Source: CNN
A review of the medical records of thousands of adolescents treated for obesity found that kids who received the GLP-1 medications semaglutide or liraglutide were less likely to have suicidal thoughts or attempts than those treated with behavioral interventions.
The study of about 7,000 children between ages 12 and 18, published this week in the journal JAMA Pediatrics, showed that the medicines were associated with a 33% lower risk over a year.
Semaglutide is better known as Ozempic, approved to treat type 2 diabetes, and Wegovy, for obesity; liraglutide is approved as Victoza for diabetes and Saxenda for obesity.
It’s the latest datapoint, in a sometimes conflicting body of research, suggesting that the medicines don’t contribute to suicide risk. Regulators in both the United States and Europe opened investigations into the issue after reports of possible cases of self-injury and suicidal thoughts among people using the drugs, but both thus far have not identified a link.
And understanding the risks in adolescents, whose use of GLP-1 drugs has soared since they were approved for the age group in the US in 2020, is particularly important, doctors say.
“We know that generally, with and without obesity, mental health and suicidality is a leading cause of death in teens and young adults,” said Dr. Kitty O’Hare, senior medical director for pediatrics at Duke Primary Care in North Carolina, who was not involved with the new research. “And it’s been known for a long time that adolescents and young adults with obesity are more likely than others to experience depression, anxiety and eating disorders.”
O’Hare said she was excited to see the study, which included up to three years of follow-up, because it provided several years’ worth of data in an age group for whom the medicines haven’t been as widely studied as in adults. “It’s really helpful to have the additional research,” she said.
The study was conducted by researchers at Hadassah University Medical Center and the Hebrew University of Jerusalem in Israel, and it examined medical records from 120 health-care organizations, mainly in the US, between December 2019 and June 2024. The researchers compared rates of suicidal ideation or attempts for kids who’d been prescribed GLP-1 drugs for obesity with those of children treated with a behavioral intervention, such as diet and exercise.
It found that over 12 months, 1.4% of adolescents on GLP-1 drugs had a suicide attempt or ideation, compared with 2.3% who weren’t on the medicines. There was no sign of an increase associated with the medicines out to three years. The study did find higher rates of gastrointestinal issues among those using the medicines, side effects that many people encounter on the drugs.
“The results of this study are encouraging,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health, who has done similar work analyzing medical records to assess GLP-1 drugs. She noted that the new findings “align with what we’ve found in similar studies on the association of GLP-1 medications with lower risk of suicidal ideation.”
It’s still important, though, for clinicians to assess mental health and suicidal thoughts among adolescents taking these medications, Volkow wrote in an e-mail, “so that proper support can be given to those at risk and harmful health outcomes can be prevented.”
“Adolescence can be a particularly difficult time for mental health,” she added.
The researchers who did the study suggested multiple potential reasons GLP-1 drugs may be associated with lower suicide risk that they said were worthy of further investigation.
First, obesity is associated with “diminished quality of life” during adolescence: Kids with obesity are more likely to be bullied and to have lower self-esteem, O’Hare pointed out. GLP-1 medicines, which mimic a hormone important to appetite, satiety and digestion, are effective in leading to weight loss.
The researchers also pointed to early research suggesting that the medicines may affect the brain in ways that reduce the likelihood of depression, although more work is needed to prove that link. Additionally, citing other early work on the drugs in addiction, they posited that they could help by curbing food addiction.
Until the medicines are better understood in relation to mental health, they shouldn’t be thought of as treatments for depression, said Dr. Sarah Armstrong, chief of the Division of General Pediatrics and Adolescent Health at the Duke University School of Medicine, who directs Duke Children’s Healthy Lifestyles Program and who wasn’t involved with the new study.
“Families who are seeking care for obesity and depression in teens need to recognize that treatment exists for both, and they should seek out care for both of these conditions independently of each other,” she said.