Drugs such as Ozempic used to aid weight loss may help reduce the likelihood of depression, research finds.
GLP-1 medications such as
Wegovy and Ozempic were associated with a reduction in diagnoses of depression
and anxiety in a new report.
The report observed the
connection in the medical records of over three million people with diabetes
and nearly one million taking GLP-1 drugs for weight loss.
The results of the report
suggest a mental health benefit for this class of drugs beyond diabetes health
and weight control.
GLP-1 agonist diabetes drugs
have found a second use as weight-loss medications. Now, a new study from
electronic medical records company Epic reports that their use also corresponds
to a reduction in depression and anxiety.
Five GLP-1 drugs were linked
to reduced depression and anxiety in people with diabetes, compared with people
who were not taking GLP-1 medications.
This group of medications is
based on related compounds, all of which are glucagon-like peptide-1 (GLP)
receptor agonists that mimic the natural GLP-1 intestinal hormone. In doing so,
they produce insulin after eating, helping to reduce blood sugar. They also
slow the emptying of the stomach and promote a sensation of being full, leading
to a reduction in appetite.
The medications are
generally injectable, although oral versions are also available.
The most well-known GLP-1
drugs, Wegovy and Ozempic, are based on semaglutide. Other GLP-1 agonist
compounds tested in the study are liraglutide, dulaglutide, and exenatide, as
well as tirzepatide that
mimics a second intestinal hormone, gastric inhibitory polypeptide, or GIP, in
addition to GLP-1.
People with diabetes taking
tirzepatide were 65% less likely to be diagnosed with depression and 60% less
likely to have anxiety, compared to people not taking GLP-1 drugs. People with
diabetes who were taking semaglutide were 45% less likely to be diagnosed with
depression, and 44% less likely to have anxiety.
Two of the drugs,
semaglutide and liraglutide, were assessed as regards depression and anxiety in
people without diabetes.
For people who do not have
diabetes, only semaglutide was associated with a reduction in depression and
anxiety, compared to people who were not on GLP-1 medications.
There was no statistically
significant improvement for people taking liraglutide.
The study was undertaken by
Epic Research, an investigative branch of Epic, one of the largest holders of
electronic medical records in the U.S. Two teams of in-house researchers
analyzed anonymized patient data, coming to the same conclusions.
The study analyzed patient
records for 3,081,254 people with diabetes and 929,174 without diabetes, who
were taking the drugs for weight loss. The researchers factored in a range of
variables to eliminate confounding influences on their results.
The study is published by
Epic Research.
Can Ozempic treat
depression?
“The results suggest a
potentially new therapeutic benefit of GLP-1 medications beyond their
established use for glucose control and weight management,” said general
practitioner with Zava, Dr. Kathryn Basford, who was not involved in the
research.
Dr. Crystal Wyllie, also a
general practitioner with Zava, who was also not involved in the research,
noted that the study “goes some way in addressing concerns raised by the FDA
[U.S. Federal Food and Drug Administration] about depression and suicidal
ideation associated with semaglutide, as it suggests that these concerns may
not be directly linked to these specific weight-loss treatments.”
In early January 2024, the
FDA released an update regarding their investigation of a connection between
GLP-1 drugs and suicidal ideationTrusted Source.
“Our preliminary evaluation
has not found evidence that use of these medicines causes suicidal thoughts or
actions,” the agency concluded.
Dr. Mir Ali, medical
director at the MemorialCare Surgical Weight Loss Center, who was not involved
in the study, was not surprised by the findings, saying, “There were only a few
case reports and there’s hundreds of thousands of patients on these
medications.”
One question left unanswered
for now is whether the reduction in depression and anxiety diagnoses are a
direct result of the medication.
Dr. Basford said the study
“doesn’t definitively clarify whether these improvements are due to the
biochemical effects of the medicines or are a result of improved self-esteem. I
would be interested to see further research in this area.”
The impact of GLP-1 drugs on
weight loss culture
With acknowledged benefits
for people with diabetes, having first been approved for use in 2005, GLP-1
drugs for weight loss may re-position overweight and obesity in a clearly
medical context, with the potential of reducing the historical stigma
associated with these conditions.
“It’s a paradigm shift that
we’re thinking of obesity not as a failure on the patient’s part to control
their habits, but more of a chronic disease, and treating it like any other
chronic disease such as diabetes or high blood pressure, arthritis, or other
diseases that people readily will say is not the patient’s fault,” Dr. Ali
said.
“My hope is that these
treatments will allow patients to live healthier, happier lives — whatever
weight they finally achieve,” said Dr. Wyllie.
“We need to recognize
obesity as a multifaceted condition that requires interventions that address
both the physical and psychological needs of the patient,” Dr. Basford added.
Off-label uses for GLP-1
drugs
Of the 13 GLP-1 medications
listed by the FDA, only three, Wegovy (semaglutide), Saxenda (liraglutide), and
Zepbound, (tirzepatide), are officially listed as approved for weight loss.
However, they are commonly prescribed “off-label” for this purpose.
Dr. Ali explained that the
lack of official approvals in this case may be less than they seem. “That’s
just a drug company strategy for getting a broader indication for these
medications — rebranding them and marketing them for weight loss.”
The cost of a GLP-1
medication may be intimidating in that one needs to remain on the drug
long-term to maintain its effect for diabetes, weight loss, or perhaps a
reduction in depression and anxiety.
Dr.
Ali noted that “It is difficult to get it covered by most insurance companies,”
but said many will pick up the tab if the individual meets medical
qualifications. For weight loss, for example, one needs a Body Mass Index of 30
or above to obtain coverage from some insurance carriers.
https://www.medicalnewstoday.com/articles/weight-loss-drugs-help-lower-depression-and-anxiety-risk
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