A large international study published in The Lancet Psychiatry suggests that GLP-1 receptor agonists used for diabetes and weight loss are linked to a lower risk of worsening mental health in people with existing anxiety or depression. The drugs include semaglutide, marketed as Ozempic and Wegovy, and liraglutide. The analysis drew on Swedish health records from 2009 to 2022 covering nearly 95,000 individuals diagnosed with depression or anxiety. Semaglutide use was associated with a 42% lower risk of worsening mental health, including a 44% lower risk of depression and a 38% lower risk of anxiety, as well as a 47% lower risk of substance use disorder. The results were most pronounced when depression or anxiety co-occurred with diabetes and obesity.
The study also reported a 42% lower risk of psychiatric hospitalizations and work absences during periods when patients were taking semaglutide compared with periods when they were not. Liraglutide was similarly linked to a reduced risk of worsening depression.
The findings are significant enough to justify a clinical trial to determine whether Ozempic and Wegovy can be used to treat mental health disorders, according to Bloomberg. If such benefits are confirmed in randomized trials, GLP-1 medications could support mental health care in addition to roles in weight management and glycaemic control. The study’s authors emphasized that their work is observational and cannot definitively rule out confounding factors. They noted that the indicators used largely reflect more severe outcomes such as hospital care or prolonged sickness absence. They cautioned that the analysis cannot establish causality, only a strong association between semaglutide use and improvements in mental health-related measures.
Scientists have proposed several explanations for possible mental health benefits. One hypothesis is that GLP-1 receptors in brain regions involved in the reward system could mediate direct effects on emotional regulation, impulsivity, or cravings. Indirect pathways could include improved mood and anxiety symptoms from weight loss, better glycaemic control, reduced alcohol consumption, and improved body image. Evidence from the same research field indicates that GLP-1 medications, particularly semaglutide, have shown an impact on addiction and substance use disorders. Use has been linked to a 47% lower risk of hospital care and sickness absence related to these conditions compared with periods off treatment. Other GLP-1 receptor agonists, including Eli Lilly & Co.’s Zepbound, have also shown an impact on addiction in clinical observations.
Related research has identified safety signals to monitor. A separate Danish study examining national health registries found that women taking semaglutide for diabetes before pregnancy had an 84% higher relative risk of preterm birth compared with those not taking a GLP-1 medication. That heightened risk was not observed when GLP-1 drugs were used for weight management, suggesting that the underlying diabetes, rather than the medication itself, may be a key driver.
Type 2 diabetes
Type 2 diabetes affects more than 800 million people worldwide, and individuals with diabetes are about twice as likely to experience depression as the general population. In Europe, approximately one in six people are estimated to live with a mental health condition. These overlapping burdens make the possibility of dual-action treatments—addressing metabolic and mental health dimensions—especially consequential if validated in controlled trials.
Clinicians and researchers remain cautious about how these findings should influence practice. Some experts note that better mental health often follows improvements in physical health, making it difficult to disentangle whether GLP-1 drugs have unique neurobiological effects or whether benefits arise from downstream consequences like weight loss and stabilized blood sugar. “It is well established that better mental health tends to follow from better physical health and since the 1880s we have known that diabetes is associated with depression, although I think it’s unlikely that using GLP-1R agonists alone as treatments for depression or anxiety will work,” said Prof David Nutt, according to The Guardian.