Alcohol consumption, lifestyle behaviors, and emotional well-being during GLP-1 receptor agonist therapy: a post hoc analysis of the several study

Background Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been associated with alcohol-related and other behavioral outcomes, although much of the observational evidence derives from retrospective studies. We prospectively evaluated longitudinal changes in self-reported alcohol-consumption categories, lifestyle behaviors, and emotional well-being during GLP-1 RA therapy in routine clinical practice. Methods This post hoc analysis of the prospective multicenter SEVERAL study included adults with obesity and type 2 diabetes receiving GLP-1 RAs over 44 weeks. Alcohol consumption categories, dietary adherence, and physical activity were assessed at baseline and weeks 4, 12, and 44. Emotional well-being was evaluated using the EuroQol 5-Dimension questionnaire (EQ-5D) and the 12-Item Short Form Health Survey (SF-12). Paired comparisons were performed using Wilcoxon signed-rank and McNemar tests. Results A total of 135 participants were included. At baseline, 87.7% of participants with available alcohol data (114/130) were already in the lowest alcohol-consumption category (0–1 standard drink units/day; 1 unit = 10 g of pure alcohol). This proportion increased to 96.2% at week 44, while the proportion reporting more than 2 units/day decreased from 5.4% to 0%, indicating a statistically significant shift toward lower categories (p = 0.003). Dietary adherence increased from 47.7% to 63.2% (p = 0.001). No significant long-term change was observed in physical activity (p = 0.392). Neither the SF-12 Mental Component Summary (MCS) score (p = 0.114) nor the EQ-5D anxiety/depression dimension (p = 0.055) changed significantly. Exploratory item-level analyses showed an increase in the proportion reporting feeling calm and peaceful all or most of the time (51.9% to 69.2%; p = 0.002).. Conclusions During 44 weeks of GLP-1 RA therapy, a shift toward lower self-reported alcohol-consumption categories and improved dietary adherence were observed. Changes in selected emotional well-being items were exploratory and were not accompanied by significant improvements in global mental health measures. These observational findings warrant confirmation in studies designed to assess alcohol-related behaviors and their potential underlying mechanisms.