Comprehensive review of the psychological and behavioral effects of GLP-1 and GIP receptor agonists including tirzepatide on weight loss, covering appetite regulation through mesolimbic reward pathways, reduction in 'food noise' and hedonic eating, behavioral changes in food preference, emotional eating patterns, and psychiatric safety considerations. Bridges pharmacological and behavioral dimensions. Provides a unified psychobehavioral framework for tirzepatide's weight loss mechanisms—explaining why pharmacological appetite suppression through GLP-1R/GIPR mesolimbic engagement produces behavioral changes beyond simple caloric restriction and why tirzepatide may benefit patients with disordered eating patterns driving obesity.
Abstract
RATIONALE: Obesity remains a major global health challenge, severely affecting metabolic and cardiovascular health. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) receptor agonists mark a significant breakthrough in diabetes and obesity management, significantly aiding in weight loss and glycemic control. Tirzepatide, a dual agonist for GLP-1 and GIP receptors, effectively promotes weight loss and improves metabolic parameters by influencing insulin secretion, appetite regulation, and gastric emptying.
OBJECTIVES: This review highlights the dual metabolic and psychological impacts of GLP-1 and GIP agonists in diabetes and obesity management, emphasizing the need for a holistic, patient-centered approach to optimize treatment outcomes.
RESULTS: While GLP-1 and GIP agonists demonstrate significant metabolic benefits, their long-term use is often limited by gastrointestinal side effects and psychological impacts. These medications, while regulating appetite and food reward pathways, can also lead to mood disturbances and altered eating behaviors, potentially affecting patient adherence.
CONCLUSIONS: A comprehensive strategy for obesity management using GLP-1 and GIP agonists must consider both metabolic and psychological factors. Future research should focus on elucidating the complex mechanisms underlying their psychological effects and integrating mental health considerations into therapeutic strategies. Personalized diet and exercise interventions, alongside pharmacological treatments, are crucial for enhancing both metabolic and psychological outcomes, ensuring a more sustainable and effective approach to managing obesity.