Originally developed for the treatment of type-2 diabetes, GLP-1 agonists like Ozempic (semaglutide) have gained widespread attention for their ability to help people manage their weight. However, as more people turn to the medication, it’s important to understand its impact on mental health.
With reported side effects like depression, anxiety, and disturbances in mood and sleep, the medication has raised some concerns about mental health. At the same time, studies indicate the drug’s potential to curb impulsive behaviors like nail-biting, hair-pulling, and overeating, which has sparked interest in how it may affect people living with obsessive-compulsive disorder (OCD).
Read on to learn more about how Ozempic impacts mental health, and what people with OCD need to know.
What is Ozempic?
Ozempic is a FDA-approved prescription medication that was created to treat type-2 diabetes and belongs to a class of drugs called GLP-1 (glucagon-like peptide-1) receptor agonists. These drugs mimic the action of a naturally occurring hormone in the body that helps regulate blood sugar levels, insulin production, and appetite.
The medication works by enhancing insulin secretion in response to food intake, slowing down gastric emptying (which helps you feel fuller longer), and suppressing glucagon release (which helps lower blood sugar). Some of these medications have been approved for weight loss by the FDA, but it depends on the specific drug.
Medications include:
- Semaglutide (Ozempic, Wegovy)
- Liraglutide (Victoza, Saxenda)
- Exenatide (Byetta, Bydureon)
- Dulaglutide (Trulicity)
- Lixisenatide (Adlyxin)
These medications are typically administered as a once-weekly injection and are often prescribed when diet and exercise alone aren’t enough to control blood sugar. As with any medication, it’s important to work with a healthcare provider to determine if it’s appropriate for you.
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Can Ozempic affect mental health?
Studies say yes—Ozempic can potentially cause side effects like depression (the most commonly reported mental health impact), followed by anxiety and suicidal ideation.
It’s important to note that these mental health impacts are not experienced by everyone who takes Ozempic, but they can occur. This may be due to the medication’s impact on the brain’s neurotransmitter systems, which cause appetite-suppressing effects, changes in blood sugar levels, and may result in other reactions.
As research into the mental health impacts of Ozempic continues, the European Medicines Agency (EMA) and other global regulators are evaluating over 150 reports of suicidal thoughts and self-harm related to Ozempic and other GLP-1 usage. Wegovy, another GLP-1 medication, now includes a warning about the potential for suicidal thoughts on its label. Rimonabant, another GLP-1 previously on the market, was withdrawn in part due to severe mental health side effects, including suicidal ideation.
However, as of right now, more research is needed to determine the full scope of the mental health risks associated with Ozempic. Researchers are focused on better understanding the connection between GLP-1 medications and mood-related side effects, as well as how these drugs may interact with other mental health conditions, like OCD.
Can Ozempic affect OCD symptoms?
While some medical professionals online have claimed that Ozempic can help with OCD, Tracie Ibrahim, MA, LMFT, CST says there is no valid research supporting Ozempic use for OCD: “It can be dangerous to advertise this medication as a treatment option. There are no longitudinal, peer-reviewed, meta-analyzed studies that support Ozempic as having any effect on OCD symptoms.”
What the research says
There are studies on the effects of Ozempic on addiction, demonstrating that the medication may curb impulsive behaviors such as shopping, overeating, and body-focused repetitive behaviors (BFRBs) like nail-biting and hair-pulling as it is thought that the medication affects the reward pathway in the brain.
While addictive behaviors like these may seem similar to OCD compulsions, there is a difference. Both are driven by a strong urge to engage in repetitive behaviors, but the motivation and feeling of engaging in these behaviors is different. OCD compulsions are done to alleviate the anxiety caused by obsessions, and any relief they provide is very temporary. Addictions and body-focused repetitive behaviors, in contrast, are not responses to obsessions and typically feel good to engage in—even if they have harmful long-term consequences.
