Adults who took prescription weight-loss medication in the past year reported higher rates of depression, mental health counseling, suicidal thoughts and suicide-related behavior than those who did not, according to an observational study out of South Korea.
Researchers at Asan Medical Center analyzed data from 27,741 adults, including 10,908 men and 16,833 women. Of that group, 846 had used prescription weight-control medications in the previous year, while 26,895 had not.
The study found weight-loss drug users 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 report suicidal thoughts and 1.7 times more likely to have attempted suicide.
These associations were stronger among people who gained or regained weight while on the medications. Users who gained weight despite taking the drugs had 4.2 times higher odds of suicidal ideation compared to non-users.
“The tendency for depression and suicide-related indicators to increase as weight rebounds after using weight-loss drugs may reflect not only the neuropsychiatric effects of the drugs themselves, but also a complex interplay of psychological and social factors associated with failed weight control,” the research team wrote.
The findings were published in the Korean Journal of Family Practice on Aug. 23. The data itself was collected between 2013 and 2022.
Older Drugs, Not Today’s GLP-1 Medications
Bonnie Mitchell, a licensed professional clinical counselor practicing in California, cautioned that the study is observational and cross-sectional, meaning it can show a correlation but not prove that the medications caused the mental health symptoms.
“It shows a correlation between weight-loss drug use and self-reported mental health symptoms, but it cannot prove causation,” Mitchell told Fox News Digital. “It does not demonstrate that weight-loss medications directly induce depression or suicidal thoughts.”
Mitchell also pointed out that during most of the study period, newer GLP-1/GIP receptor drugs such as high-dose semaglutide (Wegovy) or tirzepatide (Zepbound, Mounjaro) were either unavailable or barely used in South Korea. Instead, the sample largely reflects older anti-obesity drugs historically prescribed there, including phentermine, diethylpropion, phendimetrazine, topiramate and orlistat.
Central nervous system stimulants, including phentermine-based drugs, have separately been linked to risks of anxiety, mood changes and insomnia, Mitchell noted.
Weight Regain and Psychological Distress
Mitchell said the sense of failure that can come with regaining weight after treatment may trigger guilt, shame and helplessness. She also noted that people with severe obesity already have higher baseline rates of depression, anxiety and body dysmorphia, making it hard for a cross-sectional survey to separate pre-existing mental health struggles from new symptoms.
More research is needed to determine whether the medications themselves affect mental health, or whether the symptoms are tied to obesity itself or the frustration of unsuccessful weight loss. Researchers also still need to determine whether risks vary between specific drugs.
What Drugmakers and Regulators Say
Mitchell noted that even though clinical trials for GLP-1 drugs show low absolute risk, FDA labeling for chronic weight management drugs like Wegovy and Zepbound includes warnings to monitor for mood changes.
Eli Lilly, which makes the tirzepatide drug Zepbound, explicitly mentions “depression or thoughts of suicide” in its safety information, advising patients to watch for changes in mood, behavior, feelings or thoughts and to contact a provider if changes are new, worse or worrying. Separately, on its medical-information site, Lilly says that after reviewing clinical trials and medical reports, it identified “no increased risk” of suicidal ideation or psychiatric adverse effects.
Novo Nordisk, which makes the semaglutide drug Wegovy, states that fewer than 1% of trial participants experienced suicidal ideation or behavior during treatment, and that there was “no difference” between the 2.4 mg dose and placebo.
Fox News Digital reached out to both companies for comment.
Mitchell’s Recommendations
Mitchell recommends that physicians conduct a baseline mental health evaluation before prescribing new weight-loss medications, checking for past or current depression, bipolar disorder, or history of suicidal thoughts or behavior.
“Doctors can inform patients and caregivers about potential mood changes so they know what to watch for,” Mitchell said. “The next important step for ongoing monitoring would be to schedule check-ins at 4- to 8-week intervals during dose escalation, to evaluate both physiological progress and psychological well-being.”
She said patients should contact their healthcare provider immediately if they notice new or worsening depressive symptoms. “Any active suicidal thoughts require immediate emergency medical care,” Mitchell advised. “If a patient develops emergent depression or suicidal ideation during treatment, clinicians should discontinue the weight-loss medication and connect the patient with psychiatric support.”
This story discusses suicide. If you or someone you know is having thoughts of suicide, contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
