GLP-1 treatment lowers suicidal ideation risk by 33% in adolescents with obesity, study findsLatest revision | Image Credit: © Patrick Bay Damsted - © Patrick Bay Damsted - stock.adobe.com.

Background

In a recent study, treatment with glucagon-like peptide 1 receptor agonists (GLP-1s) in adolescents with obesity resulted in a 33% lower risk of suicidal ideation or attempts at up to a 3-year follow-up, compared to those who initiated behavioral interventions.¹

The study, published in JAMA Pediatrics and led by authors Liya Kerem, MD, MSc and Joshua Stokar, MD, noted that childhood obesity affects more than 124 million children and adolescents across the globe.² Over the last 40 years, the prevalence of obesity among children aged 5 to 19 years of aged has increased 8-fold.¹

In the United States, liraglutide 3 mg and semaglutide 2.4 mg are approved by the FDA to treat obesity in adolescents with a BMI greater than the 95th percentile for age and sex.¹

"The neuropsychiatric outcomes associated with GLP1R are not well established, and, to our knowledge, have not been examined exclusively in adolescents," stated the authors. "In this study we conducted a propensity score–matched analysis using a multi-institutional federated health care network to assess the risk for suicidal ideation or attempts following exposure to GLP1R in adolescents with obesity."¹

Study details and results

Study data was derived from 120 health care organization, mainly located in the United States and included data on adolescents aged 12 to 18 years with an obesity diagnosis and evidence of an anti-obesity GLP-1 prescription or lifestyle intervention without GLP-1 within the following year. Main outcomes and measures included Incidence of suicidal ideation or attempts based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, which were recorded in patient electronic health records during the 12 months of follow-up period. Negative control outcomes were diagnoses of upper respiratory tract infections (URTI), while gastrointestinal symptoms (GI) were used as positive control outcomes.¹

"A total of 4052 adolescents with obesity and a concomitant anti-obesity intervention were identified for the [GLP-1] cohort and 50,112 were identified for the control cohort," the study authors wrote. After propensity score matching, 3456 participants made up each balanced cohort.1

The use of prescription GLP-1 was associated with a 33% reduced risk for suicidal ideation or attempts during a 12-month follow-up period (1.45% vs 2.26%; hazard ratio [HR], 0.67; 95% CI, 0.47-0.95; [P = .02]) compared to lifestyle interventions, and a higher rate of GI symptoms (6.9% vs 5.4%; HR, 1.41; 95% CI, 1.12-1.78; [P = .003]). There was no difference in rates of URTI diagnoses, according to the study results.¹

"No signal for an increase in suicidal ideation or attempts associated with [GLP-1] prescription was seen across subgroups stratified by sex, race and ethnicity, [GLP-1] type, and diabetes status as well as over a range of follow-up times up to 3 years," stated the authors.¹

Conclusion

Further, the authors said that results from this large, multicenter cohort study warrant future research to assess the association of GLP-1 treatment with psychiatric outcomes in this patient population.

References:

1. Kerem L, Stokar J. Risk of Suicidal Ideation or Attempts in Adolescents With Obesity Treated With GLP1 Receptor Agonists. JAMA Pediatr. Published online October 14, 2024. doi:10.1001/jamapediatrics.2024.3812

2. Collaboration NCDRF; NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-2642. doi:10.1016/S0140-6736(17)32129-3