Alcoholic Use Disorder Outcomes After Roux‐en‐Y Gastric Bypass in Patients Taking GLP‐1 RAs: A Multicenter Analysis

Objective Roux‐en‐Y gastric bypass (RYGB) has been linked with increased alcohol‐related outcomes, whereas glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) have been associated with reduced risks. We performed the first multicenter retrospective cohort study to identify alcohol use outcomes of GLP‐1 RAs post RYGB. Methods Using TriNetX, adults (≥ 18 years old) with obesity (BMI ≥ 30 kg/m 2 ) who underwent RYGB between January 1, 2019, and May 31, 2023, were identified. Two cohorts were analyzed: patients initiated on GLP‐1 RA versus non‐GLP‐1 RA users. Patients with other liver diseases and other bariatric surgeries were excluded. Covariates were balanced via propensity score matching (PSM). Participants were followed for at least 1 year post RYGB and GLP‐1 RA initiation. Outcomes include the risk of alcohol use disorders (AUD), alcohol liver diseases (ALD), and all‐cause mortality. Hazard ratio (HR) was calculated through Cox regression analysis. Results After PSM, 3438 were matched in each cohort. GLP‐1 RA initiation was associated with a reduced incidence rate of AUD versus control (1.1% vs. 1.8%) (HR 0.77, [95% CI: 0.549–0.840, p = 0.041]) and all‐cause mortality (1.2% versus 3.9%) (HR 0.497, [95% CI: 0.346–0.715, p = 0.039]). Conclusions Post RYGB, GLP‐1 RAs provide the potential to reduce AUD and all‐cause mortality.