Recovery is Possible!

Ozempic, Wegovy, and the Dilemma of Weight-Loss Drugs


A Message from Sarah Lee:

I firmly believe all bodies are good bodies. The goal is to care for our bodies in whatever way that supports our well-being and fits our season of life; not through control, manipulation, biohacking, obsession, or perfection. We are each given the free will to make decisions, and I have zero judgment on what path anyone chooses to take. Yet, I encourage you to lead with great caution and due diligence when examining the risks vs. rewards of an extreme measure like semaglutide and other weight-loss drugs. You can through injections, rigid dieting, surgery, etc., change the physical body, at least for a temporary amount of time.

But unless you work on matters of the heart, challenge toxic thoughts, heal trauma, and relinquish maladaptive ways to cope with stress, you will not truly change your relationship with food, your body, and yourself. At this stage, I do not believe we should treat eating disorders with semaglutide; however, I do think we should stay open and curious about further developments in science and health while allowing real conversation to dismantle shame and empower personal agency.


The Headlines Have Been Everywhere


Seeing the news about these weight-loss drugs has been triggering for many in the throes of an eating disorder. From Kelly Osburne’s viral red carpet controversy to Oprah’s recent ABC special about obesity and the new medications to treat it, the cultural conversation surrounding weight loss has never been louder.


After decades of dieters hoping for a “miracle pill” to cure their weight woes, multiple appetite-suppressing medications like Ozempic, Wegovy, and Mounjaro have exploded onto the market, making entryway into the mainstream as this generation’s magic bullet for obesity.


What started as Danish diabetic research has radically transformed the medical and cultural discussion around weight loss in the United States, where the pursuit of thinness has driven millions to fill out prescriptions to the point of medication shortages.


Semaglutide, the generic drug behind the recent frenzy, was approved in 2017 as a long-lasting diabetic injectible with a noteworthy side effect: prevalent weight loss. In some cases, up to 15% of a person’s body weight. And these users weren’t just losing the weight to regain, they were keeping it off entirely while taking the medication.


The hype has some validity; these medications show remarkable effectiveness in reducing appetite and managing weight to a degree unseen by previous drug interventions. However, the wave of excitement for this latest “medical revolution” to treating obesity has resurfaced uneasy tensions between dieters, recoverers, and the average person affected by the U.S.’s pervasive diet culture and toxic over-promotion of weight-loss drugs–without reading the finer print.


The Reality of Glorifying Diet Drugs


In the chaos to be the most relevant on the newest cultural trend, a lot can get disregarded in the process, especially when it comes to highlighting the negative experiences of those who have taken said “miracle drug” and find it not worth the cost.


For instance, the aforementioned ABC special An Oprah Special: Shame, Blame and the Weight Loss Revolution was seen by 4.285 million viewers when it premiered across American households this March. Yet, the 42-minute long airing only relayed a single negative guest story when it came to bad experiences with semaglutide-type medications, noting that it’s “not all pretty.”


The majority of the special focused on destigmatizing the usage of weight-loss drugs, leaning on the personal testimonies of both Winfrey and the show’s guests to highlight that the obesity epidemic is not just a failure of willpower but a serious chronic condition that affects millions of people. While this message is laudable in its emphasis on breaking self-shaming cycles and releasing negativity associated with being overweight, the prime-time special still failed to accurately disclose the risks of these weight-loss medications, instead zeroing in on the negative side effects of obesity itself.


With such a monumental scale of influence, Winfrey’s weak attempt at a nuanced take on these novel weight-loss drugs, many of which are still only approved for diabetic use and being prescribed off-label, is indicative of the current media climate when it comes to over-aggrandizing products believed to be the end-all, be-all.


Side Effects 


To provide a more comprehensive overview of taking drugs like Ozempic or Wegovy, knowing the possible complications is of utmost importance in order to make an informed decision.


“Gastrointestinal side effects are more the rule than exception,” according to Jody Dushay, MD, an endocrinologist at Beth Israel Deaconess Medical Center in Boston. With these gastrointestinal side effects can come bouts of:

  • Nausea
  • Dizziness
  • Vomiting
  • Diarrhea


The severity of the side effects can fluctuate depending on the person, but there isn’t a non-zero chance these negative complications won’t affect you; finding out how your body responds to the medication can be a trial-and-error process involving time and the guidance of medical professionals.


Greater Risks for Those with Eating Disorders


When it comes to these weight-loss drugs’ intended uses, however, even the way they are meant to work can prompt serious risk for people who struggle with an eating disorder or are vulnerable to disordered eating patterns. Ozempic, for example, is approved to treat Type 2 diabetes by controlling blood sugar levels. By doing so, it also suppresses hunger instincts and slows food digestion, meaning users feel fuller and don’t feel the need to eat as much as they would typically.


This can be dangerous territory for many reasons. Not nourishing your body accordingly can lead to a litany of health complications in the same way any extremely restrictive diet would, including:

  • Bone loss
  • Organ damage
  • Hormone disruption
  • Neurological issues
  • Lowered heart rate


Multifaceted Face of an Eating Disorder


For those struggling with eating disorders, especially those dealing with restrictive and avoidant compulsions, the promise of medication to reinforce these already ingrained maladaptive behaviors can become too much to resist. It may tempt others out of their recovery process, triggering the desire to cling to weight loss as the ultimate solution to their problems instead of focusing on developing a healthy relationship with their body and food.


Using a weight-loss drug to appease the voice in your head that obsesses over weight only fixes the physical, cosmetic facet of the disorder. While you may look the way you’ve always wanted to look on the outside, the deeper root of your eating disorder is still there. The mental, emotional, and psychological toll that your eating disorder imposed remains untouched, still being controlled by the detrimental mantras and mental routines that may have become ingrained.


