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

Aug 26, 2025Obesity (Silver Spring, Md.)

Alcohol Use Outcomes After Gastric Bypass Surgery in Patients Using GLP-1 Medications: A Multicenter Study

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Abstract

GLP-1 receptor agonist initiation post RYGB is associated with a reduction in alcohol use disorder incidence from 1.8% to 1.1%.

GLP-1 receptor agonists may lower the risk of developing alcohol use disorders after Roux-en-Y gastric bypass surgery.
There is an observed decrease in all-cause mortality rates among users of GLP-1 receptor agonists, dropping from 3.9% to 1.2%.
The hazard ratio for alcohol use disorders with GLP-1 RA use is 0.77, suggesting a significant reduction in risk.
The hazard ratio for all-cause mortality in the GLP-1 RA group is 0.497, indicating a potential protective effect.

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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) 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. 2

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.

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

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