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ozempic's success as a weight loss drug linked to eating disorders

"thin is back in," says registered dietitian abby langer of the weight loss trend driven by new drugs.

by karen hawthorne
published mar 10, 2023
last updated mar 24, 2023
read time 4 minute read
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read time 4 minute read
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eating disorders linked to weight loss drugs
drugs like wegovy and ozempic can make losing weight a compulsion, says eating disorder expert dr. allan kaplan. getty
the relentless pursuit of thinness is all over social media as celebrities shrink their size with popular weight loss drugs like ozempic. but experts say the trend reinforces diet culture messages about being a perfect, model-thin size, and that access to these drugs could trigger eating disorders or make recovery harder for people who struggle with eating disorders.
ozempic and wegovy are both forms of the medication semaglutide, the main active ingredient. ozempic has been approved by health canada to treat type 2 diabetes and wegovy has been authorized by health canada for weight loss for obesity, ctv news reports. however, medications can also be prescribed for purposes not authorized by health canada — a practice known as prescribing off-label — something that we are now seeing with these weight loss drugs.
“people use it who don’t have a weight problem, they don’t have any of the complications or risks of being overweight, and they want to lose weight for cosmetic reasons, not health reasons. so, it gets misused, is the best way to put it,” says dr. allan kaplan, a senior clinician and scientist at the centre for addiction and mental health in toronto (camh) where he counsels patients with eating disorders.

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weight loss drugs can be ‘disastrous’ for someone with an eating disorder

and while many obesity specialists in canada are welcoming each new iteration of these drugs as effective for treating their patients, there are health risks for others.
“the drug causes the pancreas to increase insulin secretion so that pushes glucose into cells, but just as important, it slows gastric emptying so people lose their appetite and they don’t have a desire to eat, and they lose weight that way,” says kaplan, who has worked in the field of eating disorders for over 35 years, lectures widely, and is also a professor in the department of psychiatry at the university of toronto. “that can be quite disastrous for somebody who’s already got an eating disorder and trying to maintain an adequate intake to begin with.”
further compounding the risks is the fact that the drugs are not a short-term solution or quick fix to weight loss. research published in the journal diabetes, obesity and metabolism showed that one year after withdrawal from the once-weekly semaglutide injections and lifestyle interventions, participants regained two-thirds of their prior weight loss. the study authors say obesity is a chronic condition and ongoing medication is required to maintain improvements in weight and health.
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another concern is that taking these drugs can actually trigger an eating disorder in someone who may be at risk because the drug is effective in weight loss — for as long as you take it.
“once somebody starts losing weight, it can become a compulsion and they can’t stop the drug because they want to continue to lose weight, and that can lead to a formal eating disorder,” says kaplan.

eating disorders come with a genetic predisposition

eating disorders are highly complex and can’t be simplified as a lifestyle choice an individual makes with regard to food or their weight. there’s neurobiology and genetic predisposition that put people at risk.
“it’s not a question of willpower,” he says, or “blaming the victim with, ‘if you really try hard enough, you can get over this.’ and it’s not just about esthetics. these are mental disorders which carry a big burden.”
kaplan also notes that the pervasiveness of social media messaging can be a powerful influence on vulnerable people.
“for someone who has self-esteem issues, doesn’t feel good about themselves, doesn’t feel like they’re as successful as they should be, or doesn’t feel that they’re beautiful — and beauty is often measured by weight, even though it shouldn’t be — they’re going to be extremely vulnerable to social media promoting this treatment or disuse,” he says.
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weight loss spurred by social media

abby langer agrees. a registered dietitian in toronto for 24 years who has worked in hospitals and done private one-on-one counselling for people with eating disorders, she says the social buzz around these drugs is a concern, especially for adolescents and young people.
“young people don’t have that insight into their own relationship with food and eating and their bodies in order to say, ‘you know what? this is going to trigger me. i’m going to stay away from it.’”
langer flags the problem of reported lack of medical supervision with telehealth companies and medi-spas prescribing the drugs and not following patients for possible side effects or progress as a primary health-care provider would. she also points to how the push for a super-thin body undermines all the progress that’s been made on body acceptance and being happy in our own skin.
“i don’t know what happened to body positivity but thin is back in and it’s really scary for young people,” langer says. “they don’t necessarily understand when they are at increased risk for an eating disorder or health issues.”
karen hawthorne is a toronto-based writer.
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karen hawthorne
karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

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