The Ozempic Era: A Cultural Shift

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as Ozempic, have rapidly reshaped societal attitudes toward body image. In just three years, these medications have ignited a renewed focus on thinness, impacting various aspects of culture, from the food and beverage industry to the body positivity movement. While initially intended to aid individuals with weight-related health issues, the demand for these drugs has surged, with one in eight Americans reportedly trying them, according to recent surveys.This widespread adoption has led to the emergence of telehealth companies offering more affordable, yet perhaps less regulated, versions of these medications.

How GLP-1s Work

Ozempic,a brand name for semaglutide,and other GLP-1 agonists function by mimicking a naturally occurring hormone in the body. This hormone stimulates insulin release and slows gastric emptying, thereby promoting a feeling of fullness.While these properties make GLP-1s effective for weight loss, they also raise concerns about their potential impact on individuals with disordered eating patterns.

The Dark Side: “Drug-Induced” Eating Disorders

Some healthcare specialists express concern that the appetite-suppressing effects of GLP-1s could inadvertently encourage or exacerbate eating disorders. Dr. Kimberly Dennis, a psychiatrist and expert on eating disorders, has stated, these drugs are rocket fuel for people with eating disorders. Reports have surfaced of patients developing drug-induced anorexia after using GLP-1s, raising alarms among professionals who treat anorexia, bulimia, and other eating disorders.

Navigating the Ethical Minefield

Pamela Keel, a psychologist and eating disorder expert at Florida State University, emphasizes the risks associated with prescribing appetite-suppressant drugs to individuals with restrictive eating disorders. She argues that such medications should not be used to perpetuate malnutrition, regardless of a person’s weight. We are not interested in helping people do a better job of having an eating disorder, Keel asserts, highlighting the ethical complexities involved.

Beyond Appetite Suppression

GLP-1s may inadvertently encourage other disordered behaviors beyond simple appetite suppression. These drugs could potentially reinforce unhealthy thought patterns and behaviors associated with eating disorders, making it crucial for healthcare providers to carefully assess patients before prescribing them.

A Glimmer of Hope for binge Eating Disorder

Despite the concerns, GLP-1s show promise in treating binge eating disorder. Research suggests these drugs could help curb binges by rebalancing hormone levels. Studies indicate that GLP-1 responses may be blunted in individuals with a history of binging.

Megan, a 39-year-old nurse, experienced notable relief from binging and purging cycles after starting GLP-1s. She switched to Mounjaro and found that the constant hunger pangs that once consumed her disappeared. I thought it was a willpower issue and I always blamed myself, Megan said. But the medication helped her realize the biological component of her disorder and made me forgive myself for what I went through.

Leslie Heinberg, a psychologist at the Cleveland Clinic, notes that GLP-1s reduce “food noise” and preoccupation with eating, making them potentially helpful tools for those with binge eating disorder. Preliminary studies do show that these drugs hold promise in reducing binge eating behaviors, but more research is needed, she cautions.

the Shadow of Control and Shame

The desire to control bodies to achieve thinness has historical roots, dating back to the Enlightenment and linked to racist ideologies. Sabrina Strings, a professor of Black studies at the University of California, Santa Barbara, argues that GLP-1s offer a medicalized avenue for this control.Control and shame are prevalent mindsets among individuals with eating disorders,according to Debra safer,a psychiatrist at Stanford’s medical weight loss clinic.

Morgan, a 27-year-old marketing project manager, found herself grappling with these tensions. After learning about the Health At Every Size framework in therapy, she initially embraced body acceptance. however, she eventually decided Wegovy was right for her, experiencing reduced joint pain and less preoccupation with food. It’s been kind of earth-shattering to admit to myself that it could be something that helps me, Morgan said, acknowledging the relief the medication has brought despite feeling like a betrayal of her values.

Maria Rago, a psychologist and president of the National Association of Anorexia Nervosa and Associated Disorders, highlights the role of cultural fatphobia in contributing to eating disorders. she expresses concern that GLP-1s reinforce the idea that everyone should be thin, potentially exacerbating eating disorders and hindering body acceptance. People will never be able to accept their bodies, they’ll always be told, ‘Well, you could be thinner, just use this medicine,’ Rago warns.

Responsible Prescribing: A Case-by-Case Approach

Clinicians are advised to screen patients for a history of eating disorders before prescribing GLP-1s.Chika Anekwe, an obesity medicine physician at Massachusetts General Hospital, states that patients with active eating disorders should be treated for those conditions first. For patients with a history of restrictive eating disorders, a case-by-case assessment is necessary to determine if the benefits outweigh the potential risks.

Lily, a patient on Ozempic, believes her doctors should have been more careful when they prescribed it to me. Despite her diabetes diagnosis, she feels the potential risks associated with her eating disorder history were not adequately considered. Ultimately,she is grateful for the medication,finding the prospect of managing her binge eating disorder without it scarier than managing her restrictive impulses while on it. This has been one of the most confusing things that I’ve ever done to my own body, she concludes, acknowledging the complex emotions surrounding her experience.