Mental Health Risks Linked to Prescription Weight-Loss Drugs

Adults using prescription weight-loss medications have reported higher rates of depression, mental health counseling, suicidal thoughts, and suicide-related behaviors compared to those who did not use these drugs. This information comes from an observational study conducted at Asan Medical Center in South Korea.

The study analyzed data from 27,741 adults, comprised of 10,908 men and 16,833 women. Of these individuals, 846 took prescription medications for weight control during the previous year, while 26,895 did not.

Research findings indicate that users of weight-loss drugs were 1.9 times more likely to experience depression and twice as likely to seek mental health counseling. Additionally, they were 2.7 times more likely to have suicidal thoughts and 1.7 times more likely to attempt suicide.

Strong Associations with Weight Gain

The study noted a stronger correlation among those using medication who gained or regained weight. The researchers attribute this to not only possible neuropsychiatric effects of the drugs but also the psychological and social factors linked to unsuccessful weight control.

Observations from a Mental Health Expert

The study is observational, creating a correlation between weight-loss drug use and self-reported mental health symptoms. However, it does not prove causation, said Bonnie Mitchell, a licensed professional clinical counselor in California.

Historical Prescription Trends

The data collected between 2013 and 2022 largely involved older anti-obesity agents prescribed in South Korea, such as phentermine, diethylpropion, phendimetrazine, topiramate, and orlistat. Central nervous system stimulants, including phentermine-based drugs, have been shown to pose risks of anxiety, mood changes, and insomnia.

Risks Associated with Weight Regain

Weight regain or perceived failure in weight management can trigger feelings of guilt, shame, helplessness, and psychological stress, Mitchell explained. Individuals with severe obesity often have higher baseline rates of depression, anxiety, and body dysmorphia.

Additional research is necessary to determine if weight-loss medications directly affect mental health or if depression and symptoms stem from obesity or struggles in losing weight.

Warning Signs and Recommended Precautions

Mitchell emphasizes the importance of conducting a mental health history before prescribing new weight-loss medications. Physicians should evaluate past or current depression, bipolar disorder, or suicidal ideation or behavior. The FDA’s product labels for drugs like Wegovy and Zepbound include precautions to monitor for mood changes.

Patients should immediately inform healthcare providers if experiencing new or worsening depressive symptoms, such as:

• Persistent low mood or unexplained sadness
• Anhedonia (loss of interest in activities once enjoyed)
• Increased anxiety or panic attacks
• Sleep disturbances or insomnia
• New or worsening self-harm or suicidal thoughts

Active suicidal thoughts require emergency medical care. If a patient develops emergent depression or suicidal ideation during treatment, clinicians should cease the weight-loss medication and seek psychiatric support.

Manufacturers’ Insights and Recommendations

Eli Lilly, maker of the weight-loss drug Zepbound, mentions depression or thoughts of suicide in its safety information. Novo Nordisk, producer of the semaglutide medication Wegovy, states that less than 1% of trial participants experienced suicidal ideation during treatment.