CNN
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There’s still a lot researchers don’t know about the popular weight loss drug, and the lack of research could have the following effects: eating disorderaccording to experts.
The drug semaglutide, sold under brand names such as Ozempic and Wegovy, is Glucagon-like peptide-1 receptor agonist or a GLP-1 agonist. Semaglutide was originally prescribed for diabetes, but has become increasingly popular for weight loss.
As treatments become more available, experts said they are concerned about the impact these weight loss products may have on eating disorders.
“We are seeing more and more people joining our clinical services as patients begin receiving GLP-1 agonists and experience new onset or worsening of eating disorder symptoms. clinically,” said Dr. Aaron Keshen, co-director of the Nova Scotia Feeding Association. Office of Disabilities and Assistant Professor, Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia.
Nearly 1 in 10 people in the U.S. suffer from an eating disorder, according to the nonprofit organization. National Association for Anorexia Nervosa and Related Disorders, provides support services to people with these conditions.second highest after opioid addiction crude mortality rate The association said any mental illness could be the cause.
Because GLP-1 agonists can worsen or spread eating disorders, “they should be prescribed very slowly and very carefully considered when to prescribe them,” says one eating disorder doctor. said Dr. Jennifer Gaudiani, Founder and Medical Director. at the Gaudiani Clinic in Denver.
The scope of research on the relationship between eating disorders and weight loss drugs is very narrow, leaving experts with many unanswered questions, said Susan HOPE Lindner Center Principal Investigator and Linda and Harry Fass Endowed Professor. Dr. McElroy said. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine.
“I see eating disorders as the last frontier of psychiatry,” she added. “The field of eating disorders is tough because we just get ignored.”
Are there any examples of these drugs actually helping people with eating disorders? Perhaps, the experts said:
Generally, if a drug causes weight loss, there is a good chance that weight loss will also occur. McElroy says it reduces bulimia.
Bulimia is the most common eating disorder. However, like anorexia and bulimia nervosa, there is not enough research into drug treatments, she added.
“We desperately need more compounds to treat people with eating disorders,” McElroy said.
Although these drugs could theoretically help, they are not yet approved to treat bulimia, she added.
“There is some preliminary evidence that GLP-1 agonists may be able to reduce binge eating symptoms in some people,” Keshen says. 1 Agonist for bulimia. ”
Keshen and McElroy worked on it. 2023 paper The paper was published in the International Journal of Eating Disorders, which reviewed the existing literature on GLP-1 agonists and eating disorders. The studies they found on bulimia were small and many did not test against placebos. Keshen said.
“Further research needs to be done,” he added. “And it may happen in the future.”
Eating disorders occur in people of all shapes, sizes, and health conditions. As a result, Gaudiani says, doctors may unknowingly prescribe these drugs to people who have a history of eating disorders or who have an active eating disorder.
“Their ability to pay for drugs that cause weight loss while possibly causing medical complications is concerning,” she says.
Gaudiani said he has heard anecdotes of people whose eating disorders were in remission but relapsed after taking GLP-1 agonists.
Gaudiani said eating disorders are complex biopsychosocial illnesses, and the process of losing weight can increase dietary restriction and cause “old gremlins” to emerge.
Additionally, these drugs suppress appetite. Feeling full quickly or feeling sick after eating a small amount can disconnect us from our natural hunger and satiety cues, she added.
“It’s unimaginable if someone with a history of eating disorders, or just someone with a difficult personality, were surrounded by a society that placed so much emphasis on weight loss and fatphobia and started losing weight,” Gaudiani said. Not,” he said. But it can become very compulsive for them and can develop into something very unhealthy both mentally and physically. ”
Although experts cannot say whether GLP-1 agonists increase the likelihood of developing an eating disorder because there is little research on the topic, Gaudiani said there is reason to be concerned.
“Many eating disorders start with restrictive eating and weight loss,” she says. “The act of reducing caloric intake or physiologically reducing weight has been shown to trigger eating disordered behaviors even in people who are not considered temperamentally or socially predisposed to eating disorders. Masu.”
Gaudiani pointed to the 1944 Minnesota Starvation Experiment, in which individuals volunteered to starve themselves so researchers could experiment with the best refeeding methods.
She said if the volunteers were starving, there were effects that the researchers hadn’t anticipated. They became obsessed with food, reading cookbooks, constantly chewing gum, cutting their food into smaller pieces to make it last longer, and criticizing people in restaurants who they considered to be gluttons.
“Essentially, (they) were behaving like people with anorexia,” Gaudiani said. “When she loses weight due to a calorie deficit, there’s something fundamentally changing in our brains.”
There are also risks for behaviors such as bulimia, Keshen added. If your appetite is suppressed, you may not eat at all during the day and binge eat at night. In a purge action, he said.
“Maybe some moderate weight loss is a healthy outcome for some people,” Keshen says. “However, achieving rapid weight loss through excessive and pathological dietary restriction is never a healthy outcome.”
First, health care providers who prescribe these drugs should screen for a history of eating disorders, active eating disorders, or even predisposition to eating disorders, Keshen said.
“It may be worth trying to treat the eating disorder first, and perhaps not using GLP-1 agonists at all in that patient,” he says.
If doctors and patients choose to proceed with medication, it’s important to also consider information about eating disorders and the importance of regular eating, Keshen said.
People taking appetite suppressants should review their nutrition Gaudiani said he tries to talk to them regularly.
“Like all mammals, humans need to be nourished throughout the day to give their bodies and minds the energy to do what they want to do. So we need to make sure we’re eating enough. Yes,” she says. “How often do I think about food and my body?”
Gaudiani said people with a history of eating disorders who notice they relapse into old behaviors while taking GLP-1 agonists should contact their doctor or therapist. .
And even if you haven’t been diagnosed with an eating disorder, or may not even meet the criteria for an eating disorder, if your goals and priorities are distracted by thoughts of weight and food. , it may be time to consult an eating disorder specialist if you have the resources. Available, she said.
“If not, visiting eating disorder treatment websites or listening to podcasts can give you some support and clarity about what’s going on,” Gaudiani says. Told.
