Dietitian Exposes The Truth About Ozempic, Hollywood’s Newest Weight-loss Drug
Trigger warning: mentions of weight loss, body fat percentage, the word o*esity
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Ozempic is Hollywood’s latest weight-loss drug-du-joir and the use of it is particularly difficult and triggering for those in recovery from disordered eating and eating disorders.
Over the past few years, this drug has made its way into headlines sparking controversy among doctors, dietitians, and healthcare providers. Some believe that ozempic is the “future of medical weight-loss solutions”, while others believe this medication has potential to cause great harm both in the short and long term. With so much controversy, it can be difficult to discern facts from myths regarding ozempic.
What is Ozempic?
Ozempic was originally developed as a treatment for type 2 diabetes, and it is delivered as an injection into the skin of the thigh, upper arm, or stomach. These injections can cost upwards of at least $250 or greater for one month. Ozempic is a sema-glutide or a GLP-1 receptor agonist. Sema-glutides mimic hormones necessary for glucose regulation that are naturally produced in your body when you eat. Ozempic lowers blood glucose levels by stimulating insulin production and inhibiting glucagon secretion. This in part contributes to slowing down how quickly your stomach empties as your food digests. This is particularly helpful for those that have diabetes, the population for which the drug was designed, where there are issues with glucose regulation.
How does your body handle glucose and insulin if you don’t have diabetes?
Your body utilizes a molecule called glucose for energy (yes, this is from carbohydrates). When you ingest carbohydrates, your body breaks down glycogen (chains of carbs) into the individual units of that chain, otherwise known as glucose. When this breakdown happens, the amount of glucose in the blood increases. If blood glucose levels are too high for too long (a condition known as hyperglycemia that happens for folks who have unmanaged diabetes), this can cause harm to the body.
To counterbalance this spike of blood glucose, your body produces a hormone called insulin. Insulin is your friend and isn’t bad. Insulin enables the glucose to enter your cells, which lowers the amount of glucose in your blood. However, it is also harmful if your blood glucose levels are too low (known as hypoglycemia). In a state of low blood glucose, your body releases a different hormone called glucagon to raise your glucose levels. Your body has a built-in system where insulin and glucagon work together to regulate how much glucose you have in your blood. It’s almost magical how they work in tandem to support the body and its needs!
In people diagnosed with diabetes, the body either can’t produce insulin or the cells are insulin-resistant, making it hard for glucose to get into your body’s cells. As a result, blood glucose levels are too high, and the body does not have a way to regulate it. This is why many people with diabetes need to take insulin or take medications that help insulin to work more efficiently.
Why is ozempic being prescribed for weight loss?
While ozempic was originally designed as a treatment for type 2 diabetes in order to improve blood glucose levels, some studies are showing that ozempic can cause 5-15% total body weight loss. Due to medical weight stigma, doctors are prescribing ozempic to assist weight loss in patients with a body mass index that indicates an “increased risk for diabetes” which is solely based on body size or BMI. But the drug isn’t just being exclusively prescribed for this reason. Everyone from celebrities, influencers, adults, and young people are taking this drug to change their body shape and size.
Ozempic can cause temporary weight loss by:
Delaying gastric emptying - Ozempic increases the time that your food passes through the digestive system. Because your food takes more time to digest, you feel fuller for longer. This increases the time between meals and snacking periods, causing some to eat less frequently.
Mimicking hormones that simulate fullness - Ozempic mimics hormones that signal fullness, causing you to feel fuller than you normally would when you eat. This may cause you to eat less food than you normally would.
Causing nausea, explosive diarrhea and vomiting - These adverse side effects of ozempic can lower appetite and ability to eat.
Some doctors seemingly are prescribing Ozempic when the patient in question has tried other weight loss attempts, but they haven’t lost weight. Doctors are suggesting that ozempic for weight-loss should be prescribed in individuals that “weigh 30-50 pounds more than the “recommended” weight range and have a BMI of 27 or greater.” Doctors argue that the benefits of the drug outweigh the risks of chronic disease.
Some doctors though are advising people not to take the drug if they are not diabetic. They state that the drug used for off-label purposes poses great risk for individuals who take the drug as a quick weight-loss solution. For these people, they say that the health “benefits” do not outweigh the potential risks.
It’s important to note that Ozempic isn’t the first drug that has been used as an aid for weight-loss and praised for being a “miracle”. You may have heard about Fen-Phen and Ephedra, past drugs prescribed by Doctors to assist in weight-loss efforts but later taken off the market. Similar to ozempic, these drugs were prescribed shortly after development with little research only to later reveal serious irreversible side effects, including heart valve complications and death. In this way, Ozempic is not a new story, and we’ve seen this before.
What are the side effects of Ozempic?
