Oct. 16, 2024 – It may not sound surprising that treating obesity in adolescents and teens may have positive mental health impacts, but researchers this week reported reassuring findings about whether popular new injectable weight loss medicines carry mental health risks.
Youths who used one of two drugs from the class of medicines known as GLP-1s didn’t have a higher risk of suicidal thoughts or actions, compared to others of their age who were also trying to lose weight but not taking the medicines.
The study, published this week in JAMA Pediatrics, specifically looked at youths ages 12 to 18 years old who were taking either the drug semaglutide or the drug liraglutide for weight loss. Both drugs have different names depending on whether they are prescribed for diabetes or weight loss. Semaglutide is the active ingredient in Ozempic and Wegovy, and liraglutide is the active ingredient in Victoza and Saxenda.
The study is based on a review of medical records for 4,052 adolescents with obesity who were taking semaglutide or liraglutide for weight loss plus making lifestyle changes. The researchers compared the likelihood of documented suicidal thoughts or attempts among them to other youths with obesity who were not taking the medicines. Those in the comparison group were doing lifestyle changes like exercise or behavioral changes for weight loss.
Suicidal thoughts or actions were 33% less likely in the GLP-1 group.
Concerns about suicide risk arose in 2023 in the U.S. and Europe amid reports that people taking GLP-1 medicines had suicidal thoughts or thoughts of self-harm. The FDA formally investigated the reports and also combed through clinical trial data but announced in January that its “preliminary evaluation has not found evidence that use of these medicines causes suicidal thoughts or actions.”
But the agency cautioned that due to the small number of reports, “we cannot definitively rule out that a small risk may exist; therefore, FDA is continuing to look into this issue,” the January announcement stated.
Scientific published studies on the topic have offered conflicting views, including a January paper in the journal Nature Medicine that didn’t find any increased risk of suicidal thoughts among people taking semaglutide, compared to people taking different types of weight loss or diabetes medicines. But in a different analysis published in JAMA Network Open in August using data collected by the World Health Organization, researchers said they “found a signal of semaglutide-associated suicidal ideation, which warrants urgent clarification.”
The American Academy of Pediatrics has endorsed GLP-1s as options for treating obesity and offered a session at its national conference this year titled “When and How to Prescribe Anti-Obesity Medications.” The presenter, Claudia Fox, MD, MPH, said in a news release at the time that sometimes, patients ask for the medicines, but usually, the requests are from parents who themselves are using weight loss medicines.
Nearly 31,000 adolescents (ages 12 to 17) filled a prescription for a GLP-1 in 2023, according to a report published this year in the journal JAMA. Among them, 60% were female and about 45% lived in the South region of the U.S.
Nearly 15 million youths ages 2 to 19 have obesity in the U.S. The CDC estimates that 1 in 5 youths meet the criteria, which is based on a combination of height and weight called body mass index.
While adults are considered to have obesity when their BMI is 30 or higher, youths are considered to have the condition when their BMI is at or above the 95th percentile for their age and sex. For example, a 15-year-old boy who is 5 feet, 4 inches tall and weighs 165 pounds is in the 95th percentile, and so is a 15-year-old girl of the same height who weighs 172 pounds, according to an online CDC calculator.