Adults who reported using prescription weight loss medications during the previous year also reported higher rates of depression, mental health counseling, suicidal thoughts and suicide related behaviors than people who did not use the drugs, according to an observational study.

This story discusses suicide. If you or someone you know is having thoughts of suicide, contact the Suicide & Crisis Lifeline at 988.

Researchers at Asan Medical Center in South Korea analyzed data from 27,741 adults, including 10,908 men and 16,833 women. Among the participants, 846 had taken prescription medications for weight control during the previous year, while 26,895 had not.

The people who used weight loss drugs were 1.9 times more likely to experience depression and twice as likely to seek mental health counseling. They were also 2.7 times more likely to have suicidal thoughts and 1.7 times more likely to make a suicide attempt.

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The associations were stronger among medication users who gained or regained weight. The research team wrote that increases in depression and suicide related indicators as weight returned could reflect a complex combination of possible drug effects and psychological and social factors connected to unsuccessful weight control.

The findings were published in the Korean Journal of Family Practice on Aug. 23. However, Bonnie Mitchell, a licensed professional clinical counselor in California, emphasized that the research was observational and cross sectional.

Mitchell told Fox News Digital that the study identified a correlation between weight loss drug use and mental health symptoms reported by participants. However, she said it could not establish that the medications directly caused depression or suicidal thoughts.

The data was collected between 2013 and 2022. Mitchell noted that during most of that period, newer medications such as high dose semaglutide, sold as Wegovy, and tirzepatide, sold as Zepbound and Mounjaro, were either unavailable or had very limited real world use in South Korea.

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According to Mitchell, the sample largely captured older obesity medications prescribed in South Korea during that decade. Those included phentermine, diethylpropion, phendimetrazine, topiramate and orlistat.

Mitchell said central nervous system stimulants, including medications based on phentermine, have been shown to carry risks of anxiety, mood changes and insomnia. She also highlighted a finding that medication users who gained weight had 4.2 times higher odds of suicidal ideation than people who did not use the drugs.

Weight regain or a perceived failure to manage weight can produce guilt, shame, helplessness and psychological distress, according to Mitchell. She said the study design could not separate mental health struggles that existed before treatment from symptoms that appeared after a medication was started.

“Individuals with severe obesity have higher baseline rates of depression, anxiety and body dysmorphia,” Mitchell said. More research is needed to determine whether weight loss medications affect mental health or whether reported symptoms are connected to obesity or difficulties with losing weight.

Researchers also need to determine whether mental health concerns differ among specific weight loss medications. Mitchell noted that clinical trials have shown a low absolute risk, while product labels for chronic weight management drugs such as Wegovy and Zepbound advise monitoring for mood changes.

Mitchell recommends that physicians conduct a baseline mental health history before prescribing a new weight loss medication. That evaluation could cover past or current depression, bipolar disorder and any history of suicidal ideation or behavior.

She also recommends informing patients and caregivers about potential mood changes and scheduling checkups at intervals of 4 to 8 weeks during dose escalation. Those appointments can evaluate physical progress and psychological well being.

Patients should contact a health care provider immediately if they experience new or worsening depressive symptoms, including persistent low mood, unexplained sadness, severe fatigue, loss of interest in previously enjoyed activities, increased anxiety, agitation, panic attacks or extreme restlessness. “Any active suicidal thoughts require immediate emergency medical care,” Mitchell advised.

Eli Lilly, the manufacturer of Zepbound, mentions “depression or thoughts of suicide” in its safety information. Its website tells patients, “You should pay attention to changes in your mood, behaviors, feelings or thoughts,” and advises contacting a provider if changes are “new, worse or worry you.”

Lilly also says its review of clinical trials and medical reports identified “no increased risk” of suicidal ideation or psychiatric adverse effects. Novo Nordisk, the manufacturer of Wegovy, states that less than 1% of trial participants experienced suicidal ideation or behavior and that there was “no difference between semaglutide 2.4 mg and placebo.”

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Are you feeling overwhelmed or hopeless right now? Have you been withdrawing from people or activities you usually enjoy? Are you having thoughts about hurting yourself, or feeling like things will never improve?

You do not have to handle those feelings alone. Support is available, and talking to someone can make a difference. You can reach out to the 988 Suicide & Crisis Lifeline by calling or texting 988, or by chatting online at 988lifeline.org. Trained counselors are available 24 hours a day to listen and help.

If you believe someone is in immediate danger, call emergency services right away. Even a small step, like reaching out to a trusted friend, family member, or professional, can help create a path forward.