Hunger pain and its reduction; qualitative insight from people with schizophrenia on semaglutide

It is often reported that people with schizophrenia experience weight gain and disordered eating, partly due to antipsychotics. As part of the RCT "Home-based Intervention with Semaglutide Treatment of Neuroleptic-Related Prediabetes, HISTORI", the present study investigates experiences of hunger and eating habits in people using antipsychotics during semaglutide treatment.

Eleven semi-structured interviews were conducted 4 months to 1,5 years after treatment completion. Six women and 5 men were interviewed. The interviews were analysed using Braun & Clarke's reflexive thematic analysis.

Three themes were identified; "Hunger pain induced by antipsychotic medicine", "Positive and negative experiences of reduced hunger", and "Eating habits and what influences them". The term "Hunger pain" was applied. It defines an excruciating combination of feeling extremely hungry, never achieving satiety, and relentless preoccupation with thoughts about food. The analysis suggested a focus on the patients' coping styles.

The hunger pain, probably induced by antipsychotics, seemed to reinforce maladaptive coping styles. The relief from hunger pain due to semaglutide was in most cases a liberation. Yet, it is important also to pay attention to the negative effects of reduced hunger. It is relevant to assess patients' eating problems prior to semaglutide treatment.