How virtual mental health care can support patients on GLP-1s

This is the first in a series of articles exploring the intersection of GLP-1s and digital health. 

What are GLP-1s? 

GLP-1s, or glucagon-like peptide-1 receptor agonists, are a class of medications that mimic the action of the GLP-1 hormone naturally produced in the gut. This hormone is released in response to eating and helps regulate blood sugar by stimulating insulin release from the pancreas and suppressing glucagon, another hormone that raises blood sugar. GLP-1 agonists are primarily used to manage type 2 diabetes and, more recently, for weight loss, as they also slow gastric emptying and promote satiety, leading to reduced food intake. 

When were GLP-1s approved by the FDA?

Various GLP-1s have hit the market over the past twenty years. The first GLP-1 receptor agonist, exenatide (Byetta), was approved by the FDA in 2005 for the treatment of type 2 diabetes. Subsequent approvals included liraglutide (Victoza) in 2010, dulaglutide (Trulicity) in 2014, and semaglutide (Ozempic) in 2017, which offered more convenient dosing schedules and improved efficacy. The first oral GLP-1 analog, semaglutide (Rybelsus), was approved in 2019. More recently, dual agonists like tirzepatide (Mounjaro/Zepbound) have entered the market, combining GLP-1 and GIP receptor activity for enhanced metabolic effects.

What is the total market size?

The global GLP-1 market was valued at approximately $49.3 billion in 2024, with projections to reach $157.5 billion by 2035, reflecting rapid growth driven by increased adoption for both diabetes and obesity.

How many patients are using them?

In the United States, a recent survey found that about 13% of adults—roughly one in eight—have tried a GLP-1 drug, with about 6% currently using one. These numbers reflect the rapid uptake of these medications.

Why are they so popular? 

GLP-1 drugs, such as Ozempic, Wegovy, Mounjaro, and Zepbound, have been dubbed “miracle drugs” by the media, patients, and some physicians because of the substantial weight loss many users experience. These medications are also associated with benefits beyond weight loss, including improved blood sugar control, reduced risk of heart attack and stroke, and potential protective effects against neurological and behavioral health issues like addiction, dementia, and Alzheimer’s disease. 

GLP-1s and mental health 

There is plenty of evidence supporting GLP-1s as highly effective medications for diabetes treatment and weight loss which leads to other improved health outcomes. However, most medications come with side effects of some kind or another, and one of the underdiscussed side effects of GLP-1s is increased risk for mental health conditions. A study published in Nature of 162,253 case and control patients, “showed a significant association between GLP-1 RA treatment and a 98% increased risk of any psychiatric disorders. Notably, patients on GLP-1 RAs exhibited a 195% higher risk of major depression, a 108% increased risk for anxiety, and a 106% elevated risk for suicidal behavior.” The study also notes that patients with a history of major depression were excluded from phase 3 clinical trials of GLP-1 medications. Another important note was that risk increases over time as patients use the medications for years. 

How digital health companies can support GLP-1 users

There are well-known correlations between mental health and body image. Body dysmorphia can lead to anorexia and bulimia. Worry and stress can lead to comfort eating and weight gain. And people with a history of obesity may also be co-morbid with depression (according to CDC data, 75% of adults with depression were also obese), particularly if the increase in body mass is from an acute injury or chronic disease that reduces their ability to exercise and care for themselves the way they did before. Even without the addition of GLP-1s it stands to reason that patient care for weight loss should also be paired with mental health care.  

As telehealth companies, like Hims & Hers, LifeMD and Ro, increasingly prescribe GLP-1s virtually, they have the opportunity (responsibility?) to combine mental health screening and care alongside medication prescription. One of the overarching concerns heard among the medical community when it comes to standalone telehealth platforms is that medications are being prescribed without a full health history or longitudinal data on how past treatments have succeeded or failed for patients. One way for standalone telehealth providers to close that gap when prescribing weight loss medications is to conduct a mental health history screening to look for any outsized risk in exacerbating pre-existing conditions with the addition of a GLP-1. If the patient and virtual provider decide to go ahead on the new medication, the patients could also be either paired with a mental health counselor or sent follow up questionnaires on their mental health at regular intervals. The continued patient engagement seems particularly pressing considering that risk for anxiety, depression, and suicidal thoughts increase significantly over time. 

Supporting mental health care for GLP-1 users isn’t just the responsibility of telehealth providers. Traditional care delivery models may make it easier or harder to add mental health screenings or services, depending upon how overloaded their existing mental health providers are. In an ideal world, as soon as a patient is prescribed a GLP-1 they are also referred to mental health care – either in person or via a virtual care network like Talkiatry, Better Health, or Brightside Health so everyone has access to the guidance that they need. 

GLP-1s have transformed care for type 2 diabetes and obesity, delivering significant results in blood sugar control and weight loss. As their use grows, it’s vital to recognize potential mental health risks, especially with long-term treatment. Integrating mental health support alongside GLP-1 prescriptions—particularly by leveraging telehealth—can help ensure safer, more holistic care.

Katie D. McMillan, MPH is the CEO of Well Made Health, LLC, a business strategy consulting firm for health technology companies. She is also a curious researcher and writer focusing on digital health evidence, healthcare innovation, and women’s health. Katie can be reached at [email protected] or LinkedIn.