GLP-1 Agonists Decreasing Weight and Improving Mood
There is an association between mood disorders and disordered eating that has long been recognized by Psychiatrists and patients alike. It can present as a loss of appetite with associated weight loss, but more typically in my experience, presents as increased appetite and weight gain. Eating sweet and starchy foods can help our bodies make serotonin which maintains a sense of calm. Chronic overnutrition, however, leads to associated weight gain and a proinflammatory state which creates stress on all of the body’s organs, including the brain. Proinflammatory states can lead to worsening of depression and anxiety. Additionally, patients who have gained weight due to disordered eating are more likely to experience joint pain, fatigue and other issues which makes increasing their activity more difficult. This also perpetuates the depression and sense of low self worth which leads to lower mood, more disordered eating, and additional weight gain.
Fortunately, in the last 10 years we have seen the arrival of a new class of medications that help with weight loss. This class of drug is called the glucagon-like peptide 1 (GLP-1) agonists and include medications such as semaglutide (Ozempic) and most recently, tirzepatide (Mounjaro). Until tirzepatide received FDA approval this year for type 2 diabetes, semaglutide was considered the most effective GLP-1 agonist for weight loss. Studies have shown that tirzepatide has an average weight loss of 22.5%, which is double or triple that of other weight loss medications and is similar to the results seen with bariatric surgery. It is anticipated that tirzepatide will eventually receive FDA approval for weight loss. In the meantime, patients can still be treated with it off label or receive a prescription for semaglutide which is FDA approved for weight loss.
The side effects of the GLP-1 agonists are nausea and GI disturbances. The best weight loss results are seen when medication is combined with lifestyle modifications and healthy eating habits. In addition to benefits for mental health, other benefits of weight loss include improved blood pressure control, normalized blood sugars, lower cholesterol and improved cardiac health. These benefits can be seen with as little as 5% weight loss.
Having watched so many patients struggle with maintaining a healthy weight over the years, I’m excited to have a medication as effective as tirzepatide in the tool box. My first patients to be treated with tirzepatide are showing an early response to a relatively low dose and finding the side effects minimal or non-existent. They are returning to activities they previously enjoyed as they feel lighter and have more energy. We have also been able to minimize some of their other medications as their mood improves.
No one medication is going to be the answer for everyone so it’s important to consider all of the factors that contribute to emotional wellness. If extra weight is contributing to depression and anxiety, it’s important to know that there are more effective treatments available than what we have had in the past. If you are wondering if a GLP-1 agonist might be helpful for your health and wellness, please call our office for a consultation.
