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A major new meta-analysis led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, alongside the University of Oxford's Department of Psychiatry, has found that glucagon-like peptide 1 receptor agonists (GLP1- RAs) - a class of medications used to treat obesity and diabetes – may also offer benefits for emotional wellbeing.
The research, published in JAMA Psychiatry, provides reassurance that use of GLP1-RAs, such as semaglutide, are not associated with any increased risk of psychiatric adverse events or worsening of depressive symptoms.
People living with obesity and/or diabetes are at an increased risk of poor mental health such as depression. This can have a knock-on impact, resulting in lower adherence to physical health medications, poor control of their blood sugar levels, and an increased risk of health complications related to obesity and diabetes. While there have been some concerns raised by health agencies about the potential negative psychological impact of GLP1-RAs, these reports have been inconsistent.
Researchers in this study identified 80 double-blind placebo-controlled randomised control trials representing 107,860 patients experiencing obesity and diabetes to examine their mental health outcomes, mental health related quality of life, and risk of psychiatric adverse events as a result of GLP1-RA use.
When analysing the data, researchers found that use of GLP1-RA was not associated with a significant difference in risk of serious or non-serious psychiatric adverse events1, nor a change in depression symptoms compared to placebo. However, it was associated with improvements in mental health-related quality of life, restrained eating, and emotional eating behaviors.
Co-author Associate Professor Robert McCutcheon, Wellcome Career Development Fellow at the University of Oxford, said:
People with mental illness are significantly more likely to experience obesity, yet they often face barriers to accessing effective treatments. This study provides reassurance that GLP-1 receptor agonists are unlikely to worsen psychiatric outcomes, strengthening the case for ensuring that individuals with mental illness are not left behind in the obesity treatment revolution.”
Dr Toby Pillinger, an Academic Clinical Lecturer at King’s IoPPN and the study’s senior author, said, “Living with obesity and diabetes can take a significant toll on both physical and emotional well-being. Our analysis of data from a large number of clinical trials shows that GLP-1RAs are not only safe from a psychiatric perspective but may improve mental health outcomes. As the use of these medications continues to grow, our findings provide important reassurance to patients and clinicians alike that these treatments can support both body and mind.”
Co-author Dr Riccardo De Giorgi, Clinical Lecturer in the Department of Psychiatry at the University of Oxford, added:
This study is the result of a concerted effort across several centres and medical specialisms. To date, it is the largest meta-analysis that assesses psychiatric events in people taking GLP-1 medications for diabetes and obesity. It highlights once again the safety, from a mental health perspective, of these revolutionary drugs for a growing number of patients taking them for their approved indications. I think it also shows that we now have strong supportive evidence to move toward investigating the potential of GLP1-based therapies in people with cognitive and mental disorders."