NBER Analysis Finds GLP-1 Agonists Yield No Detectable Gains in Employment or Mental Health for Diabetic Adults

Robert Kaestner and Cuiping Schiman used the Medical Expenditure Panel Survey to follow adults with diabetes from 2012 to 2023. By comparing within-person changes rather than cross-sectional differences, the economists isolated the effect of GLP-1 initiation on non-clinical outcomes. Initial gaps in employment and marriage rates between users and non-users vanished after the fixed-effects adjustment, indicating selection rather than causation.

The absence of broader effects matters for coverage decisions. Insurers weighing expanded access to semaglutide and tirzepatide already know these agents improve glycemic control and reduce cardiovascular events; the new evidence suggests they should not count on downstream economic or social returns to justify cost. The study examined one- and two-year horizons and found consistent null results.

Related trials such as the SELECT cardiovascular outcomes study and real-world claims analyses confirm robust physical benefits yet rarely capture employment or relationship data. Kaestner’s design highlights a gap: objective life-event measures may miss subtler improvements in energy or self-efficacy that future surveys could detect.

Longer follow-up and richer instruments will be needed as GLP-1 use expands beyond diabetes into weight management populations.