Co-authored by Taylor Alves and Robert T. Muller, Ph.D.
Eating disorders have the highest overall death rate of any mental illness. Globally, eating disorders affect at least 9 percent of the population. With the rise in attention surrounding weight loss drugs like Ozempic, what are the concerns for those living with eating disorders?
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Ozempic has been widely covered in the media for its benefits as a weight loss drug. Originally intended to treat Type 2 diabetes, it belongs to a class of medications called GLP-1 agonists. Ozempic works by imitating hormones that make people feel full for longer, curb cravings, and stop overeating.
The drug has gained significant media attention as many celebrities including Chelsea Handler, Elon Musk, and Sharon Osbourne reported using the drug to lose weight. The topic has been featured in magazines and ads and has been widely discussed on social media. Hashtags such as #ozempic and #ozempicweightloss have upwards of 300 million views on TikTok.
During the 2023 Oscars, talk show host Jimmy Kimmel commented on the buzz created by Ozempic: “When I look around at this room, I can’t help but wonder: Is Ozempic right for me?” With increased attention on the drug, experts are concerned that its misuse might have negative implications for those living with eating disorders.
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Lisa Hoffman, a social worker and registered dietician specialising in eating disorders, has expressed concern for the potential influences Ozempic has on those with eating disorders: “I think Ozempic has only strengthened the societal focus on weight loss, ideal body weights, and the associated weight stigma. It reinforces the ‘thin dream’ and that all people [should] strive for thinness, no matter what the cost or consequence. The prevalence of eating disorders increases with more repeated societal messages that everyone needs to be thinner.”
While Ozempic was intended to be used by people with Type 2 diabetes, due to the attention it’s received for weight loss, it has gone through a worldwide market growth of 50 percent. It is often easily accessible to those who can afford it, with many nurses and medical spas willing to prescribe it.
The problem? Potential consequences for patients using the medication for diabetes as it may leave them unable to easily fill prescriptions. Some have reported needing to try several pharmacies or taking lower doses as their only option.
Another problem is research suggesting that the potential for regaining weight after stopping Ozempic can lead to disordered eating. Further, the rebound weight gain increases users’ health risks as it may have a negative impact on metabolism, cardiovascular health, and self-image. This may put people at increased risk for disordered eating.
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Further, the popularity of Ozempic is touching on a much larger issue of the thin ideal, which describes society’s desire to push a thin body type as being the ideal despite this being naturally unattainable for many.
Samantha Brown, a social worker specialising in adolescent eating disorders, notes, “Using Ozempic as an off-label weight loss solution can worsen restrictive eating patterns that initiate and perpetuate eating disorder progression. The rapid reduction of appetite caused by Ozempic creates physiological changes that underpin these dangerous eating behaviours. Ozempic has known side effects of nausea, vomiting, diarrhoea, and other undesirable consequences. In addition to being uncomfortable, this may mimic or exacerbate the symptoms of an eating disorder, such as bulimia nervosa.”
Yet to complicate matters further, the impact of Ozempic on people with eating disorders may not be one-size-fits-all. Some research suggests that the drug may in fact help those with binge eating disorder (BED) combat cravings for food and curb their appetite.
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BED is characterised by recurrent uncontrollable episodes of eating large quantities of food. This can often lead to great distress for those struggling with BED, as many understand their behaviour is atypical but are unable to change it.
BED is the most common type of eating disorder, with 3.5 percent of women and 2 percent of men being diagnosed in their lifetime. Unfortunately, people with BED are highly stigmatised, which may lead to them not seeking out treatment. Research has shown only 40 percent of people with BED receive treatment.
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In this case, how is Ozempic thought to help? The drug curbs appetite and cravings, so many people with BED are acknowledging that Ozempic has positive benefits for reducing binge eating episodes. People with Type 2 diabetes have a higher risk of also having eating disorders, including BED, with research suggesting that 20 percent of people with Type 2 diabetes have BED.
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While the jury is still out on the myriad positive and negative effects of Ozempic on mental health in general, and eating disorders in particular, some experts wonder how they can keep recommending healthy eating to clients when so many messages tell people to do the opposite.
