1= /GIP co-agonist called brenipatide that is being looked at for a whole ho= st of nueralogical disorders. A large phase 3 trial with a potential subm= ission for approval and an actual indication will begin this year. The in= cretin class of medications are serving up hope to many people fighting v= arious addictions.

There are an estimated 8 million Amer= icans living with both obesity and problematic alcohol use. =46or them, a= drug already prescribed and in many cases covered for weight loss may be= doing something else quietly. Despite several years of anecdotal evidien= ce, science is now meaningfully catching up to the potential benefits of = these medications. =46or the broader population of people with AUD, this = study adds meaningful weight to a growing body of evidence that GLP-1 rec= eptor agonists deserve serious investigation as a treatment for addiction= , not just metabolism. The door has been stuck for a very long time. This= research doesn=E2=80=99t fling it open, but it moves it. And for people = who have been pushing on it for years, that is not nothing.

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