Psychiatrists Prescribe or Recommend Ozempic, Other Weight Loss Drugs

On November 3, 2023, the New York Times broke a story analyzing the role of Ozempic and other weight loss drugs in mental health or psychiatric care. Upon reaching out to 13 psychiatric departments at major health institutions, reporters noted that 6 departments already recommend or prescribe Ozempic or other comparable drugs to their patients to manage weight gain side effects for those taking antipsychotics or antidepressants.

The International Journal of Obesity estimates that patients taking antipsychotic medications are 3–5 more likely to be obese than those not taking the drug. Furthermore, a 2019 review published in Obesity Management/Etiology and Pathophysiology suggests that individuals taking antidepressants gain an average of 5% of their body weight.

Although these side effects do not affect all patients — and some can be managed through lifestyle changes like diet and exercise, obesity-related adverse reactions to psychiatric medication may deter some patients from adhering to the recommended treatment regimen.

Prescription nonadherence continues to be a significant problem in mental healthcare settings. While providers do their best to address the complications associated with mental health medications, weight gain often takes a back seat.

However, a 2022 study published in Frontiers Psychology suggested that traditional medications to manage weight, such as metformin, can effectively minimize the obesity-related side effects of antipsychotic drugs.

Ozempic and other weight loss drugs are just an added tool for some healthcare institutions.

"It's been a real welcome addition, for people who truly have endured significant weight gain because of atypical antipsychotics and have doggedly tried their best to overcome that," Joseph Goldberg, a professor of psychiatry at Icahn School of Medicine at Mount Sinai in New York, told Reuters.

Dost Öngür, MD, chief of the division of psychotic disorders at McLean Hospital in Massachusetts, has also championed this approach, telling the New York Times that all mental health professionals should know how to evaluate their patients for weight loss drugs. Reuters notes that he has gone as far as developing a guide for mental health professionals.

Despite the potential positive impacts of these drugs for psychiatric patients, they are not without their risks. Even in the general population, Ozempic, Wegovy, and other injectable weight loss medications have caused dangerous and adverse events.

Mahavir Agarwal, a psychiatrist and scientist at the Centre for Addiction and Mental Health in Toronto, emphasized that this population is vulnerable, and there is limited data on the effects of semaglutide in patients with mental illness.

Some providers have suggested these medications may even exacerbate eating disorders or body image-related mental health conditions.

There continues to be gaps in researchers’ understanding of the impact of these weight-loss drugs on vulnerable populations. Whether or not a psychiatrist chooses to prescribe or recommend these drugs, mental health professionals should monitor research and updates on the impact of these drugs in psychiatric populations.