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The signal is real and biologically supported, but a larger multi-site phase 3 would be the only way to know if the effect generalizes

Patients who moderate during therapy simply get more out of it. How Does Alcohol Affect Peptide Therapy

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These studies report increased abundance of bacterial groups including Negativicutes , Christensenellaceae , Selenomonadales , and Ruminococcus , alongside a notable decrease in Verrucomicrobia , Akkermansia muciniphila , and Erysipelotrichaceae UCG003 showed an decrease (Liu et al., 2023)