Could semaglutide weight loss drugs be inducing reckless decision-making?
Intro
In a commentary published today in the Quarterly Journal of Medicine (IF 14), two senior clinicians (including UWL's Professor Raymond Playford) are urging doctors to warn patients about a previously unrecognised potential risk of prescribing semaglutide weight loss drugs. The potential side effect is described as "impulse control disorder," where normal decision-making is interfered with and impulsive, uncharacteristic decisions may occur.
Article body
Popular weight loss drugs (like Ozempic and Wegovy, otherwise known as Glucagon-like peptide 1 or GLP-1 agonists) are typically prescribed to people with diabetes, severe obesity and other serious obesity-related health conditions. However, GLP-1 agonists are now being used more widely for simple weight loss and are increasingly used globally, particularly by celebrities and internet influencers for rapid lifestyle weight loss, with limited clinical indications.
Professor Raymond Playford (UWL) and Professor Martin Deahl (Institute of Psychiatry, London) have observed anecdotally that the drugs may be causing patients to exhibit potentially reckless and "out of character" decision-making, including making major life-changing decisions regarding their domestic situation, such as divorce or moving house. The authors are recommending that research should be conducted to explore this risk and in the interim, patients starting GLP-1 agonists should be cautioned about making rapid life-changing decisions.
The authors of the article suggest that taking GLP-1 agonists may result in cognitive changes in decision-making through the combination of metabolic changes resulting from calorie deficit and rapid weight loss, in combination with the direct effects of the drug on brain function.
GLP-1 agonists increase brain dopamine levels, a brain-signaling chemical colloquially known as the "happy hormone" due to its role in feelings of happiness, pleasure and reward.
It is well-known that other drugs that influence dopamine levels in the brain (such as Levodopa, which is used in the treatment of Parkinson's Disease) impact decision-making and increase the risk of impulse control disorders. These side effects can include pathological gambling and hypersexuality, with the British National Formulary (used by medical professionals as a guide to dosage and side effect risk) advising that patients need to be warned about this risk.
However, there is no equivalent advice for GLP-1 agonists in patient information leaflets or from government regulatory agencies. Current warnings about GLP-1 agonists mainly relate to gut motility issues, such as bloating, nausea and acid reflux.
The NICE (Semaglutide) website advises doctors to warn patients about potential impairment of driving and performance of skilled tasks. In the USA, FDA advice (Wegovy) also focuses on the potential development of psychosis and suicidal ideation, advising doctors to warn patients to be alert to sudden changes in mood, behaviours, thoughts or feelings.
However, effects on cognition (particularly decision-making abilities) have received little attention, with the very few studies that have been published focusing on longer-term outcomes, rather than during the early phase of starting treatment when rapid weight loss and dose escalation of GLP-1 therapy is taking place.
It is therefore imperative that as the indications for the use of these drugs expand, we remain vigilant for previously unrecognised side effects and keep patients informed about potential risks.
Related news
-
Could semaglutide weight loss drugs be inducing reckless decision-making?
Two senior clinicians (including UWL's Professor Raymond Playford) are urging doctors to warn patients about a previously unrecognised potential risk of prescribing semaglutide weight loss drugs.
-
University of West London recognises the importance of knowledge exchange with inaugural awards ceremony
April saw the University of West London recognise its growing portfolio of Knowledge Exchange activities with the UWL Knowledge Exchange Awards. Featuring five categories, the awards took place at the Ealing site.
-
UWL hosts inaugural TEDx event: Beyond Boundaries: Unleashing Limitless Perspectives
Topics under discussion included SEGA Europe and cyber security; research on astronaut bone health using smart tech to improve osteoporosis; digital dexterity, artificial intelligence (AI) and the future of creative communications and immersive engineering.
-
Students from UWL’s School of Biomedical Sciences consider big questions for the Grand Challenge
The University of West London’s School of Biomedical Sciences set its students a challenge in February – to think creatively and identify a scientific question and then give a presentation considering how to potentially solve it.
-
Professor of Applied Philosophy at the University of West London (UWL) contributes to ground-breaking academic volume on Philosophical Health
Published by Bloomsbury, 'Philosophical Health: Thinking as a Way of Healing' examines the theory and practice of philosophical health in contemporary contexts of care.
-
UWL Associate Professor of Biomedical Sciences meets the Princess Royal at opening of MRC Laboratory of Medical Sciences (LMS) building
Dr Bernadine Idowu, Associate Professor at the University of West London, was among those invited to meet the Princess as she toured the new Medical Research Council (MRC) Laboratory of Medical Sciences (LMS) building on Imperial College’s Hammersmith Hospital campus.
