Mental health, obesity and GLP-1s: why integrated care matters

With GLP-1s reshaping obesity care, addressing mental health is central to long-term results

I always enjoy hearing the stories of the people we support. It’s great to learn what motivated them to engage, what parts of the program had the biggest impact on their success or how their life has changed. 

When we talk with people in our weight management program, it’s common to hear them explain how they feel differently about themselves. They also notice others responding to them in a different way. These changes can be negative, and navigating shifts in self-image and others’ perceptions often takes time and support.

The emergence and effectiveness of GLP-1s further emphasize the challenge of navigating shifts in body image while creating new stigmas. As plan sponsors continue to evaluate their GLP-1 and weight management benefit strategy, it’s important not to forget mental health.

Mental health and obesity must be addressed together

Mental health conditions and obesity have an intertwined relationship. People with obesity are more likely to have depression, anxiety disorders and other mental health conditions—and vice versa.

It’s understandable why the presence of one condition can make the other more likely. Mental health conditions, such as chronic stress and depression, can contribute to weight gain and have other negative cardiometabolic impacts because of hormonal imbalances or changes in behavior, such as reduced activity or emotional eating. For people with obesity, stigma and poor body image, can fuel anxiety and depression, which can reinforce behaviors and further weight gain.

Core to improving both physical and mental health is nutrition, activity, sleep and stress management. By addressing these foundational behaviors together, we can get to the root of obesity, as well as mental health, creating an environment that supports sustainable, long-term outcomes—whether or not a person is on a GLP-1.

GLP-1s have surfaced new mental health considerations

In 2013, the American Medical Association designated obesity as a disease. GLP-1s accelerated our understanding with, research showing obesity is influenced by biology rather than a lifestyle concern or a lack of discipline.

As more people have used GLP-1s for weight loss, we’ve learned they often face new emotional challenges stemming from societal views about obesity. Long-standing cultural misconceptions fuel feelings of guilt or shame about using GLP-1s, and some people experience evolving body image or judgement about how their weight loss was achieved.

Research is also examining how GLP-1s affect mental health conditions, and it’s something worth monitoring as results are inconclusive. For example, one study found people with obesity on GLP-1s had slightly elevated risk of anxiety and an increased risk of depression; another study found those without known mental health issues weren’t any more likely to develop them.

The research further reinforces the importance of an integrated mental health and obesity solution. An integrated offering supports people going through these emotional challenges, while ensuring they have access to tools that will help them maintain the foundational behaviors—nutrition, activity, sleep and stress management—required to maximize the effectiveness of a GLP-1.

Weight management integrated with mental health can help maximize outcomes

While weight management and mental health programs can be effective on their own, results improve substantially when they’re combined. Teladoc Health research shows that people in our chronic condition management program who engaged with digital mental health achieved 10%+ greater weight loss compared to those who didn’t engage with a digital mental health program.

In addition to better weight loss results, people also saw 80%+ greater improvement in blood sugar levels and a 30+% improvement in blood pressure.

The most effective integrated programs include a continuum of mental health solutions, including digital self-guided tools, coaching and licensed clinical care. With a comprehensive mental health offering, people can be guided to the right level of care based on their condition, severity and preferences.