Ozempic Part II
The last post I wrote about Ozempic, entitled “NOzempic” was partially an introduction to how it is being used, off label, as a pure weight loss drug for those who want to lose weight.
They have none of the medical indications that constitute “needing” the drug.
These diagnoses include: diabetes, pre-diabetes, cardiovascular disease, as well as other medical illnesses where weight loss is significantly connected to mortality. The side effects caused by these drugs which I discussed in my last post remain unchanged.
BUT, the piece that I did not discuss and I think needs more attention is in the appreciation and understanding of what Ozempic does for those who have issues with food, separate from weight loss.
Why is Ozempic helpful to those who have eating issues?
Consistently, both in the media and with my own patients the way in which Ozempic (and other weight loss injectables) is helpful is that it quiets the brain noise involved in the decision making around food choice.
For those living in an Eating Disordered brain, the concept of food noise is not new.
It is the decision making process around what to eat, when to eat and how much to eat.
Calorie content, what I ate yesterday and what I may eat tomorrow.
It is looking at menus, anticipating what you may eat when you go out for dinner, and even the process of limiting food at one meal, so you can be free to eat at the following meal.
These injectable medications, through a combination of direct impact on brain receptors and serving as communication interference between the brain and GI system, quiet this chatter.
It is too soon to tell the exact science of why the impact is so profound, but from an observational perspective the relief from that noise appears to be dramatic. So much so that these drugs are also being looked at as a treatment alternative in addiction, to see if they can potentially reduce desire and cravings in the world of substance use.
I see that the relief people feel who have been burdened by this food decision making for most of their lives is profound. The space that has been freed up for them, the ease of not having that chronic layer of preoccupation and worry must feel like a respite.
Food has simply become normal and no longer a larger than life issue that needs to be managed.
Unlike drugs and alcohol, food is required for living, so even the relief of the totality of abstinence is not an option when managing issues with food.
AND, this opens the door for a larger discussion. This relief needed from food noise is also something that we humans have created. Generation to generation we have transmitted the precedent that thin is better.
Though eating disorders are biologically based and 55% of sufferers are genetically predisposed, this psychological drive for thin superiority and concept of thin privilege was created by humans for humans.
Humans were wired for survival not food restriction. Yet, food restriction and thinness has become a way to express superiority, privilege and sanctimony.
Now the question is: How do we heal from these antiquated beliefs and what can we do differently to STOP this from transmitting to the next generation?
How do humans reset the center, and open up the acceptable range of weight to the entire spectrum, not merely the coveted low end of the range?
That is our work and there is much more to come…
