GLP-1 Medication and Mental Health

Mental health is one of the most searched-for concerns about GLP-1 medicines such as Mounjaro (tirzepatide) and Wegovy (semaglutide). After reports of suicidal thoughts in some users, both the European Medicines Agency (EMA) and the UK's MHRA reviewed the evidence in 2024 and concluded that it does not support a causal link between GLP-1 receptor agonists and suicidal or self-injurious thoughts and actions. The MHRA's current guidance says the same about depression, and monitoring continues. That does not mean mental health is irrelevant: changes in eating, body image, side effects and life circumstances can all affect how you feel, and some people need extra care.

Why mental health questions have come up

GLP-1 medicines act on receptors in the gut, pancreas and brain, including areas involved in appetite and reward. Because they affect the brain, it is reasonable to ask whether they might affect mood or behaviour.

Concerns became prominent in 2023 when regulators received case reports of suicidal thoughts and self-harm in people using liraglutide and semaglutide. In July 2023, both the EMA and the MHRA began reviews. Media coverage at the time understandably caused worry among people taking or considering these medicines.

What the regulators concluded

The EMA's review considered clinical trial data, post-marketing surveillance and published studies, including large observational studies. The MHRA said its own evaluation of UK data aligned with the EMA's conclusions and that it would continue to monitor the issue closely and assess new evidence as it becomes available.

What about tirzepatide?

The 2024 EMA review named specific GLP-1 receptor agonists and did not include tirzepatide, which is a dual GIP/GLP-1 receptor agonist. The MHRA's 2026 patient guidance on GLP-1 medicines, which covers Mounjaro, states that available data do not support a causal link with depression or suicidal thoughts. Depression and suicidal thoughts are not listed as side effects in the current UK Mounjaro SmPC. As with any medicine, this could change if new evidence emerges, so check the current patient leaflet and MHRA guidance.

What "no causal association" means

It is worth being precise. "The evidence does not support a causal association" means regulators did not find convincing evidence that these medicines cause suicidal thoughts. It does not mean that no one taking them has ever experienced low mood or suicidal thoughts. Depression is common, and people living with obesity have higher rates of depression and anxiety than the general population. Some people will develop mental health problems while taking any medicine, for reasons unrelated to it.

This is why reporting matters. If you experience mood changes on a GLP-1, you can report them via the MHRA Yellow Card scheme. Reports help regulators detect any signal that may emerge in future.

Obesity, weight stigma and mental health

The relationship between weight and mental health runs in both directions. Living with obesity is associated with higher rates of depression, anxiety and low self-esteem, partly because of weight stigma and discrimination. Some medicines for mental health conditions, including certain antidepressants and antipsychotics, can cause weight gain. Depression itself can change appetite and activity levels.

Recognising obesity as a chronic, relapsing condition with biological drivers, rather than a failure of willpower, can help reduce shame. Our guide to obesity as a chronic disease explores this.

How GLP-1 treatment can affect how you feel

Even if the medicines do not directly cause depression, starting treatment involves real changes that can affect mood, positively or negatively.

Changes in appetite and "food noise"

Many people describe a reduction in constant thoughts about food after starting a GLP-1 medicine, sometimes called "food noise". Some find this a relief. Others feel a sense of loss if food has been an important source of comfort, pleasure, routine or social connection. These experiences are widely reported, but research measuring them formally is still developing.

Side effects

Persistent nausea, vomiting, diarrhoea, constipation, tiredness and poor sleep can all wear down mood. The UK SmPCs list fatigue as a side effect of both Mounjaro and Wegovy. Managing side effects well, often by slowing dose increases, can make a big difference. See our guides to nausea and diarrhoea on GLP-1 medication.

Eating very little

Eating far less than your body needs can cause tiredness, irritability, difficulty concentrating and low mood. Make sure you are eating regular, balanced meals with enough protein, even if portions are small. Our guide to what to eat on GLP-1 medication can help.

Low blood sugar in people with diabetes

People with type 2 diabetes who take insulin or sulfonylureas alongside a GLP-1 can develop low blood sugar (hypoglycaemia). Symptoms such as anxiety, shakiness, sweating, irritability and confusion can feel like a mental health problem. If you have diabetes and notice these symptoms, check your blood sugar if you can and follow your diabetes team's advice.

