Research presented at the the European Congress on Obesity suggests weight loss injections are safe and work for the mentally ill – and they might even make them feel happier
Weight loss jabs could help people beat the blues as well as shed pounds, research shows.
Scientists believe appetite suppressing drugs may boost mental health and general wellbeing by lowering inflammation in the brain. A research review being presented at the European Congress on Obesity in Malaga, Spain, is the best evidence yet that the injections could be good for the mind as well as the body. Scientists behind the findings say the hormone imitating medicines should now be trialled specifically to treat mental illness.
The Royal College of Psychiatrists has called for patients with mental illness to be prioritised for the drugs.
Swiss researchers analysed 36 studies including 26,000 adults in 19 countries and showed that for participants the weekly jabs improved mood, wellbeing and quality of life measures more than insulin and other anti-diabetic drugs.
The jabs slow digestion and reduce appetite by mimicking the glucagon-like peptide 1 (GLP-1) hormone which regulates hunger and feelings of fullness.
Author Dr Sigrid Breit from the University of Bern, said: “GLP-1 RAs (receptor agonists) may have antidepressant and anti-anxiety effects, potentially due to their anti-inflammatory and anti-oxidative properties, which can also help reduce neuroinflammation.”
GLP-1 jabs were designed to combat diabetes and are now also prescribed to help obese people lose weight. However there is increasing evidence they have other benefits.
It comes amid mounting evidence that insulin resistance and chronic inflammation – hallmarks of diabetes – are also tied to depression and cognitive decline. Previous research has shown that diabetes can affect thinking ability, causing memory loss and brain fog.
GLP-1 injections may help fix that by reducing inflammation in the brain, improving how insulin works in the body, and even helping brain cells communicate with each other better.
Previous tests on animals also suggest GLP-1 drugs could strengthen memory signals in the brain’s hippocampus – a region linked to mood and learning – and could even protect against dementia by improving insulin signalling and reducing damaging oxidative stress.
The latest review looked at studies which included obese patients and some who also had Type 2 diabetes. It included the injections semaglutide – known by its brand names Ozempic or Wegovy, liraglutide – also known as Victoza, exenatide – also known as Byetta or Bydureon, and dulaglutide also known as Trulicity.
The review also appeared to disprove early concerns that the drugs increased the risk of suicidal behaviour new mental illness or psychiatric hospital admissions. Five studies found that they were safe and improved mental illness outcome and quality of life in people with schizophrenia spectrum disorders, major depressive disorder, and bipolar effective disorder.
Dr Ed Beveridge, spokesman for the Royal College of Psychiatrists, said: “We know that, for a variety of reasons, many people with mental illness will have weight management issues. Therefore, where clinically assessed as suitable, it is crucial that they are regarded as a priority group for access to semaglutide medication, with appropriate monitoring arrangements in place following prescribing.”
Scientists are now calling for further trials to see if weight loss jabs could be prescribed to tackle mental illness. One trial showed better life quality improvements in patients treated with the newer tablet form of semaglutide than with dulaglutide GLP-1 injections.
Dr Breit said: “These results are particularly important for people with severe mental disorders who are three times more likely to be living with obesity than the general population.
“This research provides much-needed evidence in support of GLP-1RAs [receptor agonists) to help safely address the burden of obesity in people with mental illness. However, more data from large-scale randomised trials and longer treatment and follow-up periods are needed to establish the long-term efficacy of GLP-1 RAs, as well as future studies exploring whether these medications might be useful for the direct treatment of mental health disorders.”
Mental illnesses are associated with an increased risk of weight gain and type 2 diabetes.
Weight gain is also a common side effect of mood-altering drugs including antidepressants and antipsychotics, especially for individuals with severe mental illnesses who must take their medications indefinitely to reduce the risk of symptom relapse.
Prof Naveed Sattar, obesity expert at Glasgow University, said: “This [study] is important as many drugs used to treat depression or other psychiatric conditions can lead to weight gain, which can be really troublesome for patients and lead them to develop other comorbidities faster, whereas intentional weight loss would mitigate such impacts.”
Half million Brits are already taking the appetite-suppressing injections – mostly via private prescriptions. They are available on the NHS via specialist weight management clinics because of the intensive support users need. Known side effects include vomiting and constipation.
Most are purchasing them privately for around £200 a month because the NHS has a waiting list of up to two years. Just one in 10 overweight people who are eligible are currently able to get the powerful drugs on the NHS.
Dr Breit added: “We concluded that GLP-1RAs are safe and effective weight loss treatments for individuals with obesity and mental illness exerting a positive effect on mental state and quality of life. However, the effect on mental state has not been proven yet and further research is needed to assess their long-term effects and their use in improving mental health.”