Ozempic for Life? A few things to consider...

As a practicing dietitian in the field of eating disorders and disordered eating I’m writing because I feel like I need to. The following information is not meant to shame anyone who is currently taking these medications or to point fingers. It’s purely for information purposes with a sprinkle of my thoughts included.

As many of you know by now Wegovy, Ozempic and Mounjaro are all GLP-1 agonists, otherwise known as glucagon-like peptide 1 agonists. When we talk about agonists we are essentially talking about a mechanism that behaves similarly to our bodies natural hormone GLP-1. GLP-1, in short, helps slow down food absorption in the stomach so you feel fuller longer, it also regulates insulin and blood sugars, and tells your brain that you are full quicker. Ultimately, these drugs significantly suppress hunger, and still require a calorie deficit to work.

That being said, I wanted to point out some things to consider if you are on the fence about taking one of these medications, are already taking one, or if you just want more information.

Side Effects:

Of note, the most common side effect is nausea. Other symptoms take the shape of diarrhea, vomiting, constipation, stomach pain, dizziness, bloating, belching, and gas. The most significant long-term side effect is gastroparesis, which has no cure and can be extremely troublesome to manage. And truthfully, we still aren’t sure about the long-term side effects in humans, however, thyroid cancer and pancreatitis have been noted in animal research.

Cost: These meds can run up to $1000 - $1300 a month. That’s pretty pricey and a lengthly investment long-term.

Could taking this medication lead to an Eating Disorder?:

Quite possibly. Just keeping the idea alive that weight is a problem and putting your body into a long term energy deficit replicates the conditions of an eating disorder. Malnutrition is no joke and can leave a very damaging wake. I see it every day in my practice.

Our worlds continued focus on the thin ideal is sad and so unhealthy for everyone. Interestingly, bodies are diverse and always have been. Large, medium and small bodies have co-existed from the being of time. And, 70% of how we look is actually genetic!!

Long Term Use and Safety:

The most frequent question I receive is “If I start taking Ozempic to lose some weight, do I need to stay on it for the rest of my life?” The answer is likely, yes. It’s just like any other diet program. In fact, one research study found that one year after coming off Ozempic or Wegovy, participants gained an average of ⅔ of the weight back.  ⌒̎

In terms of safety, I wanted to note that generic semaglutide is exempt from normal FDA approval, so many pharmacies and medi-spas are offering their own compounded products. These products are usually cheaper but physicians warn these compounded prescriptions could be ineffective and even dangerous. Not cool in my book. And, doses used for weight loss are often significantly higher than what is used for diabetes management.

In summary, I realize the need for these medications for those suffering with diabetes and for those with health conditions where the low doses utilized are helpful for disease management. Aside from this though I agree with a fellow colleague in the field for mental health, Esder Shin, psychiatric nurse practitioner specializing in eating and body image issues who states in an article written on Psychology Today

“Ozempic and other weight-loss medications might be a tempting solution for many; however, it is important to understand that these medications may actually exacerbate body image issues and worsen symptoms of disordered eating and gastrointestinal problems. This can cause one to feel even more self-conscious about themselves. I cannot stress enough to my patients how important it is to work on developing a healthy relationship with their bodies where patients can allow themselves to achieve a greater sense of self-confidence and overall well-being.”

Devon, Allie, Paige and myself, instead encourage the incorporation of all foods. And, we also help people stand up to weight stigma and advocate for adequate health care access for all body sizes. If you choose to work with us while taking these meds or not, we will work tirelessly to help you develop a healthy relationship with food and your body. Contact us here.

By Peggy Pratt, PhD, RDN, LDN