Safety and Effectiveness of GLP-1 Receptor Agonists for Obesity Treatment in Adults with Mental Illness

Recent research presented at the European Congress on Obesity in Malaga, Spain, highlights that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are both safe and effective for promoting weight loss and improving metabolic health in adults suffering from severe mental illnesses. The systematic review, published in the journal Psychoneuroendocrinology, analyzed data from 36 studies involving over 25,000 adults across 19 countries.

GLP-1 RAs, which include medications such as liraglutide, semaglutide, exenatide, and dulaglutide, were originally developed to treat diabetes by mimicking the action of the hormone GLP-1, stimulating insulin release, and lowering blood sugar levels. More recently, these drugs have gained attention for their capacity to induce weight loss by slowing digestion and increasing feelings of fullness.

The review shows that these medications can significantly reduce weight and improve blood glucose control in individuals taking psychotropic drugs, often used to manage severe mental disorders like schizophrenia, bipolar disorder, or major depression. For example, in one trial, liraglutide led to weight reductions of up to 5.3 kg and decreased HbA1c levels, indicating better glucose control. Semaglutide, administered weekly, resulted in weight loss of up to 15.7% over 68 weeks.

Importantly, the studies found no association between GLP-1 RAs and increased suicidal thoughts, behaviors, or worsening mental health, alleviating some concerns about potential psychiatric risks. Trials involving individuals with bipolar disorder, depression, or alcohol use disorder showed no significant increase in suicidal ideation or behavior.

Beyond metabolic health, GLP-1 RAs have shown positive effects on mental well-being and quality of life, especially in people without mental illness, improving mood and emotional health compared to other diabetic treatments.

Lead researcher Dr. Sigrid Breit emphasizes that these findings support the use of GLP-1 RAs as safe options to address obesity in people with mental health conditions, a population at higher risk—approximately three times more likely—to experience obesity. Nonetheless, thorough monitoring is recommended, and further large-scale, long-term studies are necessary to confirm their sustained efficacy and explore their potential in directly treating mental health disorders.