How Do Weight Loss Drugs Actually Impact My Mental Health?

Table of ContentsView AllTable of ContentsWhat You Might Feel Pre-GLP-1During GLP-1sAfter GLP-1sCopingNext in GLP-1s and Mental Health GuideTaking a GLP-1 For Weight Loss? These Healthy Habits Will Help

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With millions of Americans taking GLP-1 medications for weight loss, the thought of taking one of these medications might have crossed your mind.

For any medication, you should inform yourself about both its benefits and disadvantages. But with GLP-1s in particular, you might want to consider not onlyhow the medication will affect you physically and emotionally, but also how the associated weight loss will impact your life.

Maybe you’ve heard some of the more extreme stories in the media about gastroparesis (delayed emptying of the stomach) or people vomiting in workout classes, and you’re terrified that will be you. Or you’re worried about being on medication for the rest of your life.All of your concerns are valid.

It’s also important to be sure you feel confident in whoever is managing your care while on one of these medications. With the growing popularity of GLP-1s, there are plenty of less-than-scrupulous practitioners just trying to make a buck off a trend.

You should know that, no matter what,youare always the one in charge of your own body, and if something feels off with a medication or a practitioner, you deserve totrust your gutand make a change if necessary.

For starters,if you’re considering taking a GLP-1,there are two crucial things you need to know: you are not a failure, and taking this medication (or not!) doesn’t change anything about who you are as a person.

As a therapistanda human who’s just realizing this as she’s typing these words: this medication should carry no more or less judgement from yourself or anyone else than any other medication.

Similarly to anantidepressant, statin (cholesterol-lowering drugs), or blood pressure medication, it is just one more tool to help you improve your health.

And if you’re reading this particular article on this website, maybe either you or a loved one deals with a mental health condition. You may be judging yourself about your weight, your mental health condition, or both.

The Metabolism and Mental Health Connection

But you might find some comfort in knowing how interconnected metabolic and mental health issues can be. In so-called modern healthcare, our different body systems are often treated as totally separate entities that don’t interact at all, when that couldn’t be further from the truth.Metabolism and mental healthhave a bidirectional influence on each other.

Even controlling for other risk factors such as gender, race, family history, or lifestyle choices like diet and exercise, those exposed to childhood adversity were predisposed to obesity over their peers who weren’t.

Similarly, a major study of more than 100,000 women showed that those who experienced post-traumatic stress disorder (PTSD) symptoms also had their BMIs increase more rapidly than those who hadn’t.

PTSD and BMI IncreaseThis happens for both biological and behavioral reasons—meaning that some of these are factors you can change and some you can’t. Biologically, some of the reasons for this include:changes in how your neurons communicate with each otherhormonal changes such as disturbances in both appetite hormones and stress-control hormones, leading to disruption in the hypothalmic-pituitary-adrenal (HPA) axis, which regulates body systems that include weight.

PTSD and BMI Increase

This happens for both biological and behavioral reasons—meaning that some of these are factors you can change and some you can’t. Biologically, some of the reasons for this include:changes in how your neurons communicate with each otherhormonal changes such as disturbances in both appetite hormones and stress-control hormones, leading to disruption in the hypothalmic-pituitary-adrenal (HPA) axis, which regulates body systems that include weight.

This happens for both biological and behavioral reasons—meaning that some of these are factors you can change and some you can’t. Biologically, some of the reasons for this include:

Behaviorally, these changes can also lead to trouble controlling appetite and using food and alcohol to cope with theirsymptoms of PTSD.

In terms of treating both, it doesn’t necessarily matter which caused the other, saysHui “Christina” Wang, LCSW, clinical social worker in the Center for Weight Management and Metabolic Health at Cedars-Sinai.“We usually tackle it all at once. Patients who have had metabolic issues and issues with their body also often find their depression harder to handle.”

And depression—particularlytreatment-resistant depression (TRD)—and obesity have shared biological mechanisms. Though there are still few biomarkers for TRD, C-reactive protein is typically elevated in people with TRD,similarly to people dealing with obesity.

How Gut Bacteria and Depression Are Connected

What Happens To Your Mental Health When You Take a GLP-1 Medication?

While you’re on a GLP-1 medication, you may experience some mental health benefits—and that’s not just because you’re happy with reaching your health goals. Since GLP-1 medications regulate metabolic hormones, it tracks that those more stable hormone levels would also lead to an increase in ourfeel-good hormones, too.

“I’ve seen the joy that folks have had,” says Wang. ”Body image may be a big change, but what I hear more of is the increase in energy levels and improving other conditions. It actually rarely is about appearance.”

Although most of the research linking GLP-1 medications with positive mental health outcomes is still in its infancy, researchers are learning that these medications can play a role in the management of conditions including depression, PTSD and preventing cognitive decline.

