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For Those With Eating Disorders, Ozempic Can Be A Triggering Nightmare

The conversation and widespread use of Ozempic for weight loss speaks to a larger cultural fear of fat, experts say.

By Brittany WongMar 25, 2023, 09:00 AM EDT|Updated Mar 28, 2023 The nonstop TV ads for Ozempic ― a diabetes medication that has off-label use as a weight loss drug ― are plenty annoying: “Oh, oh, oh, Ozempic!” the unnervingly upbeat TV spot goes, sampling the 1970s classic-rock hit “Magic.” For some people who’ve dealt with eating disorders, the TV spots ― along with suspected celebrity use and media coverage that some feel glamorize the drug ― aren’t merely annoying; it’s all been emotionally triggering. In some cases, talk of Ozempic is pushing those in recovery one step closer to relapse. “The ease and availability of both Ozempic and Wegovy have given me pause and made me doubt my recovery journey,” said Becca, a 26-year-old from Ontario, Canada, who’s suffered from disordered eating for years. Ozempic is part of an expanding, groundbreaking class of drugs called GLP-1 receptor agonists that were first introduced as a diabetes treatment in 2017. Soon, it was discovered that the prescription injections also led to significant weight loss in people with obesity. That’s because GLP-1 slows down digestion and reduces food intake. The FDA approved semaglutide, the active ingredient Ozempic, for weight loss in 2021 under the brand name Wegovy. “This is the first time ever that we have really effective drugs to treat obesity,” one bariatric surgeon told HuffPost earlier this year of the “game-changing” drug. In a year-end earning call a few months ago, Novo Nordisk, the manufacturer that produces both drugs, reportedly cited worldwide market growth of 50%, with almost 40,000 new Wegovy prescriptions being written every week. Now some folks who seemingly don’t need the drug for their health ― including celebrities ― have discovered Ozempic and Wegovy. It’s not terribly hard to find doctors, nurse practitioners or medi-spas willing to prescribe both for off-label use. That’s all perfectly legal, though not generally advised. That development is disheartening for Becca. After a year of working with a therapist and body-neutral trainer to set body goals tied to strength and weight training rather than weight loss, Ozempic is giving her pause. “The existence of drugs like Ozempic have me thinking, what would my life be like if I could simply avail of these meds?” said Becca, who asked to use her first name only to protect her privacy. “What would it feel like to fit into specific styles of clothing?” she said. “What sort of ego boost will I get from people praising my weight loss?” “The existence of drugs like Ozempic have me thinking, what would my life be like if I could simply avail of these meds?” - BECCA, 26 It’s the secrecy around Ozempic that bothers Becca most. Gossip accounts on Instagram like DeuxMoi debate which celebs they suspect are taking the weight-loss darling drug. Some celebrities, like Chelsea Handler and Elon Musk, have admitted to using it. Most stars have remained silent on the rumors, though a few have expressly denied using it, including Khloé Kardashian and “Real Housewives” cast member Kyle Richards. (The medication is a big talking point lately among the “Real Housewives” set and their fans; Jackie Goldschneider, who is recovering from anorexia and a star of the New Jersey iteration of the show, slammed the medication as “an eating disorder in a needle.”) “When celebrities deny and tout their weight loss journey and point to diets and exercise when they are availing of medication, it’s not only disingenuous but also massively fucked up,” Becca said. It doesn’t help that the dialogue around Ozempic just so happens to dovetail with the dialogue about buccal fat removal and the dialogue around Gwyneth Paltrow’s highly restrictive “daily wellness” diet that seems more dangerous than nourishing. All of it speaks to our cultural fear of being fat, said Aaron Flores, a registered dietitian and nutritionist in Calabasas, California. “It’s a reflection of how deep the fear of weight gain and existing in a large body truly is in our society,” he said. “The message being sent is very clear; being in a large body is bad and you should do anything possible to change it.” The way this medication has become trendy and in demand also speaks to the deep disparity that exists in health care, Flores said. (Ozempic retails for about $900 a month if your insurance doesn’t cover it.) The popularity of the drug has led to a national shortage, making obtaining it difficult for diabetics who use Ozempic to manage their blood sugar and reduce their risk of heart problems and other complications. “But if you have the financial privilege to go outside of your insurance coverage, you can find someone to prescribe this drug to you, no problem,” Flores said. “Large groups of people who take this for its intended purpose are going to be denied access to this intervention, only because others with more privilege and more money can circumvent the system.” Diabetics may need Ozempic to manage their blood sugar and reduce their risk of heart problems and other complications, but it's