Can you drink alcohol while taking Mounjaro?

Are you currently taking Mounjaro for weight loss and wondering whether it is safe to drink alcohol? Well, read this blog to answer the question, can you drink alcohol while taking Mounjaro? As with any medicine it is important to know if there are any interactions that could impact your health. While there is no there’s no direct interaction between Mounjaro and alcohol, drinking can affect blood sugar control and may increase side effects associated with Mounjaro.

But before we start to learn why it’s not recommended to mix alcohol with Mounjaro we will go over how this blockbuster weight loss injection works and who can take it.

You can use the navigational table below to skip to the topics that interest you.

What Is Mounjaro?

Mounjaro is the brand name for the active drug, tirzepatide. Mounjaro is the new  weekly weight loss injection that was licensed by the UK’s regulatory authority, the MHRA in November 2023. The MHRA approved Mounjaro for weight loss and weight management in adults with obesity (BMI ?30 kg/m²) or overweight (BMI 27–30 kg/m²) with weight-related conditions (MHRA 2023).

What is BMI?

Body Mass Index (BMI) is a simple and widely used measure to assess whether an individual has a healthy weight for their height. It is calculated using the following formula:

BMI=Weight (kg)/Height (m)²?

Categories of BMI

Based on the result, BMI is categorized as follows for adults:

• Underweight: BMI less than 18.5
• Healthy weight: BMI between 18.5 and 24.9
• Overweight: BMI between 25 and 29.9
• Obesity: BMI 30 or higher
  • Class 1 (Moderate): 30–34.9
  • Class 2 (Severe): 35–39.9
  • Class 3 (Very severe or morbid): 40 or higher

You can check your BMI with this handy NHS BMI calculator.

Who can have Mounjaro?

Mounjaro is now approved for use in adults with a Body Mass Index (BMI) of 30 kg/m² or higher (classified as obesity). It is also authorised for adults with a BMI between 27 and 30 kg/m² (classified as overweight) who have weight-related health conditions such as prediabetes, high blood pressure, high cholesterol, or heart disease.

This medication is intended to be used alongside a reduced-calorie diet and increased physical activity (MHRA, 2023).

Have questions about Mounjaro?

Get a FREE telephone consultation with one of our pharmacists, who will call you and help you understand what the right options are for you.

Call me about Mounjaro

How does Mounjaro cause weight loss?

The active ingredient in Mounjaro, tirzepatide, helps manage weight by regulating appetite, leading to a feeling of fullness, reduced hunger, and fewer food cravings (MHRA, 2023).

What are the different strengths of Mounjaro?

Mounjaro is available as a pre-filled injection pen containing doses of Mounjaro 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, and 15mg of tirzepatide. It is administered as a weekly injection under the skin of the stomach, thigh, or upper arm.

The treatment begins with a starting dose of Mounjaro 2.5mg once a week for four weeks, followed by an increase to 5mg weekly. Further dose adjustments, at intervals of at least four weeks, can be made up to a maximum of Mounjaro 15mg weekly, as advised by a healthcare provider.

This slow increase is designed to reduce the severity of the side effects and get the body used to the drug. In fact most side effects in the clinical trials occurred during this titration phase the body was becoming accustomed to Mounjaro (Jastreboff et al., 2022).

Advice for females patients before starting Mounjaro

Female patients who are obese or overweight and use oral contraceptives should consider using an additional barrier method (such as a condom) or switching to a non-oral contraceptive for 4 weeks after starting Mounjaro and for 4 weeks following any dose increase, as the medication may impact the effectiveness of oral contraceptives  (MHRA 2023).

How Mounjaro works: A simple breakdown

Mounjaro, also known by its active ingredient tirzepatide, is a breakthrough medication for weight loss, although it was first used to treat and manage type II diabetes. Here is quick breakdown behind how it works.

Dual Hormone Action:

Mounjaro or tirzepatide is the first of a new class of drugs that combines two gut hormones, glucagon-like peptide-1 (GLP-1)and  glucose-dependent insulinotropic polypeptide (GIP).

These gut hormones are known as incretins, be cause they “increase” the release of glucose in response to food. Because Mounjaro combines two incretins, GLP-1 and GIP it is known as a “twincretin”.

