Arthur Brooks: Do GLP-1s Make Us Happy?

In my column last Monday, I wrote about how to make better New Year’s resolutions—ones that are less likely to flop, but that are also challenging enough to provide satisfaction. Why? Because accomplishing something with a degree of struggle is the way to realize joy. I gave the example of using GLP-1 drugs for weight loss as a bad resolution. Don’t get me wrong: These medications are a miracle, transformative for many people. But they take out the struggle—which is the point of making a resolution in the first place.

The column provoked quite a few comments. For example. . .

For your resolution to do more things you enjoy: listen to and do what Mrs. B says.

Amen to that!

But the responses also inspired for me another question: New Year’s resolutions aside, how much happiness do GLP-1s stimulate? And what about other relatively struggle-free ways to change your appearance, from plastic surgery to hair implants? Let’s have a look at the research.

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1. GLP-1 Drugs

Most people who use this medication make the assumption that it will raise their well-being, at least in an indirect way, because they will look better or see health improvements. That’s a big assumption—and, as yet, it’s without much research to back it up.

Initial studies are somewhat mixed. Most research to date does suggest some positive well-being results from GLP-1 drugs, such as one review of Mendelian randomization studies (a statistical technique that allows researchers to establish causality without treatment-control experiments). They show that, on average, depression falls after people start the drugs, and their sense of well-being rises even beyond what the weight loss and health improvements would predict. In some rodent studies, researchers find that the drugs have antidepressant and anti-anxiety effects in the long term—though I question how one can tell when a rat is feeling depressed.

However, we find some conflicting evidence. One large 2024 study in Scientific Reports found that GLP-1 drugs led some patients to develop psychiatric conditions such as depression, anxiety, even suicidal behaviors. (For patients who already struggle with these maladies, GLP-1 drugs appear to increase their mental suffering.)

The bottom line is that the jury’s still out—and people using these drugs need to pay close attention to their mental health.

2. Plastic Surgery

As a general rule, cosmetic surgery has been found to raise well-being, at least in the beginning. The data on well-being reveal that people see the highest self-rated quality-of-life increases from breast augmentation, followed by rhinoplasty, liposuction, Botox, and dermal fillers. Breast augmentation improved well-being among the women who sought it for two reasons: lower self-consciousness and high self-confidence. However, longer-term studies show that the effects diminish over time, with 12 percent lower psychological well-being after three years.

3. Anabolic Steroids

Whereas most cosmetic surgery involves women, steroid use and testosterone supplementation are predominantly a male phenomenon. The research on this reveals two main patterns of outcome. First, hormone replacement under a physician’s direction (elevating unusually low testosterone) improves quality of life, by lowering depressive symptoms and raising energy levels. But steroid use (prescribed by the dude who hangs out over by the squat rack) to raise sex hormones to supraphysiological levels increases aggression and irritability, popularly known as “roid rage.” Elevated levels of depression and anxiety also tend to occur, despite the drugs’ clear success for their intended purpose (muscle strength and size).

In other words, the findings would appear to support the common contention that women’s typical cosmetic alterations raise well-being more than men’s ones do. This is consistent with the research on evolutionary psychology suggesting that aesthetic appearance is more important for female happiness, on average.

So far, I’ve written about all of these changes at a certain scholarly remove. None of them has been a part of my life. But the next one hits me more directly. . . .

4. Hair Transplants

I’m going to let you in on a secret from the Sacred Brotherhood of Bald Men: If we see a man our age with a full head of hair sent to jail for embezzlement, that feels cosmically just to us. We fight this schadenfreude internally and deny it to others, but it’s there—I’m sorry. Before you judge me too harshly, consider the words of scholars writing in the Journal of Cosmetic Dermatology: “Hair loss is associated with significant psychological distress and may exacerbate depression, anxiety, and social withdrawal.”

What is the answer? For some, hair transplants “can lead to improved self-esteem, confidence, and emotional well-being.” But not always. The scholars also note that for some men, mental health actually worsens after treatment. This certainly appears to be the case for men suffering from body dysmorphic disorder, a malady that might also account for some of the steroid use.

So there you have it, the happiness evidence on a few of the most popular body-aesthetic interventions. Nothing I’ve written here should be interpreted as a condemnation of these choices. I don’t judge, as I hope not to be judged. But I’d like to make one other point in closing. Whatever you do to your appearance—even adding hair [sob]—will not make you love yourself, if you don’t already do so. That requires work you do on the inside.

See you next week.

Love,

Cue Ball

The Pursuit of Happiness with Arthur Brooks will be back next week with a column on Monday. His newsletter returns next Friday. Sign up here to get both delivered straight to your inbox. And write to Arthur in the comments section with questions or suggestions on what he should cover next.