Body image may be a big change, but what I hear more of is the increase in energy levels and improving other conditions. It actually rarely is about appearance.—HUI “CHRISTINA” WANG, LCSW

Body image may be a big change, but what I hear more of is the increase in energy levels and improving other conditions. It actually rarely is about appearance.

—HUI “CHRISTINA” WANG, LCSW

Anecdotally, people on GLP-1 medications report less desire for alcohol, and some researchalso shows that these medications could play a role in the treatment ofalcohol use disordersand other addictions. Partially, this is because alcohol may cause nausea while on these medications, but also because the reward-seeking signals in the brain are turned down. It may even prevent relapse drinking.

And as someone who started one of these medications myself partially to dealwith my own treatment-resistant depressionand its associated weight gain, I’m finding this personally true.

I’m loathe to use the phrase “food noise,”andthe fact that the endless internal “should-I-or-shouldn’t-I” monologue has turned into a much more simple “do I want this or not” or “am I hungry or not” is genuinely something I’m not sure I ever thought I’d experience. Substance use issues also run in my genetics, and I have considered myself “mostly sober” for the past five or six years, meaning I will have a drink occasionally.

But saying no to the second drink that turns into a third that turns into…well, you get the picture…has been an act of mind over matter. Being on one of these medications has made itsomuch easier for me to decide whether I actually want the taste of the alcohol or not—and I usually don’t now, something that would have absolutely shocked me 10 years ago.

However, it’s not all puppies and sunshine for everyone. While many people experience anti-depressant-like effects, others will find an increase in anxiety because of how GLP-1 medications affect serotonin, similarly to how some people will experience this uptick after starting a selective serotonin reuptake inhibitor(SSRI)for depression.

What Happens to Your Mental Health After You Stop Taking a GLP-1 Medication?

At this writing, there is no consensus on whether everyone who starts a GLP-1 medication needs to take it for the rest of their lives to maintain their weight, but studies suggest a lifetime maintenance dose might be required.

“Obesity is a disease that needs to be managed for the rest of your life,” saysRachel Goldman, PhD, FTOS, “and that management may include a GLP-1, another medication, another form of treatment, or even a combination of treatments.

However, for many, the decision may be out of your hands due to finances/insurance or even supply issues. Either way, whether you’re on one of these medications or considering it, you’re likely wondering about how your body and brain will reactafter you stop taking them.

The cravingsmaycome back,according to preliminary research, though it seems like the longer you have been on the medication, the less likely/less intense this may be. Additionally, Wang says that she’s seen that patients who are honest—with both themselves and her—about their weight loss hurdles pre-medication are the ones who tend to do the best after they have discontinued the medication.

The Double-Edged Sword of Being Treated Differently After Losing the Weight

How to Cope With the Different Stages

As someone who’s on one of these GLP-1 drugs myself, I understand all too well some of the things youmaybe feeling before, during, and after this process, and I want you to know that you’re not alone.

Just the idea of taking this medication may be bringing up many feelings—and the process can be gratifyingandalso emotionally complicated—so I advise finding a trusted mental health professional (preferably one who specializes in the treatment of obesity, health behavior change, body image, or disordered eating behaviors) to help you work through these changes and stages:

The Impact of Body Shaming and How to Overcome It

10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DeSilver D.As obesity rates rise in the U.S. and worldwide, new weight-loss drugs surge in popularity. Pew Research Center.329.Webster EM.The impact of adverse childhood experiences on health and development in young children.Global Pediatric Health. 2022;9:2333794X2210787. doi:10.1177/2333794X221078708Davis CR, Dearing E, Usher N, et al.Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.Metabolism. 2014;63(2):199-206. doi:10.1016/j.metabol.2013.08.013Kubzansky LD, Bordelois P, Jun HJ, et al.The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women.JAMA Psychiatry. 2014;71(1):44-51. doi:10.1001/jamapsychiatry.2013.2798Farr OM, Sloan DM, Keane TM, Mantzoros CS.Stress- and PTSD-associated obesity and metabolic dysfunction: A growing problem requiring further research and novel treatments. Metabolism. 2014;63(12):1463-1468. doi:10.1016/j.metabol.2014.08.009Chamberlain SR, Cavanagh J, de Boer P, et al.Treatment-resistant depression and peripheral C-reactive protein. Br J Psychiatry. 2019;214(1):11-19. doi:10.1192/bjp.2018.66Femminella GD, Frangou E, Love SB, et al.Evaluating the effects of the novel GLP-1 analogue liraglutide in Alzheimer’s disease: study protocol for a randomised controlled trial (ELAD study). Trials. 2019;20:191. doi:10.1186/s13063-019-3259-xJerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Res. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562Jerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Research. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562Secretariat E.Is coming off semaglutide slowly the key to preventing weight regain?EASO. May 11, 2024.