The combination of both these gut hormones work to decrease you appetite, make you feel fuller and delay the emptying of your stomach. By working together, they have a stronger effect and cause more weight loss (Coskun T et al., 2018).

Now, let’s more closely into these two incretins or gut hormones.

Here’s how these gut hormones help to cause weight loss

GLP-1 (glucagon-like peptide-1)

GLP-1 is mainly released from cells in the lower small intestine and colon after eating (Müller, T.D et al., 2019).

It has several benefits for controlling blood sugar (Müller, T.D et al., 2019) , (Holst JJ 2007, Nauck MA et al., 1993,  Flint A et al., 1998) including:

• Stimulating the release of insulin when blood sugar is high.
• Slowing down how quickly food leaves the stomach (gastric emptying).
• Reducing glucagon production (a hormone that raises blood sugar).

In addition to these effects, GLP-1 helps reduce appetite and food intake, making it useful for weight loss. These actions work in both healthy individuals and people with type II diabetes, even though it doesn’t directly increase how much energy the body burns (Naslund E et al., 1999, Flint A et al., 1998).

GIP (glucose-dependent insulinotropic polypeptide)

GIP (glucose-dependent insulinotropic polypeptide) is a hormone released by cells in the upper part of the small intestine (the duodenum and jejunum) after eating. Its role depends on blood sugar levels:

During low blood sugar (hypoglycaemia), GIP increases glucagon production to help stabilize blood sugar levels (Meier JJ et al., 2003, Khoo B et al., 2020).

Other actions of GIP

GIP has a number of other actions, some of which may seem counterintuitive to weight loss (Samms RJ et al., 2020, Thondam SK et al 2016, Christensen MB et al., 2018) .

• Encourages fat storage and improves the ability of fat tissue to handle lipids.
• Reduces nausea.
• Helps maintain bone health by slowing down bone breakdown.

Preclinical studies suggest that activating GIP receptors may help with weight loss by reducing food intake (Zhang Q et al., 2021).

Comparison of GLP-1 and GIP

Together with its partner GLP-1, GIP plays a critical role in blood sugar regulation and has additional benefits for metabolism and overall health.

GIP activation appeared to act synergistically with GLP-1 receptor activation to allow greater weight reduction in mice than that achieved if the GLP-1 receptor was only activated (Coskun T et al., 2018).

Mounjaro effects summary

So, what does all this mean for Mounjaro? Let’s summarise the benefits these two gut hormones produce when they are combined.

Effective weight loss

Mounjaro has shown significant weight loss benefits in clinical trials, with up to 22.5% reduction in body weight in non-diabetic individuals (SURMOUNT-1 trial) and up to 15.7% reduction in those with Type 2 diabetes (SURMOUNT-2 trial)(Jastreboff et al., 2022).

Improved blood sugar control

Reduces HbA1c levels (blood sugar levels over 3 months) by up to-2.01% to -2.46% (dose-dependent) versus -1.86% with semaglutide (Frias et al., 2021 ).

Dual action on GLP-1 and GIP receptors

Combines the effects of GLP-1 and GIP hormones, enhancing insulin secretion, reducing glucagon release, and improving overall blood sugar management (Holst, 2019; Finan et al., 2016).

Reduced cardiometabolic risks

The weight reduction observed in the clinical trials is also to confer beneficial effects on both the cardiac and metabolic profiles by decreasing blood pressure, improving lipid profiles, and reducing liver fat (Jastreboff et al., 2022).

Promotes fat loss

Majority of the weight loss comes from reductions in fat mass, specifically visceral fat, which is closely linked to metabolic health issues (Jastreboff et al., 2022).

Appetite suppression

Regulates appetite, helping patients feel full for longer and reducing food cravings, supporting long-term weight management (Jastreboff et al., 2022 , 2022; Holst, 2019).

Convenient dosing

Administered as a once-weekly subcutaneous injection, improving compliance compared to daily medications (Frias et al., 2021).

Safe and well-tolerated

Demonstrates a similar safety profile to other GLP-1 receptor agonists. The most common side effects include mild gastrointestinal issues such as nausea and diarrhoea (Rosenstock et al., 2021; Frias et al., 2021).

Can you drink alcohol while taking Mounjaro?

