Teens on anti-obesity drugs less likely to consider or attempt suicide

Young people taking anti-obesity medications are less likely to experience suicidal thoughts or make attempts on their lives, according to the latest study to analyse the potential psychiatric risks from the new blockbuster drugs.

While the European medicines regulator concluded earlier this year that GLP-1 receptor agonists – the class of weight loss and diabetes drugs that include Wegovy and Ozempic – do not cause suicidal thoughts or behaviours, researchers remained wary about how they could affect specific patient groups, like teenagers, people taking other medications, and those with existing mental health issues.

That’s where the new study, which was published in the journal JAMA Pediatrics, comes in. 

Researchers analysed mental health outcomes for nearly 7,000 adolescents who were obese and aged 12 to 18, most of them in the United States.

Half were prescribed the drugs, while half got a lifestyle intervention instead, for example being advised to diet and exercise.

Up to three years later, patients who took the medication were 33 per cent less likely to have considered or attempted suicide than those with a lifestyle approach.

Even so, the researchers said their findings should be interpreted with caution.

“While our study offers some reassurance, it is not definitive and should be considered as a step towards understanding the potential risks and benefits of GLP-1 receptor agonists in this vulnerable age group,” Dr Liya Kerem, the study’s lead author and a paediatric endocrinologist at Hadassah University Medical Center in Jerusalem, told Euronews Health.

GLP-1 agonists work by suppressing patients’ appetites and have been approved to treat obesity and type 2 diabetes in the European Union.

They’ve also been shown to curb heart failure, but there are remaining questions about their long-term impact and potential side effects.

Kerem said that while she took body mass index (BMI), pre-existing psychiatric diagnoses, and sociodemographic factors into account, it’s not clear whether the reduced suicidality risk tied to the medicines was due to the “drug’s effect itself or the associated reduction in BMI”.

Evidence suggests no ‘increased risk’ of suicide

Meanwhile, Dr Riccardo De Giorgi, a clinical lecturer in the University of Oxford’s psychiatry department who was not involved in the study, noted that the actual number of suicidal events – either thoughts or attempts – was quite low in both groups: 50 among people taking the drugs, and 78 among those with the lifestyle intervention.

That isn’t surprising because “when you do these kinds of studies, suicidality is luckily an uncommon event, but that tells us we need to be particularly careful when we interpret this kind of data,” De Giorgi told Euronews Health.

Using the same patient database as the new analysis, De Giorgi published a study in August which showed that, compared with other diabetes medications, semaglutide – a type of GLP-1 agonist – was not associated with a higher risk of neurological and psychiatric issues.

Overall, he said, the evidence suggests “there is no increased risk, rather than convincing me there is a reduced risk” of suicidal behaviour from weight loss drugs.

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The next step for researchers, De Giorgi said, is to investigate whether there’s any link between the weight loss drugs and suicidal thoughts or actions among people who already have mental health disorders, and might be more prone to self-harming behaviour.

“We cannot tell yet whether these results can be translated to what we could call psychiatric populations,” he said.