10 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DeSilver D.As obesity rates rise in the U.S. and worldwide, new weight-loss drugs surge in popularity. Pew Research Center.329.Webster EM.The impact of adverse childhood experiences on health and development in young children.Global Pediatric Health. 2022;9:2333794X2210787. doi:10.1177/2333794X221078708Davis CR, Dearing E, Usher N, et al.Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.Metabolism. 2014;63(2):199-206. doi:10.1016/j.metabol.2013.08.013Kubzansky LD, Bordelois P, Jun HJ, et al.The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women.JAMA Psychiatry. 2014;71(1):44-51. doi:10.1001/jamapsychiatry.2013.2798Farr OM, Sloan DM, Keane TM, Mantzoros CS.Stress- and PTSD-associated obesity and metabolic dysfunction: A growing problem requiring further research and novel treatments. Metabolism. 2014;63(12):1463-1468. doi:10.1016/j.metabol.2014.08.009Chamberlain SR, Cavanagh J, de Boer P, et al.Treatment-resistant depression and peripheral C-reactive protein. Br J Psychiatry. 2019;214(1):11-19. doi:10.1192/bjp.2018.66Femminella GD, Frangou E, Love SB, et al.Evaluating the effects of the novel GLP-1 analogue liraglutide in Alzheimer’s disease: study protocol for a randomised controlled trial (ELAD study). Trials. 2019;20:191. doi:10.1186/s13063-019-3259-xJerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Res. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562Jerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Research. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562Secretariat E.Is coming off semaglutide slowly the key to preventing weight regain?EASO. May 11, 2024.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

DeSilver D.As obesity rates rise in the U.S. and worldwide, new weight-loss drugs surge in popularity. Pew Research Center.329.Webster EM.The impact of adverse childhood experiences on health and development in young children.Global Pediatric Health. 2022;9:2333794X2210787. doi:10.1177/2333794X221078708Davis CR, Dearing E, Usher N, et al.Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.Metabolism. 2014;63(2):199-206. doi:10.1016/j.metabol.2013.08.013Kubzansky LD, Bordelois P, Jun HJ, et al.The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women.JAMA Psychiatry. 2014;71(1):44-51. doi:10.1001/jamapsychiatry.2013.2798Farr OM, Sloan DM, Keane TM, Mantzoros CS.Stress- and PTSD-associated obesity and metabolic dysfunction: A growing problem requiring further research and novel treatments. Metabolism. 2014;63(12):1463-1468. doi:10.1016/j.metabol.2014.08.009Chamberlain SR, Cavanagh J, de Boer P, et al.Treatment-resistant depression and peripheral C-reactive protein. Br J Psychiatry. 2019;214(1):11-19. doi:10.1192/bjp.2018.66Femminella GD, Frangou E, Love SB, et al.Evaluating the effects of the novel GLP-1 analogue liraglutide in Alzheimer’s disease: study protocol for a randomised controlled trial (ELAD study). Trials. 2019;20:191. doi:10.1186/s13063-019-3259-xJerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Res. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562Jerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Research. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562Secretariat E.Is coming off semaglutide slowly the key to preventing weight regain?EASO. May 11, 2024.

DeSilver D.As obesity rates rise in the U.S. and worldwide, new weight-loss drugs surge in popularity. Pew Research Center.

329.Webster EM.The impact of adverse childhood experiences on health and development in young children.Global Pediatric Health. 2022;9:2333794X2210787. doi:10.1177/2333794X221078708

Davis CR, Dearing E, Usher N, et al.Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.Metabolism. 2014;63(2):199-206. doi:10.1016/j.metabol.2013.08.013

Kubzansky LD, Bordelois P, Jun HJ, et al.The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women.JAMA Psychiatry. 2014;71(1):44-51. doi:10.1001/jamapsychiatry.2013.2798

Farr OM, Sloan DM, Keane TM, Mantzoros CS.Stress- and PTSD-associated obesity and metabolic dysfunction: A growing problem requiring further research and novel treatments. Metabolism. 2014;63(12):1463-1468. doi:10.1016/j.metabol.2014.08.009

Chamberlain SR, Cavanagh J, de Boer P, et al.Treatment-resistant depression and peripheral C-reactive protein. Br J Psychiatry. 2019;214(1):11-19. doi:10.1192/bjp.2018.66

Femminella GD, Frangou E, Love SB, et al.Evaluating the effects of the novel GLP-1 analogue liraglutide in Alzheimer’s disease: study protocol for a randomised controlled trial (ELAD study). Trials. 2019;20:191. doi:10.1186/s13063-019-3259-x

Jerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Res. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562

Jerlhag E.Alcohol-mediated behaviours and the gut-brain axis; with focus on glucagon-like peptide-1.Brain Research. 2020;1727:146562. doi:10.1016/j.brainres.2019.146562

Secretariat E.Is coming off semaglutide slowly the key to preventing weight regain?EASO. May 11, 2024.

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