Ozempic and Eating Disorders: What You Need to Know
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The article highlights concerns about the widespread marketing of GLP-1 medications like Ozempic for weight loss. The experts at Eating Recovery Center caution that these drugs, originally intended for type 2 diabetes, come with significant risks, including side effects and the potential to trigger or worsen eating disorders.
Ozempic seems to be everywhere
It’s hard to miss the nonstop TV ads and influencer reels on your social media feed. They tout the benefits of Wegovy, Mounjaro, Ozempic and other weight loss drugs. But have you ever wondered if their claims are too good to be true?
These medications, called GLP-1 receptor agonists (GLS-1s), were created to treat type 2 diabetes. Today, however, they’re also prescribed to treat medical weight loss (losing weight under the supervision of a medical provider). That’s where things get complicated, especially for people at risk for or in recovery from an eating disorder.
“You can’t engage in pop culture right now without being exposed to rhetoric around these medications,” says Meredith Nisbet-Croes, MS, LMFT, CEDS-C (she/her), national clinical response manager at Eating Recovery Center and Pathlight Mood & Anxiety Center (ERC Pathlight). “What’s so concerning is that people’s ability to have informed consent decreases once they are promised a ‘magic solution’ to their body size and shape.’”
Our team at ERC Pathlight believes that weight is not an indicator of health, and we do not agree with prescribing GLP-1s for weight loss. To learn why, let’s unpack the science behind GLP-1s, explore their potentially dangerous side effects, and help you make the best decision about their use for you and your loved ones.
How GLP-1s work inside the body
When we eat, our small intestines naturally release a hormone called GLP-1, which gives the pancreas a signal to release insulin. GLP-1 meds are designed to replicate the same action within the body, which helps to regulate an individual’s blood sugar and therefore manage their type 2 diabetes.
“But early on, researchers discovered that GLP-1 medications bring additional side effects, including early satiety [feeling fuller earlier] and reduced appetite, which is how they eventually became approved for use in weight loss treatment,” Nisbet-Croes says.
Side effects of Ozempic and other weight loss drugs
By law, drug manufacturers must disclose all side effects of their medications on the package insert. But people don’t always read those inserts. Common side effects of weight loss medications include, but are not limited to:
- Nausea
- Vomiting
- Diarrhea
- Stomach pain
- Constipation
What’s also concerning is that, when used for weight loss, GLP-1s are often prescribed in higher doses than for type 2 diabetes treatment, increasing the risk for negative side effects.
“I worry that many people aren’t receiving thorough information about the potential risks of these medications from their prescribing physicians, which revokes their ability to give informed consent and is very concerning,” Nisbet-Croes says.
Additional side effects of weight loss drugs are gastroparesis and “Ozempic face.”
Ozempic and gastroparesis
New research indicates that GLP-1s may raise the risk for a condition called gastroparesis, which slows the body’s digestive system and causes symptoms like abdominal pain and bloating. In one study, 66% of people taking GLP-1 drugs were more likely to be diagnosed with gastroparesis than those who did not take them.
“Ozempic face”
Some patients taking GLP-1s have reported experiencing “Ozempic face,” a cosmetic condition linked to sagging or wrinkled skin caused by rapid weight loss [1].
Unfortunately, some of these side effects are also symptoms of an eating disorder, which is why GLP-1s can retrigger disordered eating in some individuals.
Why GLP-1 marketing is harmful
Sometimes, it can feel as if everyone you know is taking GLP-1s. One survey indicates that 13% of U.S. adults have taken them, while estimating that 4,000 GLP-1 prescriptions were filled for children ages 12 to 17 in 2023.
Their popularity is driven by messages across traditional and social media that tout GLP-1s as a miracle cure. But this type of marketing outreach reinforces the dangerous myth that being thinner will make you happier and healthier.
“The theme of ‘weight loss at any cost’ is the true indicator that diet culture is at play here,” Nisbet-Croes says. “Despite the significant side effects and dosage concerns, these medications are being heavily marketed in every arena: social media, magazines, reality TV and even Oprah’s streaming special. We haven’t seen a medication marketed this aggressively since Viagra.”
Read more about weight stigma in healthcare here.
For people who experience harmful intrusive thoughts about their body, GLP-1s can be very tempting, Nisbet-Croes explains.
“They may feel like a way out for someone victimized by bullying, self-hatred, shame and anti-fat bias,” Nisbet-Croes says. “But when we’re making decisions out of fear or shame, it’s difficult to fully comprehend any potential negative impacts. We’re coming from a place of desperation.”
"My doctor says I need to lose weight for my health."
Sometimes well-meaning prescribers may tell you that you’ll have better health and prevent future problems if you lose weight.
“But the more we learn about the vast variety of body shapes and sizes and consider other aspects that factor into health and wellness, we learn these recommendations are based on research that is flawed and incomplete,” says Elizabeth Waasenaar, MS, MD, CEDS-S, DFAPA (she/her), regional medical director at ERC Pathlight.
If your doctor makes such a comment, Dr. Wassenaar recommends that you take a step back and remind yourself that health is something you have the power to define.
“Set health goals that matter to you, such as, ‘I want to enjoy Sunday dinner with my family’ or ‘I want to take my dog for a walk in the park.’ Then find ways to work toward those goals that are separate from weight loss as the only intervention,” Dr. Wassenaar says.
