“Just like that anorexia heroin to my brain.” –A 40-year-old man with long-standing anorexia relapsed after receiving GLP-1. drug.
Weight loss drugs known as GLP-1 receptor agonists work by suppressing hunger signals. They have been a great cure for those suffering from obesity and its health consequences such as diabetes, hypertension and sleep apnea. However, due to the convenience, heavy advertising and emergence of online weight loss platforms, many users are taking these prescriptions for non-medical indications.
Last year, one of my middle-aged female patients decided to wear a haute couture dress to her high school reunion. In addition to frequenting the gym, she bought Ozempic off-label from a doctor in Dubai, where her daughter lives. When I saw him a few months later, he was thin. Her once petite frame now looked like she was suffering from a serious illness – her bones were protruding, her skin was sagging, her cheeks were hollow.
Today’s The Washington Post reported the experience of a 27-year-old woman with a history of anorexia as a teenager trying to match her sister’s wedding dress. He found a website that promised easy access to weight loss recipes. When filling out their form, he lied about his features, saying that he was wrong, heavier and had reduced mobility. After entering her payment information, she received a bottle of Wegovy pills in the mail a few days later.
What are GLP-1 drugs?
GLP-1 receptor agonists mimic naturally occurring hormone called glucagon-like peptide-1, which helps regulate blood sugar, slows stomach emptying, and signals satiety to the brain. For those suffering from obesity-related medical conditions, these medications can provide significant physical health benefits. However, because these drugs have a direct effect appetiteeating behavior and body weight, which also intersect with the psychological and emotional dimensions of eating. Although data exist for the potential benefit of these medications in the treatment of some forms of binge eating disorder, their use must be weighed against their potential for unintended harm.
Chief among these concerns is that these medications may be abused by individuals with eating disorders, particularly those with anorexia nervosa or bulimia nervosa. Both of these diseases are characterized by a pathological desire for thinness through severe dietary restrictions or other extreme behaviors such as self-induced vomiting, laxative abuse, or compulsive exercise. For these patients, the use of GLP-1 drugs may be a symptom of this pathologic tendency to lean, which can be life-threatening, as in the case of the person cited at the beginning of this article. After reaching a healthy weight, she relapsed after purchasing several weight loss drugs from various online sites. He lost 50 pounds in four months and developed multiple organ failure, requiring hospitalization and eating through a feeding tube.
Eating disorder experts are concerned
Pediatrician Rebecca Peebles, director of medical research at the Monte Nido Eating Disorders Program, said an increasing number of her patients are reporting using these drugs. Part of an eating disorder program is retraining patients how to respond to normal hunger cues. However, these drugs can be counterproductive because they suppress natural hunger signals. In fact, they mimic anorexia nervosa patients. For people who are already vulnerable to restrictive tendencies, this blunting of appetite can make undereating feel deceptively easy and socially acceptable.
Also, because these drugs often cause rapid weight loss, they may inadvertently reinforce unhealthy beliefs about food restriction, thinness, or body control. Medications can be psychologically problematic for some people, especially those with a history of eating disorders.
Social context matters
In our culture, GLP-1 drugs are prescribed, focused on thinness, diet and appearance. Social networks has fueled the phenomenon, with celebrities and influencers openly discussing rapid weight loss, while others quietly use these drugs without disclosing them. “These drugs are being marketed as big business,” says Elizabeth Wassenaar, regional director of the Eating Disorder Treatment Center in Denver. in a survey published in Comments about obesityParticipants who reported taking GLP-1 medication restricted their dietary intake to 400 to 600 calories per day. For reference, the recommended daily calorie intake for women is at least 1,600 calories. One participant reported that he subsisted on water and Diet Coke and lost 21 pounds in three weeks.
The importance of screening
Experts recommend that clinicians screen patients for current or past eating disorders before prescribing GLP-1 medications. The National Association for Anorexia Nervosa and Related Disorders states, “If you have a current or past eating disorder, please use this medication with extreme caution and be sure to work closely with a health care provider who understands eating disorders. Regular monitoring is necessary to watch for side effects or their return.” disordered eating behavior.” However, the American Academy of Family Physicians has not adopted consistent guidelines. In general, they see these drugs as one tool in a wide arsenal to treat their patients. They have not created “general recommendations based on a single clinical concern.” Several manufacturers of weight loss drugs (Wegovy, Ozempic, and Zepbound) decision making to providers and patients. There is no mention of the risk for those with a previous eating disorder in the accompanying literature.
Essential books on eating disorders
Balanced conversation
GLP-1 medications can really improve health and quality of life for many people. At the same time, they can pose serious psychological risks to others, especially those with a history of disordered eating.
A thoughtful approach requires moving beyond simplistic narratives about weight and recognizing that physical and mental health are inextricably linked. Must include a safe recipe cooperation between medical providers, nutritionists, and mental health professionals whenever possible. Ultimately, the goal shouldn’t be simply weight loss at any cost, but long-term health, psychological well-being, and a healthier relationship with food.