Understanding that dealing with your eating disorder oftentimes requires a multifaceted approach that addresses multiple sides of the struggle, as the complexities and intertwinement of body image, self-esteem, physical weight, mental well-being, and other individual nuances can decide how recovery is achieved.


A Personal Story of Semaglutide Use


Sharing someone’s lived experience with having an eating disorder, being in recovery, and then starting a weight-loss drug can be illuminating for others who are curious about what their own struggle may look like when introducing a weight-loss agent.


BC, a pseudonym for a past client of Sarah’s who once struggled with bulimia, and in recent years binge-eating disorder, recounted her personal journey with taking semaglutide which began during a challenging plateau of her recovery. BC had progressed quite a bit in her eating disorder recovery journey, yet was frustrated that food and her weight still caused her distress.


SL: Why did you decide to try semaglutide? How do you feel about it now?

BC: I have mixed feelings towards semaglutide. While I had made a lot of progress in my recovery, I felt stuck in some ways. I felt desperate for more momentum. My reasoning for turning to semaglutide was that I wanted some space between experiencing stress and the immediate response to wanting to check out with food. 


SL: How has taking semaglutide changed you?

BC: I used to obsess over food in every way, whether it was restricting, trying not to binge, planning to binge, feeling guilty about bingeing, worrying I’m not eating enough ‘healthy foods,’ worrying whether or not the amount of food I was eating was correct, etc. With semaglutide, the obsession just started to fade away. There has been a decrease in appetite, a reduction in mental ‘noise’ related to food, and feeling fuller, quicker, and longer. I’ve been able to make healthier decisions without a crazed state of mind and still allow myself to ‘indulge’ but within reason. It’s made my relationship with food feel more normal. Because I can’t binge like I used to, even though I still have the urge and desire at times, I have lost weight, which is healthy for me. However, I have a lot of shame about still having the urge.


SL: Have you had any side effects?

BC: When I first started, I thought I was going to die from feeling so sick. I didn’t eat for the whole weekend. I was so nauseous, had a terrible headache, and could barely walk for fear of fainting. I’d come to find out that the symptoms would return with each weekly injection and then lessen over the following days. For the first couple of months, I had low-grade nausea pretty much the entire time. Since then, the side effects have all but disappeared, aside from short-lived bouts of nausea and lightheadedness here and there.


SL: Is there anything you have found surprising?

BC: I’ve realized I’ve started to build up what I think is a tolerance for semaglutide. The longer I take it, the less it affects me, whether the intensity of the negative side effects or the length of time I feel the impact of the positive side effects. This scares me because I don’t want to have to increase my dose.

There have been periods here and there when I didn’t take it for a bit or waited longer than normal between doses, and I found that the urge to binge is still there. For the most part, I’ve been able to pull myself out of the trigger response of bingeing, which is good. That said, forcing that option off the table by taking semaglutide has caused me to realize I still look for other ways to check out from stress, which has, in turn, led me to start back up with therapy to address root issues.


SL: Have you noticed any new or resurfacing intrusive thoughts?

BC: The intrusive thoughts I have now are more so related to my confidence that I will be able to do this on my own and that I am dependent on semaglutide for success in recovery. I don’t want this to be a long-term accessory to a healthy relationship with food, so I worry that if and when I ween myself off, I will ricochet back to old habits. I also worry about the possible judgment around taking it in the first place. Very few people know I take it, and there is definitely some shame and secrecy around it (two things I know feed into my eating disorder). My worry is related to the unknown at this point.


SL: Has semaglutide progressed your recovery?

BC: The tendency to binge is still there. I know my eating disorder is a symptom of a bigger underlying problem, and while semaglutide has helped quell the symptoms, it doesn’t erase what caused them. This causes me to worry about whether I should stop taking it. I will say that by the time I started taking semaglutide, I think I had done enough work in recovery to have somewhat of a ‘healthy’ mindset going into it (or at least more healthy than I have been in the past). If I had tried using it earlier on in my recovery, I know I would have used it much more as a crutch, and I can see how it would have really messed me up.


SL: Is there anything else you would like to add about weight-loss drugs?

BC: I want to add a bit more about how detrimental I think it most likely would have been if I weren’t already three years into recovery. While I think it’s been somewhat helpful for me, I think it would have been so poisonous if I had started using it earlier in my journey. I still don’t know whether or not using semaglutide is the healthiest choice, but I know there are genuine health benefits to using it that come with losing unhealthy weight. I think (and hope) it is/has been helping me move to a new phase of recovery, but if I hadn’t worked for three years prior without its assistance, I think it would have done more harm than good.


Key Takeaways


Just like BC recounts, if you haven’t yet begun processing your food fears and examining unhealthy beliefs, taking a weight-loss drug might critically destabilize your future ability to manage and maintain your relationships with food. Growing dependent on an appetite suppressant only works as long as you take the pill, and while it may be beneficial to quell “food noise” and obsessive thoughts, it doesn’t address the root cause of disordered behavior, threatening relapse when or if the drug is unavailable.

Utilizing a weight-loss pill in the short term can give you breathing room from the negative coping mechanisms that prevented you from looking beyond your eating disorder initially, but the focus must be then turned to diving deeper into what’s actually driving the need to continue these harmful behaviors.

You may change the physical body through extreme means of dieting, exercise, and semaglutide drugs like Ozempic and Wegovy, but if you don’t work on changing your thought patterns, coping skills, and your food-body relationship, then true healing is highly unlikely.

With Peace,

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