Many people who read newspapers will have noticed an onslaught of articles within the past year about new drugs that magically help people lose lots of weight. These include drugs that are not supposed to be used for that purpose, typically prescribed for people with diabetes. While efforts to help people get to a healthy weight are useful, there are questions about the safety of those drugs in the long term. Little is known about what they will do to people who take them after a year, a decade, or more.

There have been recent reports about cases of people who started self-harming and becoming suicidal after taking certain weight loss drugs, and some of the drugs actually contain a warning about the risk of suicidal thoughts ^[1]. The cases have concerned the European Medicines Agency so much that it has launched an investigation ^[2]. The drug companies claim that their clinical trials did not show any evidence that the side effects include suicidal thoughts, but that is not valid evidence if they did not measure that potential outcome and if they did not conduct trials with an appropriate length of follow-up.

There is very little peer-reviewed scientific literature reporting about the mental health side effects of these weight loss drugs, possibly because it takes time for such evidence to emerge. It takes time for scientists to get funding for trials, conduct those trials, and publish them, therefore all that potential users of the drugs can do is wait for the published evidence or judge for themselves whether they think it is safe to continue.

While people likely take weight loss drugs because they want to avoid the long-term health consequences of being overweight or obese, the risk of severe mental or physical harm from the drugs might or might not outweigh the benefits of the weight loss. The truth is that no one knows what the side effects are going to be in the long run. Research is required to clarify how many people are affected, among those who use the drugs, and taking into consideration other risk factors.

However, the emerging evidence does highlight the need for the media to take a pause and think about whether it is helpful or harmful to promote these weight loss drugs. While there has been a wave of positive stories about people who had struggled with their weight for years, but shed lots of it, there is less attention on people who put the weight back on (and some) after stopping the drugs. The reality is that weight loss is a complex goal that requires psychological and physiological interventions, and it is likely that the causes of obesity cannot be solved by giving people pills to pop.

If you want to know whether or not to take a weight loss drug, be aware that there is very little evidence about the long-term consequences, and think about whether you want to gamble your health on chance. Ask an independent clinician for an expert opinion, and beware of the few clinicians who have financial incentives from drug companies to promote those drugs to patients.

Think about the best method of weight loss, but avoid the quick fixes if the cost to your mental or physical health might be too high. Reports that some people who take popular weight loss drugs have become suicidal should ring alarm bells for people taking the pills because their long-term impact is unknown. Being thinner might not be worth the potential risk to mental or physical health.