The contemporary landscape of weight loss solutions is dominated by the emergence of medications like Ozempic and Wegovy, which have gained immense popularity for their purported weight loss benefits. While these medications are making headlines and witnessing widespread prescription, their implications on eating disorders and diet culture warrant critical examination.
Yet, Ozempic has helped many alleviate health problems and feel control over their bodies. So, what does this mean for American citizens in the present day? As a therapist who works with disordered eating, I believe that while we shouldn’t necessarily condemn diet drugs like Ozempic outright, we do owe it to ourselves and our communities to more closely investigate the intricate relationship between the rise of diet drugs, problematic diet cultures, and the alarming prevalence of disordered eating.
The Allure of Diet Drugs
Ozempic, a medication initially authorized to treat type 2 diabetes, is now being utilized off-label for weight loss.[1] This shift has garnered enthusiasm among individuals seeking quick solutions to shed pounds. With reports of celebrities touting success stories and the ease of obtaining prescriptions—now even available through Costco—the allure of these medications has intensified. However, the underlying excitement masks a troubling reality for those battling eating disorders.
Research indicates that up to 90% of women are dissatisfied with their bodies, contributing to a culture that often idolizes thinness and promotes diet behaviors. For individuals grappling with eating disorders such as Binge Eating Disorder (BED) or Bulimia Nervosa (BN), the prospect of weight-loss drugs seems attractive. These medications can suppress appetite and reduce food consumption, offering a perceived pathway to “normalizing” eating behaviors. Yet, the efficacy of these solutions for actual recovery is perilous and short-sighted.
Misguided Prescriptions
Alarmingly, some healthcare providers are prescribing weight-loss drugs to patients with diagnosed eating disorders, a trend that raises profound ethical concerns. The rationale appears to be grounded in a desire to mitigate the symptoms of binge eating or purging behaviors. However, experts in the field argue that such an approach can exacerbate the underlying conditions that feed into these disorders.
Dr. Alexis Conason, a clinical psychologist specializing in BED, notes that many individuals may perceive their binge eating as the primary issue, overlooking that these episodes commonly arise from restrictive eating cycles. By providing drugs that further suppress appetite, this strategy may lead patients to become better at restriction, potentially pushing them toward dangerous patterns of starvation that are characteristic of anorexia.[2]
Complex Nature of Eating Disorders
The narrative about weight and eating behaviors is often convoluted by a societal misunderstanding of eating disorders. These are not merely issues of willpower or dieting—clinical practitioners must recognize that eating disorders are intricate illnesses with roots in anxiety, trauma, and even genetic predispositions. Many individuals suffering from eating disorders do not fit typical stereotypes related to weight. For instance, a person exhibiting signs of anorexia may present as an average weight, leading to misdiagnosis or a lack of necessary interventions.[3]
Dismally, findings suggest that nearly 30 million Americans will encounter an eating disorder in their lifetime, yet only a fraction are recognized as “underweight.” Misconceptions can lead even well-meaning providers to endorse weight loss strategies over comprehensive eating disorder treatments, ultimately hindering recovery.
The Broader Impact of Diet Culture
Further complicating the landscape is the prevailing diet culture that equates thinness with health. This message reinforces stigmas against larger bodies, often subjecting individuals to systemic discrimination and fostering considerable psychological distress. Furthermore, the framing of weight loss as a solution glosses over the underlying issues that manifest as eating disorders.
Research has explored the various ways in which treatment for disordered eating – whether it is anorexia, bulimia, orthorexia, or an undefined form of disordered eating – hinges not just on changing dangerous or problematic behavior but also on addressing the factors driving the feelings behind the need to behave in this way. The broader relationship to food, eating, and weight is often complex and intertwined with trauma or other mental health conditions. The argument that medication alone can provide a solution for concerns about weight is misleading and perilous, and the overarching message that being thin is better is extremely problematic for those who may be struggling with disordered eating of some kind.
The Danger of Short-Term Solutions
While medications may offer short-term relief from symptoms of eating disorders, they fail to provide sustainable solutions. Drugs like Ozempic and Wegovy are often intended for lifelong use—leading to dependency and potential harm when users inevitably encounter challenges, such as medication shortages or other barriers to access. The resumption of previous eating patterns may ensue upon ceasing the medication, leading to the return of bingeing and restrictive eating, with potentially life-threatening implications.
What’s more, the long-term effects of diet drugs remain largely unknown. Eating disorders are recognized as one of the deadliest mental health issues, with significant mortality rates surpassing those of many other mental illnesses. In recent years, emergency rooms have seen a spike in cases related to eating disorders, exacerbated by the COVID-19 pandemic, signaling a growing public health crisis in need of immediate attention.
Diet drugs like Ozempic intertwine troublingly with entrenched diet culture and the increasing prevalence of eating disorders. The superficial appeal of these treatments overlooks the multi-faceted complexities of eating disorders, emphasizing the urgent need for effective, compassionate, and informed approaches to treatment. By recognizing the deeper psychological struggles underpinning these illnesses and steering clear of quick-fix solutions, the healthcare community can aid individuals on their journey toward genuine recovery and self-acceptance.
Sources:
[1] Frías, J. P., Auerbach, P., Bajaj, H. S., Fukushima, Y., Lingvay, I., Macura, S., Søndergaard, A. L., Tankova, T. I., Tentolouris, N., & Buse, J. B. (2021). Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): A double-blind, randomised, phase 3B trial. The Lancet. Diabetes & Endocrinology, 9(9), 563–574. https://doi.org/10.1016/S2213-8587(21)00174-1
[2] Kazdin, C. (2024, April 16). Ozempic Hurts the Fight Against Eating Disorders. TIME. https://time.com/6966957/ozempic-eating-disorders-essay/
[3] Feng, B., Harms, J., Chen, E., Gao, P., Xu, P., & He, Y. (2023). Current Discoveries and Future Implications of Eating Disorders. International Journal of Environmental Research and Public Health, 20(14), 6325. https://doi.org/10.3390/ijerph20146325
