CLEVELAND — Most people would be overjoyed to lose enough weight to meet their goal. And there's no doubt that the new injectable diet drugs are helping many people achieve those goals. But are they also a risk to mental health?
Some people report the drugs are helping them kick other habits and studies are underway to see if they can help with substance abuse like alcohol.
But are they also causing depression and anxiety?
It's been reported about a thousand complaints were submitted to the FDA claiming mental health issues with Ozempic, Wegovy and Saxenda. The European Medicines Agency also launched an investigation into claims that the drugs lead to suicidal thoughts last summer.
Both agencies determined that there was no significant link in GLP-1 drugs to suicidal thoughts or self-harm. They based those findings on a Case Western Reserve University study of 1.8 million electronic medical records that looked into the issue. In fact, the study found an improvement in mood as people lost weight.
However, others point out that the research evaluated medical records retrospectively and was not part of a controlled study.
Still, the FDA required a warning on Wegovy and Sexenda about the risk for depression and suicidal thoughts.
Brian Burtch, M.D. is an endocrinologist with University Hospitals and has long prescribed these types of drugs to both his diabetic patients and those with obesity. He says none of his patients have reported adverse mood disorders, but he still thinks it's wise to be aware of the possibility.
"There are receptors to these medications in the brain and we've seen in animal models that there's a decreased dopamine release. Dopamine is a neurotransmitter that helps with pleasure and rewarding behavior. So we know in these patients that, likely, dopamine levels are decreased, and the question now becomes are there other applications to that," Dr. Burtch said.
Low levels of dopamine can negatively impact mood and motivation among other things. Researchers question if lower dopamine levels could be why some people on these drugs are able to stop smoking, drinking but also have a lower libido.
Only Wegovy and Sexenda are approved for weight loss, but Ozempic is often being prescribed off-label. The drugs have been used for a decade in treating diabetes.
"This class has been around a long time and as an endocrinologist for many years now, it's had some of the biggest impact, on our patients with diabetes and those that have struggled with weight, almost seeming like a miracle treatment. But I think whenever you have a medication that's widespread and hundreds of thousands of people start using it you're going to start to see more rare side effects that potentially may not have come out in clinical trials. So I think it's not something to ignore," Dr. Burtch said.
For those who've struggled with weight and yo-yo dieting, these drugs offer hope, but often insurance doesn't cover them for weight loss and they can cost $1,000 a month or more.
Mood can also be impacted by other things involving weight loss. Sometimes relationships change and other problems don't magically disappear with the weight.
But as for the drugs themselves, their success is spawning much more research into other potential health improvements, and Dr. Burtch thinks patients should be aware of the risk of all side effects, including mood.
"We should be aware about it. We should take reports seriously, and we really need to follow the data and see if we can draw any real conclusions. But at this point, this is not something I would be real concerned about," he said.