There’s no direct warning against mixing Mounjaro with alcohol, but it’s wise to approach with caution. Mounjaro stays active in your system for about a week after injection, so it’s not just the day of your injection you need to consider if you’re planning to have a drink.

Possible effects of mixing Mounjaro and alcohol

Although there are no official contraindications between alcohol and tirzepatide or Mounjaro, care must be taken because of the effects that they have on the body. This means we need to know a little bit about how both can act on the body to cause side effects.

Here are the main ways alcohol can interact with Mounjaro and impact your health:

Changes in blood sugar levels

Alcohol can change your blood sugar variations and this means if you are taking a drug that affects your blood sugar levels, you need to be extra careful. These alcohol-induced fluctuations can cause:

• Hypoglycaemia or low blood sugar, or
• Hyperglycaemia or high blood sugar

Symptoms of low blood sugar

Alcohol lowers blood sugar, which can lead to hypoglycaemia (low blood sugar). Symptoms of low blood sugar include:

• dizziness,
• shakiness,
• sweating,
• confusion, and
• headaches.

Drinking on an empty stomach or having multiple drinks increases the risk, so it’s crucial to monitor your blood sugar if you choose to drink.

Before consuming alcohol while taking tirzepatide (Mounjaro), consult your doctor. Avoid alcohol if your diabetes is poorly controlled, or if you have conditions such as high triglycerides, neuropathy (nerve damage), or pancreatitis (inflammation of the pancreas).

If you are taking Mounjaro for diabetes then if your diabetes is well-managed, moderate alcohol consumption may not significantly affect blood glucose levels. However, it’s advisable to limit alcohol intake in accordance with the UK Guidelines.

The UK Guidelines which advises consuming no more than 14 units of alcohol weekly, spread over three or more days. One unit equals 10 ml of pure alcohol (e.g., one small glass of wine or half a pint of beer).

Always consume alcohol with food as drinking on an empty stomach or after exercise may increase the risk of hypoglycaemia (Drugs.com)

It is essential to inform your doctor about all other medications, supplements, and herbal products you are taking to ensure there are no interactions. Do not stop or adjust any medication without consulting your healthcare provider.

Increased risk of gastrointestinal side effects when alcohol is taken with Mounjaro

If you have drunk alcohol before, then you know it can cause you some stomach discomfort. But did you know that gastro intestinal side effects are the most frequent adverse effects experienced with users of Mounjaro? Let’s look at the evidence.

Gastrointestinal side effects of Mounjaro

Mounjaro, known for its ability to slow down digestion, may cause gastrointestinal (GI) side effects. For most users, these symptoms are mild to moderate and tend to subside as the body adjusts to the medication. These side effects are most common when first starting Mounjaro or increasing the dosage  (Jastreboff et al., 2022).

Data from the SURMOUNT 1 trial and  SURMOUNT 2 trial , which looked at weight loss in patients without type II diabetes and patients with diabetes respectively provided the following insights to the side effects associated with Mounjaro use (Jensen, T.L et al., 2024):

• Nausea: Reported by 31% of participants without type II diabetes and 23% of those with type II diabetes taking the highest dose (15 mg).
• Diarrhoea: Experienced by 23% of participants without type II diabetes  compared to 19% of those with type II diabetes on the same dose.
• Vomiting: A similar proportion of participants reported vomiting—12% of non-T2D and 13% of type II diabetes participants at the 15 mg dose.

Alcohol’s effects on the gastrointestinal system

Alcohol consumption, especially in large quantities or over time, can have significant negative effects on the digestive system, impacting both nutrient absorption and gut health, such as (Bode, C  et al., 2003):

• Nutrient absorption: Alcohol interferes with the gut’s ability to absorb essential nutrients.
• Diarrhoea: Alcohol inhibits the absorption of sodium and water in the intestines, which contributes to diarrhoea, a common issue among heavy drinkers.
• Gut damage: Excessive alcohol intake, even in a single episode, can cause physical damage to the digestive tract:
• Duodenal erosions and bleeding.
• Mucosal injury in the upper jejunum (the initial part of the small intestine).
• Bacterial overgrowth: Chronic alcohol use increases the likelihood of bacterial overgrowth in the small intestine.
• Increased gut permeability: Alcohol damages the gut lining, making it more permeable to macromolecules. This allows harmful substances like bacterial toxins and endotoxins to move from the gut into the bloodstream.
• Immune system impact: Alcohol has been shown to alter the immune system within the gut, potentially weakening its ability to defend against infections and contributing to inflammation.