These differences are important to consider when analyzing studies that only focus on the impact of Ozempic on addictive and body-focused repetitive behaviors. There are limits to how much we can learn from this research about how Ozempic might impact OCD.
What people online say
Some people with OCD on social media have shared positive experiences using GLP-1 medications: “I am diagnosed with OCD, anxiety disorder and Semaglutide has drastically reduced my obsessive and compulsive thoughts/behaviors,” one user commented. “It’s also helped me in other areas that I have a history of being impulsive (binge drinking, compulsive shopping, taking risks).”
Others commented on how Ozempic worsened their OCD symptoms: “Since taking ozempic my OCD…has absolutely skyrocketed and I’m feeling worse than before medication and psychotherapy. Completely out of control. Old compulsions and horrible thoughts and themes I haven’t dealt with since the beginning are back and soaked in jet fuel.”
It’s important to recognize that the effects of medications like Ozempic can vary greatly from person to person. However, Ozempic is not recommended for people with eating disorders—which may co-occur with OCD.
How OCD impacts body image and food
If you have OCD and are considering taking a GLP-1, it’s also important to understand the relationship between OCD, food, and body image.
It’s not uncommon to be diagnosed with both an eating disorder and OCD. Drugs like Ozempic can be especially dangerous for people who are already navigating eating disorders like anorexia and bulimia.
Even if you haven’t been diagnosed with an eating disorder, OCD can significantly impact eating behaviors. For example, contamination OCD can cause fears around getting sick from eating certain foods, and magical thinking OCD can lead to superstitions surrounding food. Scrupulosity OCD, which involves fears of violating moral or religious rules, can also impact eating habits—making you feel like you have to follow dietary rules that align with certain religious codes, or that it’s immoral to leave food on your plate.
While these behaviors might not meet the criteria for an eating disorder, they still have a significant impact on your mental and physical well-being. If you have OCD, it’s important to consider your relationship to food before seeking relief from a GLP-1 like Ozempic.
The most effective treatment for OCD
OCD can be debilitating, so it makes sense to look for relief wherever you can find it. However, there are better methods than Ozempic for treating OCD symptoms.
Exposure and response prevention (ERP) therapy is a specialized form of cognitive behavioral therapy (CBT) specifically designed to treat OCD. ERP involves working with a therapist to gradually expose yourself to fears that trigger intrusive thoughts, while resisting the urge to do compulsions. The goal is to help you build tolerance to the anxiety these thoughts trigger, and reduce the need to engage in rituals to alleviate that anxiety.
For someone whose obsessions center on food, this might look like resisting the urge to constantly check nutritional labels, excessively wash food, or feel compelled to finish everything on your plate. ERP therapy can help you learn to sit with the uncertainty that comes with abstaining from these behaviors—teaching you to build resilience to distressing thoughts and fears. In time, ERP can help you build a healthier relationship with eating, control, and even body image.
What to consider before taking Ozempic
Studies on semaglutide indicate that it’s important to be aware of the adverse mental health effects, particularly depression, anxiety, and suicidal ideation. In fact, some even recommend screening people for pre-existing mental health conditions before prescribing the meds—so, think seriously about taking these drugs if you’re navigating OCD or a related condition.
While Ozempic may offer benefits in terms of weight loss and blood sugar control, its impact on mental health should not be overlooked. “Ensure that you meet with your prescribing provider and ask any relevant questions you may have about the medication, what it is used for, and the efficacy of its use on the condition they are treating,” says Ibrahim. And, remember, if you’re looking for GLP-1 medications to ease symptoms of OCD, more effective and well-researched treatments, like ERP, exist.
If you do end up taking Ozempic or a related drug and are in therapy for OCD, be sure to inform your therapist, as it may impact your ability to successfully engage in ERP.
At the end of the day, it’s important to listen to your body, talk with your provider, and remember that OCD is a chronic but treatable condition. By addressing root causes through ERP therapy, you can learn to have a healthier relationship to your obsessions—whatever form they take.