-
Students and graduates find out about job opportunities at Life and Health Sciences Careers Fair
Hundreds of attendees connected with more than 30 organisations offering employment opportunities plus UWL’s Volunteering, Peer Mentoring, Talent Bank and Careers teams.
-
UWL senior lecturer appears on Sky News to discuss potential Alzheimer’s breakthrough
Dr Andy Northcott, Senior Lecturer in Sociology of Medicine and member of UWL's Geller institute of Ageing and Memory, discussed news that Alzheimer's diagnosis blood tests could be offered on the NHS within five years.
-
Opera performance supports dementia-friendly events to increase access to the arts
The event was a special preview of a new contemporary opera ‘The Last Siren’, a 30-minute piece that takes a fresh look at the Greek myth from Homer’s Odyssey.
-
UWL’s Dr Federica D’Andrea selected for prestigious INTERDEM Academy Publication Award
Dr D’Andrea’s publication was recognised for its "originality and innovation" as well as its "scientific rigor."
-
Interested in a career in Biomedical Sciences?
Take your first step towards a rewarding career in nutrition, pharmaceuticals, medical research or a similar scientific discipline with a degree from the School of Biomedical Sciences here at UWL.
-
Seventh BME Early Career Researcher Conference in Leeds sparks international interest
The conference was originally founded by UWL Associate Professor of Biomedical Sciences Dr Bernadine Idowu.
-
UWL’s Dr Bernadine Idowu and Andreea-Daniela Coroama shortlisted for University Alliance Awards
The awards recognise excellence in higher education and research across the UK’s leading professional and technical universities.
-
2023 graduation celebrations begin for UWL students!
Across two days and eight ceremonies featuring thousands of students, 15 honorary degrees and countless handshakes and hugs, it is time for the University of West London’s graduation festivities to begin!
-
The expanding frontiers of genomic and proteomic technologies
The University of West London’s Professor of Microbiology, Professor Hermine Mkrtchyan, was one of the organisers of the 22nd International Conference on ‘The expanding frontiers of genomic and proteomic technologies’.
-
UWL School of Biomedical Sciences supports MRC’s Black in Biomedical Research Project
A consortium of academics, students, and industry representatives including Dr Bernadine Idowu, Associate Professor of Biomedical Science at UWL’s School of Biomedical Sciences, have been involved in efforts to ensure that £3.7 million will be committed by the Medical Research Council (MRC) over the next three years to fund initiatives to address the underrepresentation of people from Black heritage backgrounds in biomedical research.
-
UWL SBS PhD students have paper published in a high impact Bioengineering journal
Students from UWL's School of Biomedical Science have had a paper – ‘Bioengineering of Antibody Fragments: Challenges and Opportunities’ published in open access academic Bioengineering journal.
-
Cutting-edge UWL cross-faculty collaborative project to tackle retinal degeneration wins funding from the Royal Society
UWL Senior Lecturer in Pharmaceutics and founder of the Biotherapeutic Research Group, Dr Hanieh Khalili, has received a prestigious seeding award from the Royal Society to initiate a ground-breaking new project.
-
UWL to lead pioneering research project funded by British Heart Foundation
AI experts from the University of West London and clinicians from Imperial College London have been awarded £1.5 million in funding by the British Heart Foundation to lead a nationwide research project on integrating AI into cardiovascular medicine.
-
UWL researchers explore care practices thanks to funding success
The University of West London will continue to use expertise to support the care of people living with dementia during hospital stays thanks to a £1million funding grant.
-
Taking inspiration from family to build a future in medical science
Inspired by her grandmother to make waves in healthcare, a University of West London pharmacology student is setting herself up for a career in life-changing global research.
-
Covid hygiene could help fight antibacterial resistance
Keeping up Covid-levels of hygiene awareness long-term could help tackle the spread of deadly antimicrobial resistance, according to new research from the University of West London (UWL) and Royal Holloway University of London.
-
Including online interactions may slow memory decline, study finds
Regularly communicating with friends and family online as well as in person can help maintain long-term memory among older people, according to a study by the UWL's Geller Institute of Ageing and Memory, and the University of Manchester.
-
UWL looks to a new generation of biomedical experts
Ensuring the next generation of game-changing scientists are fully equipped for a leading future in health and medicines, the University of West London (UWL) is offering a whole new area of teaching.
-
UWL lecturer showcases the place of women in STEM
Making sure no girl feels excluded from a future in science, a University of West London (UWL) diversity champion is drawing on her own experiences to inspire the next generation of trailblazers.