Susanne Kuckuck1, Nina van Gerwen2,3, Johanneke E. Oosterman1, Mesut Savas1, Maryam Kavousi2, Brenda W.J.H. Penninx4, Mariëtte R. Boon1, Elisabeth F.C. van Rossum1
1) Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands, 2) Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands, 3 Department of Biostatics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands, 4) Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Background: Obesity is associated with impaired mental health, including depression and anxiety symptoms as well as decreased psychological wellbeing. The glucagon-like peptide-1 (GLP-1) analogue liraglutide effectively promotes weight loss and improved glycaemic control, but its impact on mental health is unclear. We evaluated changes in mental health and psychological wellbeing after a 4-month liraglutide 3.0 mg treatment.
Methods: We included 98 patients with obesity (72% women, body-mass-index (BMI) = 41.4 kg/m2 [37.3, 46.8 IQR]) treated with liraglutide 3.0 mg. Changes in mental health (Hospital Anxiety and Depression Scale ‘HADS’ total score (range 0-42), depression and anxiety subscores (range 0-21); ObesiQ psychological well-being (range 0-100), and BMI between baseline and 4-months follow-up were measured. Specifically, we assessed changes both in the whole group and stratified by poor vs. good baseline mental health.
Results: Body-mass-index decreased after 4 months (-2.42 kg/m2 [0.19 SE, p<0.001]). We also saw slight decreases in HADS total, depression, and (in trend) anxiety scores (-1.73 [0.78 SE]; -1.01 [0.45 SE], both p<0.05, and -0.71 [0.40 SE], p=0.07, respectively). OBESI-Q psychological wellbeing scores slightly increased (4.57 [1.79 SE], p<0.05). In stratified analyses, both groups showed similar BMI decrease (-2.92 kg/m2 [0.38 SE] in poor vs. -2.50 [0.44 SE] in good baseline mental health group, both p<0.001), but decreases in anxiety and depression scores were only observed in those with poor baseline mental health (-3.16 [1.08] and (-1.27 [0.54 SE], both p<0.05).
Conclusion: In patients with obesity, we saw slight improvement in mental health and psychological wellbeing after 4 months of liraglutide treatment. Especially patients with poor baseline mental health may benefit with mental health improvements after liraglutide treatment. Moreover, weight loss was irrespective of baseline mental health, suggesting liraglutide weight loss treatment efficacy even in the presence of mental health impairments.