Adults using prescription weight-loss medications in the past year showed higher rates of depression, mental health counseling, suicidal thoughts, and suicide-related behaviors compared to non-users, according to an observational study published in the Korean Journal of Family Practice.
The research, which analyzed data from 27,741 adults in South Korea, found that individuals taking weight-control medications were 1.9 times more likely to experience depression and twice as likely to seek mental health counseling. They also had 2.7 times greater odds of having suicidal thoughts and 1.7 times greater odds of attempting suicide.
Weight Regain Amplifies Risk
The study noted that these associations were more pronounced among medication users who gained or regained weight. Those who regained weight despite taking medication had 4.2 times higher odds of suicidal ideation compared to non-users. The research team suggested this may reflect not only potential neuropsychiatric effects of the drugs but also psychological and social factors associated with perceived weight control failure.
Bonnie Mitchell, a licensed professional clinical counselor in California, cautioned that the study's observational and cross-sectional nature means it shows correlation, not causation. She emphasized that it does not prove weight-loss medications directly induce depression or suicidal thoughts. The study's data was collected between 2013 and 2022, a period when modern GLP-1/GIP receptor agonists like semaglutide (Wegovy) and tirzepatide (Zepbound) had limited availability in South Korea. The sample primarily included older anti-obesity agents such as phentermine, diethylpropion, phendimetrazine, topiramate, and orlistat, some of which are known central nervous system stimulants with potential risks for anxiety and mood changes.
Pre-existing Conditions and Monitoring
Mitchell also pointed out that individuals with severe obesity often have higher baseline rates of depression, anxiety, and body dysmorphia. A cross-sectional survey cannot definitively separate pre-existing mental health struggles from new symptoms that may arise after starting medication. Further research is needed to determine if weight-loss medications directly impact mental health or if symptoms are linked to the underlying conditions of obesity or weight management difficulties, and if risks vary between specific drugs.
Despite the study's limitations, the U.S. Food and Drug Administration's product labels for chronic weight management drugs like Wegovy and Zepbound include warnings to monitor for mood changes. Eli Lilly, the manufacturer of Zepbound, lists "depression or thoughts of suicide" in its safety information. Novo Nordisk, maker of Wegovy, stated in its trials that less than 1% of participants experienced suicidal ideation or behavior, with no significant difference observed compared to a placebo.
Health experts recommend that physicians conduct a baseline mental health assessment before prescribing weight-loss medications, evaluating a patient's history of depression, bipolar disorder, or suicidal ideation. Patients and caregivers should be informed about potential mood changes, and regular check-ins during dose escalation are advised to monitor both physical progress and psychological well-being. Anyone experiencing new or worsening depressive symptoms, including persistent low mood, loss of interest, increased anxiety, sleep disturbances, or thoughts of self-harm, should contact a healthcare provider immediately. Active suicidal thoughts require emergency medical care.