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

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.

Using TriNetX, adults (≥ 18 years old) with obesity (BMI ≥ 30 kg/m²) 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.

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]).

Post RYGB, GLP-1 RAs provide the potential to reduce AUD and all-cause mortality.