Increased risk of eating disorders
GLP-1s pose potential risks for anyone who:
- Has recovered from an eating disorder
- Currently lives with an eating disorder
- Is in active recovery for an eating disorder
- Has a family history of eating disorders
- Is at risk for an eating disorder
Providers at ERC Pathlight have already seen rising cases of eating disorder relapses in people who take GLP-1s, some so severe that the individual had to return to receive a higher level of care. In addition, GLP-1s may trigger a new eating disorder in someone who never had one depending on a person’s individual risk factors.
Weight loss drugs and mental health concerns
Researchers are still studying the relationship between GLP-1s and mood and anxiety disorders. But anecdotal data indicates that GLP-1s may accelerate certain mental health conditions.
“Some providers have reported decreased anxiety and depression in patients taking GLP-1s, while others have reported increased lethargy, depression and suicidal thoughts,” Dr. Wassenaar says.
Weight loss drug risks for kids and teens
GLP-1s can be prescribed as early as age 12, when young people’s minds are still developing, increasing the risks for an eating disorder.
“Adolescent brains are extremely vulnerable to nutritional deprivation and malnutrition, and the use of these medications could trigger disordered eating,” Dr. Wassenaar says.
It’s not known yet whether taking GLP-1s will have any long-term effect on a child’s or teen’s cognitive and physical development.
5 tips to consider if you are prescribed GLP-1s
If you are prescribed GLP-1s for type 2 diabetes, the decision about whether to take them is up to you. Make the most informed choice possible by following these tips:
1. Get the full picture. Research all the potential risks, benefits and side effects of GLP-1s (and any other prescription medication you take).
“Don’t rely just on what you see on TV or what you read online,” Nesbit says. “Remember, no provider, influencer or marketer can tell you what the right choice is for you.”
2. Talk openly about your situation. If you’ve recovered from an eating disorder — or if you have a family history of one — let your provider know.
“Explain that GLP-1s might be triggering for you, and ask if there are any other type 2 diabetes medications that would be less likely to cause negative side effects,” Nisbet-Croes says.
3. Know your comfort zone. GLP-1s are injectable medications, so you must be comfortable injecting yourself with a small needle at least twice a week as prescribed by your provider.
4. Understand there is no “magic solution.” You could improve your type 2 diabetes and lose weight using GLP-1s and still struggle with body image. Or you might find that the medication doesn’t work as you had hoped, or that it creates unwanted side effects.
“Address these concerns from a holistic perspective, focusing less on weight loss and more on how you feel,” Nisbet-Croes says. “This will provide you with a more durable and lasting sense of relief that’s internal rather than external.”
5. Watch for warning signs. People who have recovered from or are at risk for an eating disorder should monitor their well-being closely if they choose to take GLP-1s for type 2 diabetes. Get adequate nutrition. Drink enough water. Notice when feelings of anxiety or eating disorder thoughts start popping up. Don’t step on the scale too often.
“Make sure that your mind doesn’t get flooded with those old lies your eating disorder told you,” Dr. Wassenaar says.
3 Tips for parents
Providers at ERC Pathlight caution against prescribing GLP-1s for weight loss in children and adolescents. Instead, have meaningful discussions with your child so you can help them develop a more positive relationship with food and their body.
1. Have curious conversations. Tailor the talk to your child’s stage of development and arm them with the curiosity to make choices that reflect their values and needs.
“Talk to them about body diversity and the goodness of their bodies,” Nisbet-Croes says. “Also, stress the importance of eating for pleasure and connection, as well as to refuel their bodies.”
2. Talk openly. Ask your child or teen if they’ve experienced any bullying, body shaming or other negative behaviors from their peers. Provide a safe place for them to be fully honest with you.
“Having open conversations with our children makes them less likely to fall prey to advertising, bias and peer pressure,” Nisbet-Croes says.
3. Look at the big picture. While it may be tempting to talk with your child’s or teen’s provider about GLP-1s if they are overweight, parents should instead try to understand more about their child’s total relationship with food.
“Parents can positively shape children's relationships with food and body by eating together as a family, exposing them to a variety of foods, refraining from labeling foods as good/bad or healthy/unhealthy, and teaching them about the myriad of ways we can care for and celebrate our bodies,” Nisbet-Croes says.
Don’t fall for “diet culture” myths
Marketers want you to believe that GLP-1s will solve all of your problems. But don’t be fooled. Instead, prioritize body acceptance and seek adequate support if you’re struggling with body image. And if you have type 2 diabetes and believe that you may benefit from medication, make sure to ask about all the potential side effects so you can make the most informed decision possible.
“You don’t have to lose weight to feel happy, healthy and peaceful,” Dr. Wassenaar says. “Remember that you’re worth far more than a number on a scale.”
If you or a loved one is living with an eating disorder, know that you are not alone. At ERC Pathlight, we’ll meet you where you are, listen to your story and match you with the exact support you need. Call us at 866-489-1687 or book your free assessment to get started.
Read more on this topic
Sources
- Catanese, L. (2024, Feb. 5). GLP-1 diabetes and weight-loss drug side effects: “Ozempic face” and more Harvard Health Publishing, Harvard Medical School.
Written by
Written by
Meredith Nisbet-Croes, MS, LMFT, CEDS-C, RYT-200
