Could It Be That GLP-1 Use Helps with Mental Health?

We do not think for a minute that Lilly or Novo Nordisk will be pursuing any sort of mental health indication for semaglutide or tirzepatide. But it increasingly appears that the effect of GLP-1 use for either diabetes or obesity is more positive than negative for mental health. A new systematic review and meta-analysis in JAMA Psychiatry lends credence to this thought. Aureliane Pierret and colleagues write:

“Treatment with GLP1 receptor agonists is safe from a psychiatric perspective and may be associated with improved mental well-being, which should be considered when deciding among treatment options for obesity and diabetes given the association between these conditions and poorer mental health and quality of life.”

Of course, we take all of this with a grain of salt, even as we take it seriously. These conclusions come from secondary outcomes in high quality clinical trials. But we do not have randomized clinical trials where mental health outcomes are the primary outcomes of interest.

False Fears

As the remarkable benefits of these medicines became more and more apparent, popular media also began to sensationalize potential hazards they might present. Stories about Ozempic face and Ozempic butt made for great clickbait that was mostly frivolous. But attention also turned to Ozempic brain and more serious questions about mental health effects. FDA analysis of spontaneous reports found no evidence for a causal link, but of course, the agency remains vigilant. It’s what they do.

These more recent analyses are important because they serve to temper some of the fears that skeptics have raised – for example, about disordered eating. In fact, the present analysis found a reduced risk for restrained eating and emotional eating behaviors. Likewise, a new and exhaustive review of the literature for these drugs in mental health disorders identified targets for further study, but no signals of a serious problem. In fact, the authors noted that “these medications may play a role in the treatment of certain specific eating disorders, such as binge eating disorder.”

Beware of Generalizations

With all this said, it is important to remember the hazards of generalizations. Though GLP-1 medications are generally safe to use – and may have benefits for mental health – we have no guarantee against problems. Misuse can be an issue. Idiosyncratic responses can be serious for some individuals.

Adverse events are a fact of life for any medicine. This is why careful use and monitoring is essential.

Click here for the systematic review by Pierret et al. Additional recent reviews can be found here and here. For further reporting, click here, here, and here.

Wheatfield with Crows, painting by Vincent van Gogh / Wikipedia

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May 21, 2025