How to reduce gastro intestinal side effects of Mounjaro

A simple way to reduce these side effects is to first titrate the dose of Mounjaro slowly. Start with the Mounjaro 2.5mg and then increase after every four weeks until the maintenance dose of 15mg is reached. This let’s your body become accustomed to the drug and soon the gastro intestinal side effects will disappear.

The second thing you can do to reduce the gastro intestinal side effects is to reduce your intake of alcohol. Since alcohol can also cause similar gastro intestinal side effects, by taking it with Mounjaro can compound the side effects of the medication, such as nausea, diarrhoea, or abdominal discomfort. Excessive alcohol consumption could amplify these effects and further strain the digestive system. This underscores the importance of moderating alcohol intake while on such treatments.

Alcohol interferes with the weight loss effects of Mounjaro

If you’re on Mounjaro for weight loss, alcohol can work against your goals. Alcohol has a lot of empty calories, and drinking can lead to increased appetite, making it harder to avoid high-calorie foods.

Since 1 gram of alcohol provides 7.1 kcal (29 kJ), research indicates that calories from alcohol are typically added to the overall calorie intake from other food sources, rather than replacing them (Yeomans MR 2010).

 Plus, your body prioritises metabolizing alcohol before fats and carbs, which can slow down your metabolism (Wilson, D. F., et al. (2020).

Alcohol puts a strain on the liver

People with a history of liver issues or alcohol use disorder should be cautious. Although Mounjaro itself isn’t known to cause liver damage, heavy alcohol use is hard on the liver (Walsh, K. et al., 2000), and Mounjaro has been linked to a slight increase in liver enzymes in a small percentage of people. Heavy drinking can make liver issues worse, so it’s best to drink sparingly.

Mounjaro can reduce alcohol cravings

Interestingly, some people taking Mounjaro reported a lower interest in drinking. In fact, a recent study found that people taking these types of drugs consumed fewer alcoholic beverages and were less likely to binge drink (Quddos, F et al., 2023). This could be a helpful benefit for those trying to cut back on drinking while on Mounjaro.

Is Mounjaro right for you?

Get a FREE telephone consultation with one of our pharmacists.

Call me about Mounjaro

The bottom line: Is it safe to drink while taking Mounjaro?

Moderate drinking might be safe for some people on Mounjaro, but it’s essential to monitor how your body responds.

The effects of alcohol vary by individual, for example:

• Age and gender: Older adults and women metabolize alcohol differently, increasing risks.
• Genetics: Variations in enzyme activity affect alcohol metabolism, with some populations experiencing heightened sensitivity.
• Dietary adjustments: Reduced food intake on Mounjaro increases the risk of higher blood alcohol levels.
• Alcohol use disorder: Also known as alcohol dependence is a history of dependence increases health risks and complicates treatment outcomes.

So, it’s best to speak with a healthcare provider about your specific situation before combining alcohol with Mounjaro. Remember, you can always book a FREE consultation with one of our prescribers to discuss any concerns you may have. Or if you have a specfic query you can contact us.

Also it’s best to stick to the UK Guidelines which advises consuming no more than 14 units of alcohol weekly, spread over three or more days. One unit equals 10 ml of pure alcohol (e.g., one small glass of wine or half a pint of beer).

Weight loss, Mounjaro and coaching

A study tested the effectiveness of adding personalised telephone coaching to an online weight loss program for individuals struggling to lose weight initially. The results showed that participants who received coaching achieved significantly greater weight loss than those without, with extended coaching delivering the most sustained results over 12 months. Coaching also encouraged better engagement with the program, including tracking progress and accessing resources, helping individuals stay on track with their goals (Unick JL, et al., 2024).

At Medical Mojo, we offer a comprehensive weight loss coaching service tailored to support your journey. The online coaching service includes a weekly call to discuss your progress, set realistic goals, and receive expert guidance to maximise your results.