Body image and changing appearance

Rapid weight loss changes how you look, and not always in the ways people expect. Some people feel more confident; others struggle with loose skin, facial changes or a body that feels unfamiliar. Comments from others, positive or negative, can be hard to process. Our guide to facial changes and loose skin after GLP-1 weight loss looks at this in detail.

Expectations and the scales

If weight loss is slower than hoped, or reaches a plateau, some people feel disappointed or blame themselves. Results vary widely between people. Our guides on realistic weight-loss expectations and measuring progress beyond the scales may help.

Eating disorders: an important safety issue

GLP-1 weight-loss medicines are licensed for adults with a BMI of 30 or more, or 27 or more with at least one weight-related condition. They are not intended for people with a healthy weight, and must never be used to lose weight below a healthy range.

People with current or past eating disorders need particular care:

• Anorexia nervosa: appetite suppression and weight loss could be dangerous. GLP-1 weight-loss medicines are not appropriate.
• Bulimia nervosa: vomiting and restriction can be worsened, and gastrointestinal side effects can complicate recovery.
• Binge eating disorder: some research is exploring whether GLP-1 medicines affect binge eating, but this is not a licensed use. Treatment should involve a specialist and evidence-based psychological care.
• ARFID and other conditions: restricted eating may be worsened.

The NHS lists warning signs of an eating disorder, including spending a lot of time worrying about weight and body shape, avoiding socialising when food is involved, eating very little food, making yourself sick or using laxatives after eating, and exercising too much.

Regulated prescribers should ask screening questions about eating disorders and verify weight before prescribing. The MHRA has also warned about people obtaining these medicines from unregulated sources, such as social media or beauty salons, without any clinical assessment. This is especially risky for people with eating disorders. Our guide to getting weight-loss injections online safely explains the checks you should expect.

Existing mental health conditions and GLP-1 treatment

Having a mental health condition does not automatically rule out GLP-1 treatment. In fact, people with conditions such as depression, bipolar disorder and schizophrenia often have higher rates of obesity and diabetes, sometimes linked to their medicines.

However, your prescriber should know about:

• Any current or past mental health conditions, including depression, anxiety, bipolar disorder, psychosis or self-harm
• Any history of eating disorders
• All the medicines you take, including antidepressants, antipsychotics and mood stabilisers
• Your current support, such as a community mental health team or therapist

Medicine interactions

GLP-1 medicines slow stomach emptying, which can affect how quickly some oral medicines are absorbed. For most medicines this is not clinically important, but for medicines with a narrow range between an effective and a harmful dose, such as lithium, your prescriber may advise extra monitoring. Vomiting and diarrhoea can also affect absorption and, in the case of lithium, fluid balance and levels. Our guide to GLP-1 medication interactions covers this in more depth.

Never stop or change a mental health medicine without speaking to the person who prescribes it.

Alcohol, addiction and GLP-1s

Researchers are investigating whether GLP-1 medicines affect reward pathways in the brain, with early studies looking at alcohol use and other addictive behaviours. This research is at an early stage. GLP-1 medicines are not licensed to treat addiction in the UK, and any effect should not be relied on. If you are concerned about your drinking, speak to your GP. Our guide to Mounjaro and alcohol covers the practical safety issues.

Looking after your mental health on treatment

Practical steps that may help:

• Keep a simple mood log alongside any weight or side effect notes, so you can spot patterns.
• Eat regularly, prioritising protein, fibre and fluids, even when appetite is low.
• Find non-food sources of comfort and connection, such as walking with friends, hobbies or community groups.
• Be cautious with social media, which can promote unrealistic expectations and comparisons.
• Stay active in ways you enjoy. Physical activity supports mood as well as physical health.
• Keep your GP informed, especially if you are prescribed privately, so your records are complete.
• Ask for help early if your mood dips. Your GP can refer you to NHS talking therapies, and in England you can usually refer yourself.

Stopping treatment and mental health

There is no recognised withdrawal syndrome when stopping GLP-1 medicines. However, appetite usually returns, and trials have shown that many people regain weight after stopping. For some, this can bring disappointment, anxiety or a sense of failure. It is not a personal failure: it reflects the biology of obesity.

