Ozempic Part 3
We need to better understand how and why Ozempic is treating brain noise.
In the world of eating disorder treatment, I welcome the day when we can lift what seems to be the brain-healing vehicle of Ozempic and leave the physiologic repercussions behind.
Can we isolate the specific way in which neural pathways are soothed and healed by this powerful drug and reconstitute it and make it its own drug?
Is it possible or even plausible?
I can describe what I see clinically and why I am fascinated by Ozempic. I also feel powerfully the caution and potential harm of these (and similar) drugs.
When someone comes to me with a potential eating disorder, I am explicit in saying that their weight is not relevant. It is only important if it is life-threateningly low, and we need to attend to it medically immediately.
In all other cases, the most important thing I want to understand is how much they think about food. Not merely thinking but negotiating.
The brain loops with these questions;
If I don’t eat this, then I can eat later.
If I eat this, then I can’t eat again for the rest of the day.
How much should I work out to compensate for this meal?
How much exercise will be required for my dinner out?
Can I eat in front of others, or do I feel self-conscious?
I want to go out for dinner, but what if I can’t eat anything on the menu?
Let me analyze the menu before I go. Is it worth the effort, or should I just eat alone?
This loop is ever-present and all-consuming, and my clinical questions are targeted at ascertaining what percentage of their time is spent thinking and planning around food.
This singular assessment tells me if someone has an eating disorder that needs to be treated.
If that preoccupation with food interferes with their functioning, we need to address it and help remedy it.
When I say interfering with functioning, I mean, Do they feel that their life is infringed upon because of these thoughts? Do they feel that their behavior and decisions are partially informed by their worry, preoccupation, and shame around food and body image?
The reason for needing to treat this symptom, which I believe indicates an eating disorder more than any other symptom, is because it is an absolutely excruciating way to live.
If you are reading this and resonating with my words, then you know my writing is eerily accurate.
Your food negotiation is organizing your life. Also, know that you are not alone. That obsessive, unrelenting loop is the most debilitating ongoing symptom of an eating disorder.
So, what I am seeing consistently is that injectables (Ozempic, Munjaro, Wegovy), turn the volume down on this loop.
The brain noise is quieter.
Life is easier.
There is less shame, less guilt, less negotiating.
I am cautious with writing these words that it sounds as if I am advocating for injectables, and I want to say clearly that is not the case.
I worry profoundly that the use of these medications will further narrow the stigmatizing window of acceptable bodies and weights that our society has firmly in place. These drugs also send the message that human beings should force themselves into a one-size-fits-all box.
BUT as someone who has committed their life to mental health, I cannot ignore this outcome. The relief these patients feel is real, profound, and deserved after years of a relentless loop.
That must be recognized and validated.
We must take the recognition of this comfort and relief into our understanding of eating disorders and use it to better understand treatment and, most importantly, prevention.
