Are GLP-1s Changing Happy Hour?

Big week. On Friday I went live on 3TV to talk about what GLP-1 medications are doing to people's drinking. And today I started taking my own advice, for real, for 90 days.

Story One · On 3TV

GLP-1s and alcohol: three things you need to know

"Doc, I just don't want alcohol much anymore." I hear some version of that all the time from patients on GLP-1 medications. On Friday I talked about why on Arizona's Family News at 3PM. If you're taking one of these medications, here's what you need to know.

One: it may really cut your interest in drinking. These medications seem to quiet the brain's reward system, for alcohol and not just food. Some people feel it more than others, and the strongest evidence so far is in people with obesity. In a 2026 Lancet trial of adults with alcohol use disorder and obesity, heavy drinking days fell 41 percentage points on semaglutide plus counseling, versus 26 points with counseling alone.

Two: alcohol may hit you differently. It can feel slower to kick in, so until you know your new limit, go slow and drink less. Nausea plus alcohol can dehydrate you fast, and if you also take insulin or a sulfonylurea, watch for low blood sugar.

Three: if you drink too much and want to cut back, this can be a real help. GLP-1s aren't FDA approved for alcohol alone, but if you're taking one for obesity or diabetes, it may help with drinking too. It doesn't replace counseling or a support group, but plenty of people still struggle after doing all of that. It's great to have another tool.

Here's why this matters. About 28 million Americans have alcohol use disorder. Fewer than 8% get any treatment, and only 2.5% get a medication for it. Addiction isn't a willpower problem any more than obesity is. If a medication many people already want can help, that's a door worth opening, carefully and with the science leading.

The segment video and a short compilation are coming soon. I'll share the links as soon as they're up.

Sources: Lancet trial (AJMC) · NIH · NIAAA treatment data

Story Two · 90 Day Challenge

I'm following my own advice for 90 days

Today I started my 90 Day Challenge: doing everything I tell my patients to do. That means measuring where I actually start (labs, body composition, strength and fitness testing, and an honest log of what I eat), then working the plan and measuring again in 90 days.

Watch for the trailer next week, then regular updates on my progress as I work on actually getting myself healthy. I'll share the real numbers, including the ones I'm not proud of.

Quick Note

Speaking at OMA 2027 in Orlando

I'll be presenting "The Cost of Inaction: What Not Covering Obesity Costs Us All" at the Obesity Medicine Association's annual meeting, April 2-4, 2027. Not treating obesity is the most expensive option we have, and I'm looking forward to making that case to the people who treat it every day.

New Research

Four trials worth knowing

Retatrutide (TRIUMPH-1, NEJM). Adults without diabetes lost 25.0% of body weight on the top dose at 80 weeks, versus 3.9% on placebo. Read the study

Survodutide (SYNCHRONIZE-2, NEJM). In type 2 diabetes, weight loss was 9.8% versus 3.9% at 76 weeks, but 18% stopped the drug for stomach side effects. Read the study

Petrelintide (ZUPREME 1, Lancet Diabetes & Endocrinology). This amylin-only drug produced 9.8% weight loss versus 1.7% at 28 weeks in an early-phase trial. Read the study

Orforglipron (ACHIEVE-4, Lancet). In type 2 diabetes with high heart risk, this oral GLP-1 did not raise heart attack, stroke or heart-related death risk compared with insulin glargine. Read the study

Free for Clinicians

Sleep apnea is now a treatable metabolic disease

My two-page clinical brief for PAs and primary care covers who to screen, the SURMOUNT-OSA results, the tirzepatide indication, and a prior-auth checklist. Free, and built to be forwarded.

Get the sleep apnea brief

The Bottom Line

Whether it's food or a glass of wine, the pull we feel is biology, not a character flaw. The science is moving fast, and the honest answer is to treat the cause, measure what changes, and keep the hype in check. That's what I'm asking of my patients, and for the next 90 days, it's what I'm asking of myself.

Dr. Maready is a paid speaker for Eli Lilly and Company, Novo Nordisk, and Intra-Sana Laboratories. This newsletter is independent and was not funded or reviewed by any company. Educational content only, not medical advice.