By Dr. Asnat Raziel, bariatric surgeon specializing in obesity treatment, metabolic health and healthy longevity; Director of the Multidisciplinary Center for Obesity Treatment, Assia Medical, Assuta Ramat HaChayal, Tel Aviv
GLP-1 and depression: a surprising finding from Sweden
The link between GLP-1 and depression took an interesting turn this year. A large national study from Sweden found that well-known obesity and diabetes medications may reduce worsening of depression, anxiety and even self-harm. The study was published in March 2026 in The Lancet Psychiatry, led by researchers from Finland and from the Karolinska Institute in Stockholm. According to the Karolinska Institute announcement, the researchers used Sweden’s national health registries. So it is worth understanding exactly what they found, and what they didn’t.
The complex link between obesity and mental health
Obesity and diabetes are not just metabolic diseases. They are closely tied to mental health. People with diabetes have a higher risk of depression, anxiety and even suicide. Moreover, the relationship runs both ways. A metabolic disorder affects mood, and depression or anxiety, in turn, worsens metabolic control.
In recent years, a family of drugs called GLP-1 receptor agonists has come into use. These drugs mimic a natural satiety hormone. They include semaglutide, the active ingredient in Ozempic and Wegovy, and liraglutide, the active ingredient in Saxenda. Beyond their effect on weight and blood sugar, a question arose: do they also affect the brain and mood?
The study: the same patient, over time
The study included 95,490 patients in Sweden diagnosed with depression or anxiety. All of them received medication for diabetes between 2009 and 2022. Of these, 22,480 used GLP-1 drugs during follow-up.
What makes it special is the approach. Each patient served as their own control. In other words, the researchers compared periods when a person was taking a GLP-1 drug with periods when the same person was not. This reduces many biases, such as genetics, personality and lifestyle, and brings us closer to understanding the effect of the drugs themselves.
Worsening mental illness was defined as any of the following: psychiatric hospitalization, sick leave of more than 14 days for a mental health reason, hospitalization for self-harm, or death by suicide.
GLP-1 and depression: the main result
The key finding is a lower risk of mental health worsening during treatment with some GLP-1 drugs. Semaglutide stood out in particular:
- A 42% lower risk of overall mental health worsening.
- A 44% lower risk of worsening depression.
- A 38% lower risk of worsening anxiety.
- A 47% lower risk of worsening substance use disorder.
Liraglutide also showed a positive but more modest effect: an 18% reduction in overall mental health worsening. In addition, it lowered only the risk of worsening depression, by 26%. By contrast, exenatide and dulaglutide showed no effect at all.
Not all GLP-1 drugs are the same
One of the most important findings is that there is no uniform effect across the whole GLP-1 family. Semaglutide stood out above all the others. This means the effect doesn’t come only from weight loss or better blood sugar. Each drug may have its own mechanism, for example differences in how well it reaches the brain.
Less self-harm, too
The study also found that GLP-1 drugs as a group were linked to a 44% lower risk of self-harm. These figures carry deep clinical meaning. The reason is simple: hospitalizations, sick leave and self-harm are “hard” measures of mental health worsening, not just a subjective feeling.
How might GLP-1 drugs ease depression? Biological hypotheses
The effect on mental health is still being studied. Still, there are several possible mechanisms:
- A direct effect on the brain’s satiety and reward centers.
- Less chronic inflammation, which is linked to depression.
- An effect on the dopamine system and addiction circuits.
- Better sleep quality and more energy.
- Weight loss, which improves self-image and daily functioning.
Together, these may explain the broad effect. There is also early support from a controlled trial. In a small trial of 48 adults with alcohol use disorder, low-dose semaglutide reduced both drinking and the craving to drink. You can read about the brain’s appetite circuits in my article on the physiology of satiety, and about inflammation in my article on obesity and inflammation.
GLP-1 and depression: what about the fear of worsening?
In recent years there have also been conflicting reports, including concerns about increased depression or suicidality. The Swedish study paints the opposite picture: not only is there no worsening, but there may even be a protective effect.
Controlled trials are reassuring as well. An analysis of four STEP trials, with more than 3,600 participants, found that semaglutide did not raise the risk of depression or suicidal thoughts. It is important to note that the participants in these trials had no significant mental illness. In addition, the European Medicines Agency concluded back in April 2024 that the evidence does not support a causal link between GLP-1 drugs and suicidal thoughts.
Regulators have reached a reassuring conclusion, too. In January 2026, the FDA requested removal of the suicidality warning from the labels of Wegovy, Saxenda and Zepbound. Its review found no increase in the risk of suicidal thoughts, anxiety or depression. I discuss the mental health side of these drugs further in my article on psychiatric medications and weight gain.
However, the researchers stress that this is an observational study. Therefore, randomized controlled trials are needed to prove a causal link.
GLP-1 and depression: what it means in the clinic
The data point to a new possibility: one treatment that may help both body and mind. This is especially relevant for patients with:
- Obesity.
- Diabetes.
- Depression or anxiety.
For these patients, choosing the right medication may improve the overall picture. The researchers themselves write that semaglutide, and to a lesser extent liraglutide, may be a “dual-benefit” treatment for anxiety and depression that occur alongside diabetes and obesity. Even so, these drugs are not a substitute for mental health care.
Looking ahead
The study opens a new direction in medicine: an integrated approach in which metabolic treatment also affects mental health. The next step is controlled clinical trials that will examine three questions. First, is the effect causal? Second, which patients will benefit most? And finally, what is the exact mechanism?
The bottom line on GLP-1 and depression
The new generation of obesity medications is changing more than weight. It may also be changing how we understand the connection between body and mind. The data on GLP-1 and depression are encouraging, but it is still too early to say these drugs treat depression. The key message: obesity is a systemic disease, and treating it may have effects far beyond the number on the scale. If you are living with depression or anxiety, keep up your mental health treatment, and talk to your doctor before making any change.
The information in this article is general and does not replace personal medical advice.
References
Diabetes drug Ozempic linked to better mental health
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial
Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 8-11 April 2024
The Swedish study was funded by the Sigrid Jusélius Foundation, the Jane and Aatos Erkko Foundation and the Finnish Ministry of Social Affairs and Health.