Medical Mojo Mounjaro weight loss

When you start your weight loss journey with Medical Mojo, you don’t have to worry about a thing, we have it all covered. From the complete range of Mounjaro pens to online coaching to help you optimise your weight loss journey. Medical Mojo also provides FREE needles and sharps bins making it easier for you to start losing weight today.

Our supportive coaching program is designed to keep you motivated and empowered, making your weight loss goals achievable and sustainable. Let Medical Mojo be your partner in achieving the results you deserve.

Remember: Even if you don’t experience immediate side effects, alcohol and diabetes medications can interact in ways that may affect your long-term health.

Disclaimer: Always consult with a healthcare provider before mixing Mounjaro and alcohol.

Note: This information is for educational purposes only and should not substitute for professional medical advice.

References

1. Bode, C. and Bode, J.C., 2003. Effect of alcohol consumption on the gut. Best practice & research Clinical gastroenterology, 17(4), pp.575-592.
2. Christensen MB, Lund A, Calanna S, Jorgensen NR, Holst JJ, Vilsboll T, et al. Glucose-dependent insulinotropic polypeptide (GIP) inhibits bone resorption independently of insulin and glycemia. J Clin Endocrinol Metab. 2018;103:288–94. doi: 10.1210/jc.2017-0194
3. ClinicalTrials.gov. (n.d.). Study of tirzepatide (LY3298176) in participants with obesity or overweight with weight-related comorbidities (SURMOUNT-1) (Identifier: NCT04184622). Retrieved from https://clinicaltrials.gov/study/NCT04184622
4. ClinicalTrials.gov. (n.d.). NCT04657003: A study of tirzepatide in participants with obesity or overweight and type 2 diabetes (SURMOUNT-2). Retrieved from https://clinicaltrials.gov/study/NCT04657003?cond=weight%20loss&term=NCT04657003&limit=10&rank=1.
5. Coskun T, Sloop KW, Loghin C, Alsina-Fernandez J, Urva S, Bokvist KB, et al. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: from discovery to clinical proof of concept. Mol Metab. 2018;18:3–14. doi: 10.1016/j.molmet.2018.09.009.
6. Drugs.com. (n.d.). Tirzepatide (Mounjaro) food interactions. Retrieved from https://www.drugs.com/food-interactions/tirzepatide,mounjaro.html
7. Finan, B., et al. (2016). A rational design of a triple agonist of GIP, GLP-1, and glucagon receptors to treat obesity and diabetes. Nature Medicine, 22(2), 173–177.
8. Frias, J. P., et al. (2021). Tirzepatide versus semaglutide once weekly in patients with Type 2 diabetes. The New England Journal of Medicine, 385(6), 503-515.
9. Flint A, Raben A, Astrup A, Holst JJ. Glucagon-like peptide 1 promotes satiety and suppresses energy intake in humans. J Clin Invest. 1998;101:515–20. doi: 10.1172/JCI990.
10. Holst JJ. The physiology of glucagon-like peptide 1. Physiol Rev. 2007;87:1409–39. doi: 10.1152/physrev.00034.2006.
11. Holst JJ. The incretin system in healthy humans: The role of GIP and GLP-1. Metabolism. 2019 Jul;96:46-55. doi: 10.1016/j.metabol.2019.04.014. Epub 2019 Apr 25. PMID: 31029770.
12. Jensen, T.L., Brønden, A., Karstoft, K., Sonne, D.P. and Christensen, M.B., 2024. The Body weight Reducing Effects of Tirzepatide in People with and without Type 2 Diabetes: A Review on Efficacy and Adverse Effects. Patient preference and adherence, pp.373-382.
13. Khoo B, Tan TM. Combination gut hormones: prospects and questions for the future of obesity and diabetes therapy. J Endocrinol. 2020;246:R65–74. doi: 10.1530/JOE-20-0119.