Although the long-term effects of Ozempic are not clinically known yet, there are some short-term side effects that have been identified. Those who take Ozempic have reported several gastrointestinal side effects including:
Nausea
Vomiting
Explosive diarrhea
Stomach pain
Constipation
There have also been reported cases of more serious side effects including:
Pancreatitis (with higher risk for those prescribed without diabetes),
Development of thyroid cancer
Suicidal ideation or behavior
More recently, the FDA issued a black label warning on Ozempic which rarely takes place. Black label warnings are the highest safety-related warning that medications can have assigned by the Food and Drug Administration. These warnings are intended to bring the consumer's attention to the major risks of the drug. Some scientists claim that, like many other medications, these side effects subside after the body has adjusted to the dosage. However, there have been no long-term studies to support or refute any evidence of long-term side effects associated with Ozempic and many indiviauls have had to stop using the off-label drug due to side effects.
What are the dangers of taking ozempic when you don’t have diabetes?
As Registered Dietitians, at Bravespace Nutrition who specialize in eating disorders and disordered eating here in Seattle, WA, we believe that this drug is dangerous to take off-label due to its lack of long term research and the harm that it can cause to those in eating disorder/disordered eating recovery. This is not though an attack on individuals who choose to take Ozempic. The reasons that would lead to someone taking ozempic are often complex and what matters most is that you be as informed as possible before taking a medication like this.
Those that take ozempic off-label for weight loss are at increased risk for:
Low blood sugar, also known as hypoglycemia
Malnutrition related to undereating (see “ozempic face”)
Hormone diruption
Loss of menstrual cycle
Explosive diarrhea
Bone loss
Developing an eating disorder
Other previously mentioned side effects including:
Gastrointestinal issues such as nausea, vomiting, diarrhea, stomach pain, constipation
Pancreatitis
Development of thyroid cancer
What’s ozempic face and is this concerning?
In addition to the discussed side-effects of Ozempic, one of the more commonly reported side effects of ozempic is something called “Ozempic Face”, which was coined by a New York dermatologist after seeing many of his clients exhibiting similar facial changes after taking the drug. (Prefer to learn about “ozempic face” in video? Check that out here!)
Due to rapid weight loss that some experience when taking ozempic, and as a result of not getting enough food to support its needs, Ozempic causes a person’s face to have a sunken appearance. Individuals report a hollowing of under the eyes and in the temporal regions of the face, as well as skin laxity. Interestingly, these are the same physical characteristics that dietitians use to diagnose malnourishment, including rapid weight loss, hallowing of under the eyes and in the temporal region of the face.
What happens when you stop taking ozempic?
Many people report having an insatiable feeling of hunger after stopping the medication because of the prolonged period of undernourishment caused by the effects of the drug. And, in all cases of stopping the medication, weight gain happens and people go back to their original weight, often gaining more due to being undernourished.
For individuals who have struggled with binge eating disorder and/or have taken this drug to stop binge eating, stopping ozempic causes the behaviors to return in full force, often increasing the frequency of binge eating behaviors.
Additionally, taking ozempic for purposes other than diabetes control can alter your body’s natural hunger signals, and puts you at risk for developing disordered eating behaviors or eating disorder behaviors.
Ozempic has its place in the medical world, and this medication can be life-changing for those with diabetes. However, when ozempic is taken for reasons other than its intended use, it may cause a lot of harm to the body physically and mentally.
Why is the use of Ozempic harmful for those in eating disorder and disordered eating recovery?
The borage and seemingly unending coverage of this drug is putting more people at risk for eating disorders, and likely triggering those in recovery back into the eating disorder. It’s hard to ignore information about Ozempic because it’s so popular right now, and that’s really difficult for those in eating disorder and disordered eating recovery, and/or have a history of an eating disorder. This is because one of the foundational parts of recovery is moving toward, and eventually accepting and creating peace with one’s body. Additionally, for many people weight gain does and needs to happen in recovery from eating disorders after years of being weight suppressed and dieting, not matter what size body someone is in.
Ozempic not only encourages exactly what individuals are trying to move away from in eating disorder recovery, but it also proposes a “quick fix” to body image concerns and continues to promote the message that “thinner is better at any cost”. There is currently no screening for eating disorders when prescribing this medication and seeing that the majority of individuals with eating disorder exist in larger bodies, there is cause for great concern.
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Are you feeling triggered by Ozempic? Do you have questions related to Ozempic or other nutrition concerns? Our Seattle eating disorder Dietitians can help you!
It’s so difficult to want to heal your relationship with food and your body, and be exposed to information about weight loss drugs. It can feel enticing to take it even when you know it’s harmful. At Bravespace Nutrition, our Health At Every Size, eating disorder Dietitians want to help and support you in navigating this. We specialize in eating disorders, disordered eating, intuitive eating and body image concerns. Reach out to us to schedule a discovery call today!