'Ozempic personality' and the psychological toll of GLP-1s
Key Takeaways
Social media analysis and patient testimonies reveal mixed reports of mental health effects related to taking semaglutide medications, including both improvements and deteriorations in mood, anxiety, and sleep.
The mental health side effects of semaglutide medications are currently listed only on Wegovy’s label, not Ozempic’s.
Further research is needed to better understand the potential psychiatric side effects of GLP-1 agonists like semaglutide, especially when used for weight loss.
Recently, semaglutide drugs such as Ozempic and Wegovy have skyrocketed in popularity for their ability to induce weight loss in patients both with and without diabetes. With reports of unexpected side effects, such as breast deflation (dubbed ‘Ozempic breasts’), changes in taste perception (aka, ‘Ozempic tongue’), and more, both physicians and consumers are now noting unexpected mental health changes as another (primarily negative) treatment side effect.
‘Ozempic personality’ represents the hidden psychological toll of semaglutide medications prescribed for weight loss, with reports of patients experiencing things like worsening anxiety and depression, among other psychiatric effects.[]
But can these mental health changes be attributed to the effects of the drug itself, or is it because patients are no longer able to seek solace by enjoying what they used to consider comfort foods?
Dosage matters
While Wegovy’s prescribing label lists potential mental health side effects, Ozempic’s does not—at least not yet. The clinical dose of semaglutide in Wegovy is higher than that in Ozempic, leading some experts to question whether the higher dose also leads to higher risk of negative mental health effects.[][] It's also worth noting that Wegovy is specifically prescribed for weight loss—not for diabetes management, per Ozempic’s label.
Wegovy’s prescribing information states that “suicidal behavior and ideation have been reported in clinical trials with other weight management products,” and therefore patients treated with Wegovy should be monitored “for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.”[]
Further, Wegovy should be discontinued “in patients who experience suicidal thoughts or behaviors [and] should be avoided in patients with a history of suicidal attempts or active suicidal ideation.”[]
This appears to be only a precautionary measure in Wegovy’s prescribing information related to mental health concerns, due to the history of similar risks with other weight-management drugs in the past. However, the label does not note any adverse mental health effects in its clinical trials summary (Section 6.1) or in its postmarketing experience section (Section 6.2).[]
Mental health impacts, per social media
Ozempic has been used off-label for weight loss even in patients without diabetes, particularly before the approval of Wegovy. In a rather unique mixed-methods approach, Arillotta and colleagues collected data from social media posts about Ozempic, specifically.[]
They found discussions related to insomnia (n=620), anxiety (n=353), depression (n=204), and mental health issues in general (n=165). These discussions included both positive and negative effects on mental health, including “marked improvement or, in some cases, a deterioration, in mood; increase/decrease in anxiety/insomnia; and better control of a range of addictive behaviors.”
The study authors note the challenges in “establishing a clear cause-and-effect link between metabolic diseases, depression, and medications,” due to the potential reciprocity and common underlying mechanisms, as well as differences among individual patients.[]
Additional research needed
Further research is needed to better determine and understand the safety profile of GLP-1 agonists such as semaglutide, particularly when used for weight loss. This includes potential mental health side effects across a wide range of patients.
One such study, currently underway, is examining specifically the long-term effects of add-on treatment with semaglutide on metabolic status in patients with pre-diabetes and diabetes who have been diagnosed with schizophrenia spectrum disorder and have initiated treatment with clozapine or olanzapine within the last 5 years.[]
Given the popularity of these agents, there will no doubt be further studies on the horizon to delineate the potential mental-health effects, and post-marketing surveillance will continue to be needed as real-world experience grows.
What this means for you
It’s important to be aware of the potential psychiatric side effects associated with semaglutide, regardless of which brand name is being prescribed. While Wegovy's label includes precautionary information about mental health risks, Ozempic's does not, despite being used off-label for weight loss. This discrepancy highlights the importance of monitoring all patients on semaglutide for changes in mood, behavior, or suicidal ideation, and considering individual patient history when prescribing.