Let me ask you something, and I really want you to think about the honest answer before you keep reading.
When your doctor asks how much you drink, what do you normally say?
If you’re like most people, you say something like occasionally, or a glass here and there, or just on weekends. And if you’re like most people, that’s not exactly the full truth. I know because I did the same thing for years! I worked in a medical office for nearly a decade and watched patient after patient give that same vague answer while the real number was something completely different. I was one of them.
That small act of underreporting seems harmless in the moment. I mean who wants to hear another lecture, right? BUT… it is something worth paying much closer attention to right now.
WHY? Because millions of people in midlife are currently on medications that interact with alcohol in ways that most of them have never been told about. And because they’re not being fully honest with their doctors, nobody is connecting the dots for them.
That’s what this week is about.
The GLP-1 & Antidepressants Medication Reality
According to the CDC, approximately two thirds of American adults take at least one prescription medication. Nearly half take two or more. In midlife, those numbers climb even higher as we manage blood pressure, cholesterol, blood sugar, mood, sleep, and weight.
At the same time, research consistently shows that patients underreport their alcohol consumption to physicians by a significant margin. A study published in the Journal of General Internal Medicine found that fewer than one in four primary care physicians routinely screen for alcohol use. And when they do ask, the answers they get back are often a fraction of the real number.
So what you end up with is a large population of people taking medications that have real, documented interactions with alcohol, drinking more than they’re telling their doctors, and wondering why they feel the way they do. Why the medication doesn’t seem to be working as well as they hoped. Why they feel more anxious, more depleted, more off than they can explain.
The Two Combinations Getting the Most Attention Right Now
If you’ve been paying attention to health news at all in the past couple of years, you know that GLP-1 medications have completely taken over the conversation. If you’re not currently taking one, you know at least one or two people that are. I’m talking about Ozempic, Wegovy, Mounjaro, Zepbound… just to name a few. And these medications are now being taken by an estimated nine million Americans and growing. Originally developed for type 2 diabetes, they’re now widely prescribed for weight loss and blood sugar management.
What’s really interesting is research, including a 2024 study across 682,000 individuals, found that people taking semaglutide, which is the active ingredient in Ozempic and Wegovy, had up to a 50% reduction in alcohol-related events. Some people on these medications have reported simply not wanting to drink anymore. That’s the part that made headlines. And I can see why it would.
But what didn’t make headlines is what’s happening for the people who are still drinking on these medications. Because for that group, something very different is going on inside their bodies, and almost none of them know it.
The second combination that gets far less attention but has been around much longer is antidepressants paired with alcohol. About one in eight American adults currently takes an antidepressant — medications like Prozac, Zoloft, Lexapro, Celexa, Effexor, and Cymbalta. Many of them are also drinking. And most of them don’t realize that alcohol is a central nervous system depressant working directly against what those medications are trying to do!
The medication is trying to lift them. The alcohol keeps pulling them back under. And because the effect is gradual, most people never make the connection. They just assume the medication isn’t working as well as it should, or that something else is wrong with them. And as I eluded to in the beginning of this email, many are NOT reporting this truth to their doctors.
The Question Worth Asking
I’m not going to lay out every specific risk in this newsletter, because that’s exactly what Tuesday’s podcast episode is for and I want you to actually listen to it. But I do want to leave you with a few honest questions worth sitting with before you do.
Are you being fully honest with your doctor about how much you drink?
Not the version you give when someone’s asking. The real number. The average week. Because if your doctor doesn’t have that information, they can’t factor it into what they’re prescribing or how they’re monitoring your health. That conversation has to start somewhere, and it might as well start with you being the one to bring it up.
If you’re on a GLP-1 medication and still drinking, have you noticed anything different?
Is alcohol hitting differently than it used to? Are you feeling effects faster, or feeling worse the next day than the amount you drank should warrant? That’s not random and it’s not nothing. It’s your body trying to tell you something has changed.
If you’re on an antidepressant and it doesn’t feel like it’s working, is alcohol part of the picture?
This is the one most people haven’t considered. If you started a medication hoping it would help with your mood or anxiety, and it hasn’t delivered what you hoped, the honest question is whether drinking is part of why. Not as a judgment ,but rather as information.
This Week on Beyond the Gray
Oh my goodness! Episode 20 drops Tuesday, June 30th, and it’s a milestone. I’m truly grateful for your loyalty to the show and helping it to grow. I’m also thrilled to report Beyond the Gray is in the top 10% of podcasts globally! So yes, thank YOU for being a listener! I am truly humbled by your support. Keep watching and sharing, please. It helps get the show to more people that need to hear this type of content.
Okay, now what to expect on Tuesday’s episode.
I’m sharing six specific risks of drinking on GLP-1 medications that most people have never been told about, get into what’s happening when you combine antidepressants with alcohol, share something personal about my own experience on one of these medications, and talk about why your 15-minute doctor appointment isn’t where this conversation is happening for most people.
Everything in the episode is backed by published research, all of which is linked in the show notes. If you or someone you know is on a GLP-1, an antidepressant, or both, and still drinking, this episode is going to give you information that needs to be heard.
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This isn’t about scaring anyone or adding to the pile of things to feel bad about. It’s about having the full picture. Because you can’t make an informed decision without one. And the conversation has to start somewhere. Maybe it starts right here. I’m on your side always.
Here’s to living beyond the gray,
Kari
*Disclaimer: This blog is for educational purposes only. I’m a coach, not a doctor. If anything here raises questions about your health or medications, please take those questions to your physician.
