--- title: Korean records from 13 hospitals put numbers on GLP-1 weight-loss safety, and the psychiatric signal is the one that stands out publication: Medical Insights Korea section: news category: Obesity canonical_url: https://medicalinsightskorea.com/news/korea-glp1-weight-loss-safety-thirteen-hospitals author: Chloe Moon published: 2026-10-27T15:00:00+09:00 modified: 2026-10-27T15:00:00+09:00 content_type: reporting license: Quotation permitted with attribution to Medical Insights Korea and a link to the canonical URL. --- # Korean records from 13 hospitals put numbers on GLP-1 weight-loss safety, and the psychiatric signal is the one that stands out Semaglutide carried a hazard ratio of 3.42 for depressive disorder and 3.91 for gastrointestinal obstruction. Liraglutide's psychiatric signal was smaller but measured in far more patients. ## Answer In a multicentre new-user cohort study using electronic health records from 13 South Korean hospitals between 2018 and 2025 mapped to the OMOP Common Data Model, in which 2,357 semaglutide initiators and 6,953 liraglutide initiators prescribed for weight management were compared with 22,602 and 68,001 propensity score-matched non-initiators across ten safety outcomes, semaglutide was associated with increased risks of psychiatric disorders overall (hazard ratio 2.02, 95% CI 1.30 to 3.14), anxiety disorder (2.39, 1.22 to 4.71), depressive disorder (3.42, 1.51 to 7.74), gastrointestinal dysmotility or obstruction (3.91, 1.42 to 10.82) and vision impairment (1.58, 1.04 to 2.41), while liraglutide was associated with psychiatric disorders (1.66), anxiety (1.68), depression (1.51), hepatic impairment (1.46), pancreatobiliary disorder (1.33), pancreatitis, cholangitis or cholelithiasis (1.40) and vision impairment (1.34). ## Key takeaways - Electronic health records from 13 South Korean hospitals covering 2018 to 2025 were mapped to a common data model and analysed in a new-user design. - 2,357 semaglutide initiators were matched against 22,602 non-initiators, and 6,953 liraglutide initiators against 68,001 non-initiators. - Semaglutide was associated with depressive disorder (HR 3.42, 95% CI 1.51 to 7.74) and anxiety disorder (2.39, 1.22 to 4.71). - Semaglutide was also associated with gastrointestinal dysmotility or obstruction (3.91, 1.42 to 10.82) and vision impairment (1.58, 1.04 to 2.41). - Liraglutide was associated with psychiatric disorders overall (1.66), hepatic impairment (1.46), pancreatobiliary disorder (1.33) and pancreatitis, cholangitis or cholelithiasis (1.40). - Semaglutide-associated vision impairment and liraglutide-associated hepatic impairment were not significant in some sensitivity analyses. - All of these were prescriptions for weight management rather than for diabetes, and the comparison group was people not taking the drug. ## Full article These drugs are now taken by people who are not ill in the usual sense — who want to lose weight and have no diabetes. That changes what counts as an acceptable risk, because the benefit being weighed is different. This is the largest Korean attempt so far to say what the risks are in that population. ### The psychiatric signal **HR 3.42** — hazard ratio for depressive disorder among Korean semaglutide initiators for weight management (95% CI 1.51 to 7.74) _Source: Park J et al., Diabetes, Obesity and Metabolism, 2026_ Both drugs showed it and in the same direction. Semaglutide: psychiatric disorders overall 2.02, anxiety 2.39, depression 3.42. Liraglutide: 1.66, 1.68 and 1.51. The semaglutide intervals are wide — 1.51 to 7.74 for depression — because 2,357 initiators is not many for an uncommon outcome. The liraglutide figures are smaller and tighter, resting on 6,953 initiators. Two agents in the same class producing a consistent signal is harder to dismiss than either alone. What neither can rule out is the most obvious alternative explanation: people who seek pharmacological help for weight are, on average, more distressed about their weight before they start, and distress that was already present can surface as a coded diagnosis once someone is in regular contact with a clinic. ### The physical outcomes differ by drug Semaglutide's other strong signal was gastrointestinal dysmotility or obstruction at 3.91, which fits the known mechanism — these drugs slow gastric emptying, and that is part of how they work. Liraglutide instead carried hepatic impairment at 1.46, pancreatobiliary disorder at 1.33 and pancreatitis, cholangitis or cholelithiasis at 1.40. > **Gallstones after rapid weight loss are not a surprise** > The pancreatobiliary cluster is the one most likely to be misread as a drug toxicity. Rapid weight loss of any cause raises the risk of gallstones, which is well established and is the reason it appears after bariatric surgery too. A hazard ratio of 1.40 for pancreatitis, cholangitis or cholelithiasis in people losing weight quickly may be reporting the weight loss rather than the molecule — and the study's design, comparing against people not losing weight, cannot separate the two. ### What the authors qualify themselves Semaglutide-associated vision impairment and liraglutide-associated hepatic impairment did not hold up across all sensitivity analyses, and the paper says so. Those two should be treated as unresolved rather than established. Ten outcomes were tested across two drugs, which is twenty comparisons, and some positives at conventional thresholds are expected from that alone. The design's strength is that it is a new-user comparison against matched non-initiators drawn from the same hospital records, which avoids comparing current users against people who already failed on the drug. Its limit is that the comparison group is not taking anything, so every consequence of deciding to treat obesity pharmacologically — the clinic visits, the monitoring, the expectations — sits inside the exposure. The authors' conclusion is the defensible one: careful patient selection and monitoring, not a reason to withhold. ## Sources - Park J, Kim JH, Kim YS, Lim G, Song HJ, Rhee SY, Hwang S, Cho D, Kim M, Kim BY, Jeong CW, Kim DY, Park HA, Kim MH, Kim SH, Seo WW, Kim WJ, Suh YS, Park RW, Shin JY. GLP-1 Receptor Agonists for Weight Loss and Risk of Major Safety Outcomes: A Multicentre Cohort Study. Diabetes, Obesity and Metabolism 2026;28(9):8649-8659. doi:10.1111/dom.71065. PMID:42410329. https://doi.org/10.1111/dom.71065 ## Citation Chloe Moon (2026). "Korean records from 13 hospitals put numbers on GLP-1 weight-loss safety, and the psychiatric signal is the one that stands out". Medical Insights Korea. https://medicalinsightskorea.com/news/korea-glp1-weight-loss-safety-thirteen-hospitals Retrieved from https://medicalinsightskorea.com/news/korea-glp1-weight-loss-safety-thirteen-hospitals