increasingly being prescribed for off-label use.It should be noted: Ozempic comes with some pretty gnarly side effects. Anecdotally, Flores said that his clients who’ve taken this and other medications like it have struggled with nausea, vomiting, diarrhea and constipation. Still, even knowing all that, the allure of being skinny via a simple needle jab is strong. Candice Coppola, a 41-year-old business coach who’s struggled with bulimia in the past, has had to temporarily stop herself from scrolling on Instagram, given how many people she follows who she suspects are taking Ozempic. “These are people I otherwise very much enjoy,” she said. “It concerns me seeing this rapid weight loss of other people, 35 pounds in three weeks.” Coppola, who hosts the “Power in Purpose” podcast and lives in Connecticut, said there have been times in the last month when she’s paused and thought: Maybe I could find somebody to prescribe the drug to me. Maybe I could be a little thinner. “I’ve had to remind myself of how far I’ve come and that it’s not necessarily about fitness, it’s about how you feel, and I feel good so why would I feel like I need to do that?” she said. It’s helped Coppola to talk about her worries, especially with her husband, who is diabetic. Abby Rose Morris, a 26-year-old actor from New York who experienced periods of extreme calorie restriction in middle school and high school, is worried that the normalization of off-label Ozempic prescriptions will put even more pressure on women to lose weight. “With these drugs available, fatness is starting to be viewed as a conscious choice not to take the ‘easy’ solution that would spare people from all the discrimination and harassment that comes with living in a larger body,” she told HuffPost. “I’ve worked very hard to heal my relationship with food, and going on a medication that can take away hunger or make eating difficult could definitely jeopardize that,” she said. "Drug like this clearly do not treat the root cause of eating disorders,” said Brittany Burgunder, a certified professional life coach and eating disorder specialist. “Instead, it places a temporary bandage on internal woes until it no longer works, resulting in a recipe for relapse.”Culturally, Morris thinks we’ve pathologized the desire for food, something we need to survive. “Feeling liberated from your hunger cues is not normal,” she wrote in a viral tweetearlier this month. “Sure, use Ozempic for medical reasons, but being hungry is not a disease.” Some people online have said that conversations around Ozempic and eating disorders need to be more nuanced ― “please kindly understand there is more than one eating disorder, and Ozempic is life changing for binge eating disorder,” one woman tweeted. While this can be true and valid, the experts we spoke to worry that some might look at Ozempic as a solve-all for something complex like binge eating. Yes, it’s an eating disorder, but it’s also a complex mental health condition that isn’t just about food intake. “Weight loss drugs may result in changes in weight but do not address the emotional and psychological aspects that contribute to disordered eating. Weight loss will not ‘cure’ an eating disorder,” said Ashley Moser, a clinical education specialist at the Renfrew Center, an eating disorder treatment program in Philadelphia. “Many, many people are invested in you hating your body ― it lines their pockets.” - JESSICA SPRENGLE, LICENSED PROFESSIONAL THERAPIST WHO SPECIALIZES IN EATING DISORDERS In fact, while eating disorders often do not have a single identifiable cause, Moser said many people who develop eating disorders report dieting as a precursor. Plus, Moser noted, once someone stops taking a medication, the preexisting issues return: their blood sugar rises, their cravings come back and they often regain weight. This is why most people who take the drug typically use it long term for maintenance as well. Model and size-inclusivity advocate Remi Bader recently admitted she’d been prescribed Ozempic because she was pre-diabetic. After going off the medication, she “gained double the weight back” and her eating disorder resurfaced. “Drug[s] like this clearly do not treat the root cause of eating disorders,” said Brittany Burgunder, a certified professional life coach and eating disorder specialist. “Instead, it places a temporary bandage on internal woes until it no longer works, resulting in a recipe for relapse.” But if you have an eating disorder ― no matter which one ― and see others achieving desired results with the use of a single drug, “it becomes a much more alluring route to follow versus doing the long, tedious and challenging work that is required of long-term recovery,” Burgunder said. Be cautious about the hype of another diet culture cycle in action.If talk of Ozempic as an easy path to weight loss is triggering you, we asked eating disorder specialists ― and people who are in recovery ― to share the advice they’d give to anyone who’s struggling right now. Be cautious about the hype. Be cautious about the information that you read online, since not all sources are reputable or accurate. While it can be tempting to believe losing weight will solve your problems, especially when it feels like everyone but you is using Ozempic, remember