Planning the end of treatment with your prescriber, rather than stopping abruptly, gives you a chance to put support in place. Read more in our guide to weight regain after stopping GLP-1 medication.

What is still uncertain

The regulatory reviews provide reassurance, but they are not the final word. Several questions remain open:

• Long-term effects. Most clinical trials lasted one to two years, and some people now use these medicines for much longer. Ongoing monitoring will add to the evidence.
• Specific groups. People with serious mental illness, eating disorders or a history of suicide attempts were often excluded from trials, so there is less data on how they respond.
• Newer medicines. Tirzepatide and oral GLP-1 medicines have been used by large numbers of people for a shorter period than older medicines such as liraglutide.
• Possible benefits. Some observational studies have suggested GLP-1 medicines may be associated with lower rates of certain psychiatric outcomes, but observational studies cannot prove cause and effect. These findings need confirming in well-designed trials.
• Individual sensitivity. Even if there is no effect across a population, it is difficult to rule out rare individual reactions. This is why personal monitoring and reporting remain important.

If you see headlines claiming that GLP-1 medicines either cause or cure mental health problems, it is worth checking whether they are based on a trial, an observational study or individual reports, and what regulators say.

Talking to your prescriber about mental health

Some people worry that mentioning mental health will stop them getting treatment. In most cases, being open allows your prescriber to plan safer care rather than refuse it. It can help to prepare in advance:

• Be specific. Mention diagnoses, when symptoms were worst, and what has helped.
• List all medicines, including doses and anything you have recently stopped.
• Mention eating patterns honestly, including any history of restriction, bingeing or purging.
• Agree a plan for what you will do if your mood dips, including who to contact.
• Ask about follow-up. How often will someone check in with you, and how can you reach them between appointments?

If you are prescribed privately, consider sharing your treatment details with your GP so your mental health care and weight-management care are joined up.

Supporting someone who is taking a GLP-1

If a partner, friend or family member is on GLP-1 treatment, you can help by:

• Avoiding comments that focus only on weight or appearance
• Not pressuring them to eat more than they comfortably can, or to eat less
• Noticing changes such as withdrawal, irritability, persistent low mood or very restricted eating, and gently checking in
• Knowing the red flags, both physical and mental, and how to get help
• Encouraging them to keep their prescriber and GP informed

If you are worried that someone may be at risk of suicide, it is okay to ask them directly. Asking does not put the idea in their head, and it can open the door to getting help. Samaritans and NHS 111 can advise you as well as the person you are worried about.

Choosing a prescriber who considers your whole health

A responsible prescriber, whether NHS or private, should ask about your mental health and eating history, explain what to expect, and provide follow-up. If you are comparing regulated online providers, our provider comparison sets out what each service offers. We do not rank providers, and only a prescriber can decide whether treatment is right for you.

For more background, see our hub on weight-loss injections, the Mounjaro side effects guide and our guide to who should not take GLP-1 medicines.

Reporting side effects

If you experience changes in mood, anxiety, sleep or behaviour while taking a GLP-1 medicine, you can report them through the MHRA Yellow Card scheme, online or via the app. You do not need to be certain the medicine is responsible. These reports are how regulators detect new safety signals.

When to speak to a professional

Call 999 or go to A&E if:

• You have made plans to end your life or have harmed yourself
• You feel you cannot keep yourself safe
• You have severe, persistent abdominal pain, especially if it spreads to your back, which may be a sign of pancreatitis
• You have signs of severe dehydration, such as confusion, fainting or not peeing

Get urgent help today if you have thoughts of suicide or self-harm:

• Call NHS 111 and select the mental health option (available in many areas), or contact your GP for an urgent appointment
• Call Samaritans free, any time, on 116 123, or email jo@samaritans.org
• Text SHOUT to 85258 for the Shout crisis text service
• If you are under the care of a mental health team, use the crisis number they have given you

Speak to your GP or prescriber soon if:

• Your mood has been low, flat or anxious for more than two weeks
• You have lost interest or pleasure in things you usually enjoy
• You are worrying more about food, weight or your body, or eating very little
• You are making yourself sick, using laxatives or exercising excessively to control weight
• You take lithium or other medicines that need careful monitoring and have had vomiting or diarrhoea
• You have yellowing of the skin or eyes (jaundice), or signs of dehydration such as dark urine and dizziness