Crosstalk between alcohol use disorder and obesity: two sides of the same coin?

Investigating similarities and differences between alcohol use disorder (AUD) and obesity is important because both AUD and obesity are public health concerns and share neurobiological and periphery-brain mechanisms. Furthermore, AUD and obesity often present with similar medical consequences related to organ damage, including liver and cardiovascular diseases. There is also growing evidence of changes in alcohol drinking in people who undergo bariatric surgery for obesity. In this non-systematic critical review, we identified relevant articles through PubMed searches, previous knowledge, and recursive reference searching. A librarian also used PubMed and Google Scholar for additional relevant articles, using terms such as alcohol, metabolic disorders, obesity, glucagon-like peptide-1 (GLP-1), bariatric surgery, and gut-brain axis. We provide an overview of the neurobiological, pathophysiological, neuroimaging, and clinical features related to the overlap and crosstalk between AUD and obesity. We also provide a summary of the currently approved medications for obesity and those for AUD and note the potential for some of these medications to work for both disorders. Specific to the latter point, we place emphasis on GLP-1 therapies, given their recent approval for weight loss and the growing evidence suggesting their potential efficacy for AUD and other addictions. We further review studies of the relationship between bariatric surgery and AUD and discuss potential mechanisms and future directions. In summary, studying the overlap between obesity and AUD may shed light on the mechanisms underlying the development and maintenance of both diseases. This knowledge, in turn, may help identify new therapeutic targets for AUD, and possibly comorbid obesity and/or other metabolic disorders.