Semaglutide (SEMA) for Alcohol Use Disorder (AUD) After Metabolic and Bariatric Surgery (MBS)

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study (up to 6 months: 3-month treatment plus 3-month follow up) * Age 18 and older * Have a BMI ≥30 (or BMI ≥27 with a medical comorbidity) and BMI ≤50 kg/m2 * Have had laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy within the past seven years * Meet current DSM-5 criteria for Alcohol Use Disorder * Be an otherwise healthy subject without uncontrolled medical problems, as determined by the study physician and medical co-investigators * Read, comprehend, and write English at a sufficient level to complete study-related materials * For females of reproductive potential: use of highly effective contraception and agreement to use such a method during study participation Exclusion Criteria: * Any of the following: myocardial infarction, stroke, hospitalization for unstable angina, or transient ischemic attack within the past 60 days prior to screening * History or presence of chronic or recurrent pancreatitis * History of malignant neoplasms within the past 5 years prior to screening * Personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2 * Is currently using other medications for weight loss or other GLP-1 receptor agonists * Has a history of allergy or sensitivity to Semaglutide * Has a co-existing psychiatric condition that requires hospitalization or more intensive treatment (such as bipolar mood disorders, psychotic illnesses, or severe depression) * Has untreated hypertension with a seated systolic blood pressure \> 160 mmHg, diastolic blood pressure \> 100 mmHg, or heart rate \> 100 beats/minute * Has current uncontrolled hypertension * Has current uncontrolled Type I or Type II diabetes mellitus * Has untreated hypothyroidism with a TSH \> 1.5 times the upper limit of normal for the test laboratory with repeat value that also exceeds this limit * Has active gallbladder disease * Has a history of severe renal, hepatic, neurological, chronic pulmonary disease, or any other unstable medical disorder * Has a recent history of substance use disorder (with the exception of cannabis or tobacco use disorder) within the past 12 months * Is currently engaging in other treatment for Alcohol Use Disorder or making intentional efforts to quit alcohol use * Is currently participating in another clinical study in which the subject is or will be exposed to an investigational or a non-investigational drug or device * Is breast-feeding, pregnant, or not using a reliable form of birth control * Reports active suicidal or homicidal ideation * Any disorder, unwillingness or inability, not covered by any of the other exclusion criteria which, in the investigator's opinion, might have jeopardized the participant's safety or compliance with the protocol