By Phil Cain
A survey this week highlighted a 29% reduction in how often users of GLP-1 diet drugs consume alcohol and that they spent nearly a third less on alcohol in hospitality settings and a fifth less at home.
People working to reduce alcohol harm may feel like celebrating, but we should be wary of taking such findings at face value, not least because they are promoted by the alcohol industry consultancy KAM, in partnership with the UK alcohol industry’s Drinkaware charity.
Self-serving narratives and hype often appear to fill gaps in our knowledge. This has happened around alcohol-free beer and other nolo drinks. GLP-1s unproven effectiveness looks set to spawn a new wave of misleading narratives.
The alcohol industry’s promotion of GLP-1’s potential to reduce alcohol consumption should be taken with a shovel or two of salt. Industry public relations efforts typically focus on diverting attention from evidence-based policies. Increasing alcohol’s price and reducing its availability and marketing have been shown to reduce alcohol harm across the population. GLP-1s have no such evidence behind them.
Promoting GLP-1s’ potential to reduce alcohol consumption also provides the alcohol industry with a tale of woe it can use to plead for special treatment in government policy debates. This may help the industry win renewed tax breaks or a loosening of regulations. The evidence shows these wins for the industry would increase the harm its products cause.
It is worth asking a few questions when headlines appear about GLP-1s based on surveys or other weak evidence, especially when they come from alcohol industry sources. Below are a few ideas. [Please, feel free to suggest more in the comments section of the post on LinkedIn.]
- A survey is no replacement for a full clinical trial. There has been no large-scale randomised control trial to confirm the anecdotal findings or to assess the side-effects when used for alcohol consumption.
- One possible side-effect may result from the fact that not everyone who wants to drink less alcohol would benefit from eating less. In fact, a significant proportion of heavy drinkers are malnourished and may become more malnourished if they take GLP-1s to tackle their alcohol drinking.
- It is also worth asking the degree to which the lower spending on alcohol is the result of the drug’s pharmaceutical action and how much the subtraction of £300 or so a month from a household’s disposable income to pay for GLP-1 medication. This might, in fact, simply be more evidence of the known effect of increasing alcohol’s price as a proportion of disposable income.
- People taking GLP-1s are a self-selecting group of people making a conscious and costly decision to try to improve their health. It is possible such a group may reduce alcohol consumption even without taking GLP-1s, when compared to a sample of the general population.
- These drugs show the potential to treat existing alcohol problems rather than avoiding problems before they start, so are inferior to “upstream” policies.
- The enormous cost of GLP-1s falls on the consumer or, potentially, health insurers and taxpayers, rather than on the producers of the alcohol products that are the source of harm. Is this allocation of cost either efficient or fair? ■