Impact of Weight-Loss Medications on Mental Health

An observational study suggests adults using prescription weight-loss medication face increased rates of depression, mental health counseling, suicidal thoughts, and suicide-related behaviors compared to those who do not use the drugs. This research was conducted at Asan Medical Center in South Korea, involving 27,741 adults, including 10,908 men and 16,833 women.

Among these participants, 846 individuals had used prescription medications for weight control in the previous year, while 26,895 did not. The study found that users of weight-loss drugs were 1.9 times more likely to experience depression and twice as likely to seek mental health counseling. They were also 2.7 times more likely to have suicidal thoughts and 1.7 times more likely to attempt suicide. These associations were particularly strong in those who gained or regained weight while using the medications.

The research team highlighted potential neuropsychiatric effects of the drugs and psychological and social factors associated with failed weight control as contributing to these outcomes. The study’s results were published in the Korean Journal of Family Practice on August 23.

Bonnie Mitchell, a licensed professional clinical counselor, explained that while the study shows a correlation between weight-loss drug use and mental health symptoms, it does not prove causation. The study utilized data collected between 2013 and 2022, during which modern GLP-1/GIP receptor agonists had limited use in South Korea.

Central nervous system stimulants, including phentermine-based drugs, are known to pose risks like anxiety, mood changes, and insomnia. Weight regain may provoke feelings of guilt, shame, and psychological distress, which is concerning as individuals with severe obesity already experience higher rates of depression, anxiety, and body dysmorphia.

While more research is necessary to determine if weight-loss medications directly affect mental health, it is advised that patients consult their doctors for evaluations of past mental health before starting new weight-loss medications. Physicians should monitor patients for changes in mood, especially during dose escalation.

Patients should contact healthcare providers if they notice symptoms like persistent low mood, unexplained sadness, fatigue, loss of interest in activities, increased anxiety, sleep disturbances, or thoughts of self-harm. If a patient develops significant depressive symptoms or suicidal thoughts, immediate medical attention and discontinuation of the weight-loss medication are recommended.

Eli Lilly, the manufacturer of the weight-loss medication Zepbound, mentions the potential for mental health changes in its safety information. It encourages monitoring mood and behavioral changes during treatment. Novo Nordisk, which produces Wegovy, similarly reports a low incidence of suicidal ideation in their trials. Still, monitoring is advised. Both companies emphasize the importance of consulting healthcare providers for any concerning mental health changes.