14. Meier JJ, Gallwitz B, Siepmann N, Holst JJ, Deacon CF, Schmidt WE, et al. Gastric inhibitory polypeptide (GIP) dose-dependently stimulates glucagon secretion in healthy human subjects at euglycaemia. Diabetologia. 2003;46:798–801. doi: 10.1007/s00125-003-1103-y. 
15. MHRA, 2023. MHRA authorises diabetes drug Mounjaro (tirzepatide) for weight management and weight loss. GOV.UK. Available at: https://www.gov.uk/government/news/mhra-authorises-diabetes-drug-mounjaro-tirzepatide-for-weight-management-and-weight-loss
16. Müller, T.D.; Finan, B.; Bloom, S.R.; D’Alessio, D.; Drucker, D.J.; Flatt, P.R.; Fritsche, A.; Gribble, F.; Grill, H.J.; Habaner, J.F.; et al. Glucagon-like peptide 1 (GLP-1). Mol. Metab. 2019, 30, 72–130.
17. Naslund E, Barkeling B, King N, Gutniak M, Blundell JE, Holst JJ, et al. Energy intake and appetite are suppressed by glucagon-like peptide-1 (GLP-1) in obese men. Int J Obes Relat Metab Disord. 1999;23:304–11. doi: 10.1038/sj.ijo.0800818.
18. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.). Understanding Alcohol Use Disorder. Retrieved November 30, 2024, from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
19. Nauck MA, Heimesaat MM, Orskov C, Holst JJ, Ebert R, Creutzfeldt W. Preserved incretin activity of glucagon-like peptide 1 [7-36 amide] but not of synthetic human gastric inhibitory polypeptide in patients with type-2 diabetes mellitus. J Clin Invest. 1993;91:301–7. doi: 10.1172/JCI116186.
20. NHS. (n.d.). Calculating alcohol units. Retrieved November 30, 2024, from https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/
21. Quddos, F., Hubshman, Z., Tegge, A., Sane, D., Marti, E., Kablinger, A.S., Gatchalian, K.M., Kelly, A.L., DiFeliceantonio, A.G. and Bickel, W.K., 2023. Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity. Scientific Reports, 13(1), p.20998.
22. Rosenstock, J., et al. (2021). SURPASS-2: Efficacy and safety of tirzepatide versus semaglutide. Diabetes Care, 44(9), 2070-2079.
23. Samms RJ, Coghlan MP, Sloop KW. How may GIP enhance the therapeutic efficacy of GLP-1? Trends Endocrinol Metab. 2020;31:410–21. doi: 10.1016/j.tem.2020.02.006. 
24. Seitz, H.K., Maurer, B. and Stickel, F., 2006. Alcohol consumption and cancer of the gastrointestinal tract. Digestive diseases, 23(3-4), pp.297-303.
25. Sinha R, Papamargaritis D, Sargeant JA, Davies MJ. Efficacy and Safety of Tirzepatide in Type 2 Diabetes and Obesity Management. J Obes Metab Syndr. 2023 Mar 30;32(1):25-45. doi: 10.7570/jomes22067. Epub 2023 Feb 8. PMID: 36750526; PMCID: PMC10088547.
26. Thondam SK, Daousi C, Wilding JP, Holst JJ, Ameen GI, Yang C, et al. Glucose-dependent insulinotropic polypeptide promotes lipid deposition in subcutaneous adipocytes in obese type 2 diabetes patients: a maladaptive response. Am J Physiol Endocrinol Metab. 2017;312:E224–33. doi: 10.1152/ajpendo.00347.2016.
27. Unick JL, Pellegrini CA, Dunsiger SI, et al. An Adaptive Telephone Coaching Intervention for Patients in an Online Weight Loss Program: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(6):e2414587. doi:10.1001/jamanetworkopen.2024.14587
28. Walsh, K. and Alexander, G., 2000. Alcoholic liver disease. Postgraduate medical journal, 76(895), pp.280-286.
29. Wilson, D. F., et al. (2020). Ethanol metabolism: The good, the bad, and the ugly. Medical Hypotheses. 
30. Yeomans MR. Alcohol, appetite and energy balance: is alcohol intake a risk factor for obesity? Physiol Behav. 2010;100:82–9. doi: 10.1016/j.physbeh.2010.01.012.
31. Zhang Q, Delessa CT, Augustin R, Bakhti M, Collden G, Drucker DJ, et al. The glucose-dependent insulinotropic polypeptide (GIP) regulates body weight and food intake via CNS-GIPR signaling. Cell Metab. 2021;33:833–44.e5. doi: 10.1016/j.cmet.2021.01.015.