What Happens to Your Brain When You Start Taking Ozempic?

Scroll through the Instagram comments of any celebrity who looks even a little bit thinner than usual and you’re sure to see dozens of people saying things like, “OK, Ozempic,” “The Ozempic is Ozempic-ing” and other things suggesting said celebrity is taking a medication for weight loss (even if there’s no confirmation they are or are not). Since the boom of folks taking GLP-1 medications like Ozempic and Wegovy for weight loss has started, I’ve noticed the concerning trend that too many people are too comfortable commenting on strangers’ weight. Now, I’m not normally one to especially sympathize with famous, rich, beautiful people (the sink in your house’s eleventh bathroom is leaking—how will you make it through?!), but seeing comments like these has made me curious about the psychological effects of GLP-1 medications. (I know the increased attention to what I look like would really mess with my head.) I checked in with Dr. Sanam Hafeez, Psy.D and Ashley Peña, LCSW, for their takes on what’s going on mentally when you start taking Ozempic and other GLP-1s for weight loss.

• Dr. Sanam Hafeez, Psy.D, is an NYC-based neuropsychologist and school psychologist.  She is also the founder and director of Comprehensive Consultation Psychological Services. Dr. Hafeez received her doctorate from Hofstra University and went on to train as a neuropsychologist. Hafeez provides neuropsychological educational and developmental evaluations in her practice and also works with children and adults who suffer from PTSD, learning disabilities, autism, attention and memory problems, trauma and brain injury, abuse, childhood development and psychopathology.
• Ashley Peña, LCSW, is the National Executive Director of Outpatient Services for Mission Connection, the telehealth extension of AMFM Healthcare’s compassion-driven, evidence-based, clinical program. She sees the benefits of utilizing Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) and Solution-focused brief therapy in individual and group settings. Peña is a Licensed Clinical Social Worker, licensed in the state of California, and received her master’s in social work (MSW) from Rutgers University, The State University of New Jersey.

“When initiating GLP-1 medications such as Ozempic (semaglutide), significant transformations occur within the brain that affect both physical and mental aspects,” Hafeez tells me. One prominent change is a decrease in what's called “food noise,” or the constant thoughts and cravings related to eating. Hafeez explains that this reduction likely stems from the medication's ability to regulate appetite and enhance feelings of fullness, in the process diminishing the constant preoccupation with food.

There’s also a potential increase in serotonin levels as blood sugar levels stabilize and weight loss progresses. “Serotonin plays a crucial role in mood regulation and overall well-being, so improving physical health can have positive implications for mental health,” per Hafeez.

Finally, “These medications may also influence brain regions involved in reward processing, potentially altering how individuals perceive and respond to food cues. Ultimately, the combined physiological effects, including better glucose control and weight management, along with possible neurochemical adjustments, contribute to the holistic impact of GLP-1 medications on both body and mind.”

Both experts agree that the mental and psychological effects of GLP-1 medications are not completely understood. “Although a large study found no direct correlation between a GLP-1 antagonist and mental health, mood or anxiety, the effects of Semaglutide are not completely understood,” Hafeez shares. She says that users may experience improvements in mood due to better health overall, but there's also a possibility of mood swings, anxiety or changes in eating habits. Regardless, “It's important for individuals initiating treatment with these medications to monitor their mental well-being closely and communicate any concerns with their healthcare provider for personalized management strategies,” she says. Peña echoes, “With a lack of conclusive data on something like Ozempic, the best thing you can do if you choose to take GLP-1 medication, check in with your doctor and therapist prior to starting these medications, and throughout, in order to truly assess and understand how you are feeling mentally, prior and during.”

Hafeez tells me that people with certain preexisting mental health conditions, like as anxiety or depression, may be sensitive to the effects of GLP-1 medications used for weight loss, as the appetite-suppressing properties of GLP-1 medications might potentially exacerbate anxiety symptoms or contribute to mood swings. Furthermore, if you’ve been prescribed a medication like Ozempic for weight loss, you’ve likely struggled with your weight, which comes with its own set of psychological challenges. Hafeez notes, “With some individuals, losing weight on the outside does not necessarily correlate with feeling happier on the inside.” Additionally, “Friends, family, and people and social media may also be making comments about the weight loss and outright asking if you’re using Ozempic. Not everyone is prepared to respond to such questions.” Healthcare providers should conduct thorough assessments of a patient's mental health history before prescribing these medications. “In cases where there are concerns about exacerbating existing mental health conditions, alternative approaches to weight management may be considered to prioritize overall well-being,” she stresses.

If you and your doctor have decided a GLP-1 medication is right for you, Peña recommends doing the following to ensure you’re mentally prepared for the journey:

• Utilize journaling to track your experience. Keep track of your thoughts, emotions, goals and focus on how you are feeling before and throughout the process. 
• Consult with your mental health providers. If you see a therapist, chat with them to make sure you’re choosing to start this journey for the right reasons. If you have a psychiatrist and are on some kind of psychiatric medication, talk with them about the impacts and correlations of adding a GLP-1 to the mix.
• Identify your support network. These are the people in your life you can (and should) lean on during any struggles.
• Do your research. Have a deep understanding of what the GLP-1 medication is going to do. 
• Be honest about any history with disordered eating. If you’ve previously been diagnosed with an eating disorder or have had a history with disordered eating, consult with your therapist. It’s important to know that GLP-1 hormones are not meant to change your relationship with food long term. “If there is a connection between your weight and your mental health, choosing Ozempic is not going to instantly improve your mental health,” Peña stresses. “Weight loss and a mental health journey is that, a journey, with no specific timeline or immediate fix.”