Adults who used prescription weight-loss medications and subsequently regained weight reported higher rates of suicidal thoughts and depression, according to a South Korean survey study published in the Korean Journal of Family Practice. Researchers analyzed national health data from 2013 to 2022 to examine these mental health outcomes.
Epidemiological Insights From the Asan Medical Center Analysis
A research team led by Son Ki-young, a family medicine professor at Asan Medical Center in Seoul, examined data from 27,741 adults who participated in the Korea National Health and Nutrition Examination Survey between 2013 and 2022. Among the participants, 10,908 were men and 16,833 were women. Out of this total cohort, 846 individuals reported using prescription weight-loss drugs in the prior year, while 26,895 reported no such medication use.
The statistical adjustments revealed notable differences in mental health indicators between users and nonusers. Participants who used weight-loss drugs were 2.7 times as likely to report suicidal thoughts, 1.9 times as likely to report having made a suicide plan, and 1.7 times as likely to report a suicide attempt compared to nonusers. Additionally, medication users reported depression lasting more than two weeks at 1.9 times the rate of nonusers, and they sought mental health counseling at roughly twice the frequency.
The most pronounced statistical signal emerged within a specific subgroup: individuals who used weight-loss drugs and subsequently regained weight. For this cohort, the odds of reporting suicidal thoughts were 4.2 times those of nonusers. Prolonged depression and counseling rates in this weight-regain subgroup were roughly 1.9 and 1.8 times higher, respectively.
In Plain English: The Clinical Takeaway
- Correlation vs. Causation: Researchers emphasize that this observational study demonstrates a link, not a direct cause-and-effect relationship between the drugs and mental distress.
- The Weight-Regain Factor: The sharpest increase in mental health challenges occurred when patients regained weight after using the medication.
- Historical Context: Because the survey spans 2013 through 2022, the sample predominantly captures older appetite suppressants rather than newer GLP-1 receptor agonists.
Evaluating the Pharmacological Landscape and Regulatory Context
The timeframe of the survey—spanning from 2013 to 2022—is critical for interpreting the pharmacological agents involved. Most of the data predates the widespread clinical adoption of modern GLP-1 and GIP drugs such as high-dose semaglutide (Wegovy) and tirzepatide (Zepbound/Mounjaro). Instead, the South Korean cohort largely reflects older generation prescription agents, including phentermine, diethylpropion, phendimetrazine, topiramate, and orlistat.
Stimulant appetite suppressants have been tied to neuropsychiatric side effects, including anxiety, insomnia, and mood change. Bonnie Mitchell, a licensed professional clinical counselor in California, noted that the data reflects older agents and cannot be used as a direct verdict on modern injectable medications. Mitchell also highlighted that individuals dealing with severe obesity already have higher baseline rates of depression, anxiety, and body-image distress.
| Mental Health Indicator | Medication Users (%) | Nonusers (%) | Adjusted Odds Ratio vs. Nonusers |
|---|---|---|---|
| Depression (>2 weeks) | 22.1% | 11.4% | 1.9x |
| Suicidal Thoughts (Past Year) | 9.9% | 4.5% | 2.7x |
| Suicide Plans | 2.2% | 1.4% | 1.9x |
| Suicide Attempts | 1.7% | 0.6% | 1.7x |
| Mental Health Counseling | 8.4% | 3.4% | 2.0x |
The study authors pointed toward psychosocial elements rather than purely pharmacological mechanisms to explain the spike in distress among those who regained weight. They wrote that missing a target or watching the scale rebound can intensify frustration and dissatisfaction. This aligns with regulatory evaluations in Western healthcare systems. In January 2026, the U.S. Food and Drug Administration (FDA) requested that manufacturers remove suicidal-ideation-and-behavior language from the product labels of Saxenda (liraglutide), Wegovy, and Zepbound. This decision followed a regulatory review of 91 placebo-controlled trials encompassing more than 107,000 patients, which found no increased risk of suicidal thoughts or behavior tied to GLP-1 drugs.
Contraindications & When to Consult a Doctor
Patients utilizing weight management pharmacotherapy must remain vigilant regarding their psychological well-being. Because weight regain can bring guilt, shame and a sense of failure, multidisciplinary care models that integrate behavioral health support alongside pharmacotherapy are vital.
Patients should contact a qualified healthcare professional if they experience new or worsening mood changes. Clinicians managing obesity should establish routine mental health check-ins, particularly for patients who encounter challenges with weight regain.
Conclusion
The investigation published in the Korean Journal of Family Practice underscores the intersection between metabolic health and psychiatric well-being. While observational data cannot confirm that weight-loss medications directly induce suicidal thoughts, the findings highlight that the psychological burden of weight regain is profound. As global utilization of anti-obesity medications continues to expand, healthcare systems must pair pharmacological interventions with proactive emotional support to safeguard vulnerable patient populations.
References
- Son, K.-Y., et al. (2026). Association of prescription weight-loss drug use and weight change with depression and suicide-related thoughts and behavior. Korean Journal of Family Practice.
- U.S. Food and Drug Administration (FDA). (2026).
- Korea National Health and Nutrition Examination Survey (KNHANES). (2013–2022).
