Losing the Appetite for Life: Navigating the Hidden Mental Health Toll of GLP-1s

Conflicting studies say these medications either cure depression or double it - here's what to look out for so you don't get into the depression trap.

Ugh, this topic scares me.

As if we didn’t already have enough depression around us - maybe from a world falling apart under super late-stage capitalism and excessive greed, now the GLP-1s that are supposed to save us may also be giving some of us a dose of depression on the side.

Of course, the whole body is connected. If you are not careful, removing one little cog can bring the whole stack of Jenga bricks crashing down. With GLP-1s, we are playing Jenga with our bodies and our minds.

Anyway, the point I am trying to make is that research has shown a possible increased risk of depression with the weekly jab. And the numbers are pretty wild.

According to this study, patients on GLP-1 receptor agonists had a 195% higher risk of major depression, a 108% increased risk of anxiety, and a 106% elevated risk of suicidal behavior.

And on the other hand - we have other studies - which showed that GLP1 medication reduced depression. So basically - anything can happen?

Before we go deeper, let’s take a moment to see how they are related.

So … how exactly are Glp-1s and depression related?

Let’s go back to the beginning. We know GLP-1s affect the gut, but did you know they also affect the brain?

GLP-1 is not only a gut hormone. They also affect the brain’s reward centers - that help decide what feels rewarding, motivating, desirable, or worth pursuing. That may be one reason these drugs can quiet food noise. But for some people, the question is whether the quieting stays limited to food, or starts to feel like a broader dimming of pleasure. It has a direct impact on dopamine (the feel good neurotransmitter we all love). Here’s how:

• In the brain, GLP-1s blunt the dopamine spike, which is why that juicy, carb-loaded bagel suddenly loses its spark.

• Dopamine is also created in the gut. The gut produces about 50% of the body’s peripheral dopamine. This dopamine is essential for moving food through the system, also known as peristalsis. When GLP-1s slow this process down, the normal rhythm of dopamine release may be altered.

• If you are eating much less, you may not be getting enough of the raw materials needed to make dopamine.

• Biological predisposition - Some people may already be wired for lower dopamine. For them, GLP-1s may not just be “quieting” the system. They may feel like they are extinguishing it.

• Social loss. If your language of love was cooking and eating, what happens to your soul when that language is taken away?

So how do you know if your dopamine is low?

Much like the symptoms of depression - low dopamine show up as:

• A lack of pleasure from anything - hobbies, family, creativity, music, sex, connection

• Muscle rigidity, restless legs

• Brain fog, irritability, memory issues

• Fatigue

• Low libido

• Low motivation

• Insomnia

• A sudden shift into emotional flatness or hopelessness

• A feeling that your identity has collapsed along with your appetite

• Thoughts of self-harm

If any of this sounds like you, it might be worth it to go talk with your health care provider and see if they can help you find the source of the problem, or help you fix it

if you have self harm thoughts call 988 immediately or a suicide prevention hotline.

What can you do?

1. Talk with your doctor and advocate for yourself.

   Tell them how you feel, track your symptoms and see if they can help you by adjusting the dose, referring you to a therapist, ask for them to check labs and make sure you aren’t deficient in anything.

2. Look at your life and make some changes - eat enough, restore fun rituals, start scheduling time with your friends

What not to do:

• Do not let anyone tell you that feeling emotionally flat is irrelevant because the scale is moving.

• Do not let anyone tell you that losing your appetite for food and losing your appetite for life are the same thing.

Anyway - that’s all I have for you today.

Coming back on Thursday with a dopamine menu - so subscribe if you want that!