that taking the drug is not worth losing your progress over, Burgunder said. “This drug has yet to be systematically tested in those with body weights that fall outside of the FDA’s criteria and either way, more often than not, turning to quick fixes backfire[s] in far greater ways, both physically and mentally,” Burgunder said. Remember that the diet industry is a 70 billion dollar industry that has a lot to gain from your buy-in, said Jessica Sprengle, a licensed professional therapist who specializes in treating eating disorders. “It’s geared toward making sure you hate your body enough to do anything in your power to change it,” she said. “Many, many people are invested in you hating your body ― it lines their pockets ― and they will do everything imaginable, including marketing drugs like these, even if they’re dangerous, to make money.” The pressure to buy in to quick fixes may even come from your doctor. As noted in a recent New Yorker piece on Ozempic, doctors “frequently misdiagnose, undertreat, or shame fat people, who then accumulate reasons to distrust medical care.” A 2012 survey of almost 2,500 U.S. women found that 69% reported feeling stigmatized for their weight and 52% endured recurring fat bias by their doctors. “Seeking professional support in navigating systemic diet culture messages is important,” said Ashley Moser, a clinical education specialist at the Renfrew Center. Mute words and phrases that trigger you on social media. If you’re extremely online (or even just semi-online), it’s near impossible to escape articles and gossip items about celebrities (and non-celebs with money) using Ozempic for off-label use. Thankfully, you can mute the words “Ozempic” and “Wegovy” from showing up on your Twitter, Instagram and TikTok. If your YouTube feed is wall-to-wall Ozempic trend videos because you watched a clip or two and now the algorithm thinks you’re interested, remove individual videos from your watch history. That alone may reduce the chance of similar recommendations in the future. (It also might help to remove individual searches from your search history.) Start following body-neutral influencers and writers. Time and time again, body neutrality experts we’ve spoken to recommend curating your social media feeds to omit Influencers and Instagram accounts that bring you down. (Think “fitspiration” and diet-centric content, or anyone who’s more subtly pushing the need to slim down.) Coppola said that this small step has had a huge impact on her recovery journey. “It really does help to just liberally remove people from your social media feed and from your social media world who trigger you, who bring up these thoughts and who are beginning to rewire your old habits, routines, rituals, and ways of thinking,” she said. In their place, diversify your following list to include dietitians and mid-size and plus-size content creators who value body acceptance and neutrality. “I follow a ton of anti-diet dietitians who remind me regularly that being hungry is OK and normal,” Morris said. “Outside of carefully curating your social media feeds, I just have to keep going back to the books and articles and podcasts that convinced me to stop dieting.” Sprengle suggests reading content that more holistically discusses the harm these drugs can cause and how we’ve gotten here, like Marquisele Mercedes’ piece on Wegovy from 2021. If online conversations are complicating your recovery, mute words and phrases that trigger you on social media. Get outside help and talk about it. People in recovery are always encouraged to talk with people they trust about how exposure to certain headlines impacts them. “Expressing how you feel to people who understand has a way of defusing the emotions that are activated by exposure,” Moser said. “Seeking professional support in navigating systemic diet culture messages is important while also receiving specialized help from therapists, dietitians and physicians.” Remember how far you’ve come in your recovery process. When Morris goes down a rabbit hole of reading about Ozempic or similar treatments, she tries to think of the big picture, she said. Will this matter in 10 years? “I know many of us have regrets about the experiences we’ve missed out on because we were so worried about food or what our bodies looked like, so thinking of it in terms of your past is helpful, too,” she said. “It also really helps me to think that humans evolved to need and enjoy food,” Morris said. “It’s natural, it’s normal to be hungry. That’s your body trying to keep you alive. It’s incredibly self-loving and self-caring to embrace that, listen to your body, and give it what it needs to keep you alive.” Becca, quoted at the beginning of the story, is also leaning in to her progress and coping skills, as well as her hard-earned love of cooking and food. “Eating is one of the biggest passions in life and it’s one of the ways I’ve reclaimed my relationship with myself, so the sheer apathy towards food in the culture right now makes me very uncomfortable,” she said. “Knowing that I’m feeding my body the nourishment it needs helps me ignore a lot of the disordered eating nonsense the internet seems to be promoting more and more,” she said.

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