The 30-second summary
- The worry: GLP-1 medicines are increasingly prescribed to teenagers, and concern about suicidal thoughts has followed them from adult use.
- The study: 18,444 adolescents with overweight or obesity in a global health records network, published in Diabetes, Obesity and Metabolism on 14 September 2026.
- The finding: no increase in any psychiatric outcome measured, and 26% fewer suicide-related events than in teenagers on lifestyle care alone.
- The caution: against metformin, there was no difference. The lower risk may partly reflect who gets prescribed a GLP-1, not the drug.
Why this matters for families
Teenagers with obesity already carry higher rates of depression and suicidality, which is part of why any medicine that might add to that risk deserves a hard look. In adults the question has been studied heavily, and in January 2026 the FDA asked for the suicide warning to come off the labels. Adolescents have had much less data.
This study, from psychiatrists and researchers at Chi Mei Medical Center and other institutions in Taiwan, used one of the largest pools of adolescent health records available.
How was the study done?
The researchers used the TriNetX Global Collaborative Network, a database of anonymised electronic health records. They found adolescents with overweight or obesity who started semaglutide, liraglutide or tirzepatide and compared them with adolescents receiving lifestyle interventions.
To make the groups comparable, they used propensity score matching, pairing each GLP-1 user with a similar teenager on lifestyle care. That left 9,222 in each group. They tracked outcomes from 30 days to three years after the start date.
What did it find?
| Outcome | Hazard ratio, GLP-1 vs lifestyle care |
|---|---|
| Suicide-related events (ideation or attempt) | 0.74 (0.57 to 0.95) |
| Suicidal ideation | 0.73 (0.56 to 0.96) |
| Anxiety | 0.92 (0.84 to 0.99) |
| Suicide attempt | No significant difference |
| Depression | No significant difference |
| Insomnia | No significant difference |
| Eating disorders | No significant difference |
The lower risk was clearest in girls (HR 0.61) and in teenagers without type 2 diabetes (HR 0.63). It was not significant in boys or in teenagers with type 2 diabetes.
The headline is not that GLP-1s protect mental health. It is that nothing measured got worse.
What the study cannot tell us
The authors are frank about this. When they compared GLP-1 users with teenagers taking metformin, another medicine used in adolescent obesity and diabetes, the difference disappeared. That points to selection bias, which the authors name: teenagers who are prescribed a GLP-1 may differ from those who are not in ways the records do not capture.
Other limits:
- Health records are not interviews. Suicidal thoughts only appear if someone asked and wrote them down.
- Three drugs were pooled. The study does not separate semaglutide from tirzepatide.
- Three years is the limit. Effects across adolescence into adulthood are not known.
Two other pieces of evidence
A small clinic study, same day. The Journal of Pediatric Endocrinology and Metabolism published a review of 44 adolescents aged 12 to 21 treated with liraglutide or semaglutide at one US academic centre between 2022 and 2024 (Said et al.). Among the 15 with depression questionnaires before and after, the median score fell from 6 to 1. Among 23 screened for suicide risk, none showed an increase or new suicidal thoughts. The numbers are small and the authors call it exploratory.
The FDA label change. On 13 January 2026 the FDA asked for information about suicidal behaviour and ideation to be removed from the labels of Saxenda, Wegovy and Zepbound. Its review of 91 placebo-controlled trials with 107,910 patients did not show an increased risk. The communication does not say whether adolescent data were part of that review.
What it means if your teenager takes a GLP-1
As of October 2026, the evidence points to no added psychiatric risk from GLP-1 medicines in adolescents, and the largest study is reassuring on suicide. That is not the same as "no need to watch". The FDA still asks patients to tell a health professional about new or worsening depression, suicidal thoughts or unusual changes in mood. In the US, the 988 Suicide and Crisis Lifeline is available at any hour.
Three things are worth keeping an eye on:
- Mood and sleep, especially in the first months and after dose increases.
- Eating. A smaller appetite can mask restriction. Our guide to GLP-1s and eating disorders covers the signs.
- Anxiety and low mood that do not lift. Our guide to GLP-1s and mood sets out what the adult evidence shows.
What to do with this
A growing body on a reduced appetite still needs regular meals with protein, fibre and enough energy for school and sport. Three small meals and planned snacks usually work better than waiting to feel hungry.
Sources
- Liu TH, Shen YL, Kuo TH, Wu JY, Lin CH, Lai CC. Psychiatric Safety of GLP-1 and Dual GIP/GLP-1 Receptor Agonists in Adolescents With Obesity. Diabetes Obes Metab 2026. PubMed
- Said J, Liegl M, Pan AY, Dabrowski E. GLP-1 receptor agonist use and mental health outcomes in adolescents with obesity: a retrospective review. J Pediatr Endocrinol Metab 2026. PubMed
- US Food and Drug Administration. FDA requests removal of suicidal behavior and ideation warning from glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications. Drug Safety Communication, 13 January 2026. FDA