Morning in Ottawa6:35Zompic eating disorders
One of the things Cheryl Rasband learned as part of her recovery from anorexia is that she shouldn’t actively try to lose weight. So she was a little surprised when her psychiatrist suggested she might want to try Ozempic.
“I want to give him the benefit of the doubt because I expressed my anxiety about my weight. “However, he knows my history,” she said.
The 40-year-old nurse and mother who lives in Utah County, Utah, has struggled with an eating disorder since she was 16, and said her weight has been up and down ever since.
When she was at her lowest, she had to be hospitalized and even temporarily lost custody of her children as a result, she said.
Now, after undergoing extensive treatment, Rasband said she feels much better mentally, although she says she has technically gained weight. Body mass index. (BMI is a measurement some doctors use to determine a healthy weight, although it’s been challenged as an indicator of health.)
“I feel like I’m healthier, more functional, more everything at this weight versus when I’m underweight and in and out of treatment and suicidal.”
People who work in the treatment of eating disorders in Canada say what Rasband experienced is happening in this country, and they are alarmed that their patients are being prescribed weight-loss drugs without proper screening or counseling.
Risks for people with eating disorders
Anita Federici, a clinical psychologist at York University, has noticed this trend.
“My serious concern is the movement I’m seeing where doctors are prescribing drugs like Ozempic to people with eating disorders and providing false education that these are first-line treatments for things like binge eating disorder or bulimia nervosa, which they absolutely no,” said Federici, who has a doctorate in psychology and is also a fellow of the Academy of Eating Disorders.
While there is no data to show how many of the 3.5 million Ozempic prescriptions written in Canada last year went to people with a history of eating disorders, Federici said a large number of her patients are on Ozempic and that she is concerned, not only for their mental well-being, but also their physical health.
Of particular concern are patients who have what is sometimes called “anorexia atypical,” she said, because while they may have a BMI that puts them in the overweight or obese category, they are actually starving much of the time and are at risk of becoming obese. malnourished if they are using weight loss medication.
“You are medically compromised. And now the danger is that the person with, unquote, atypical anorexia or binge eating disorder walks into the doctor’s office and is increasingly prescribed Ozempic,” Federici said.
“Hunger under the supervision of a doctor”
This is something that also worries clinical psychologist Jennifer Mills.
She is a professor studying eating disorders in the Department of Psychology at York University.
Mills said that a drug like Ozempic can even cause an eating disorder in someone “who is predisposed to have that kind of reaction” and that patients should be closely monitored during what is “almost like a physician-supervised fast.”
She said there have been some documented cases of people who have had weight loss surgery or taken weight loss medication where it has caused an “anorexia nervosa-like reaction”.
“Sometimes when people lose weight drastically, they can develop a distorted sense of how their bodies look. “It’s almost like their brain has a hard time catching up to the physical weight loss and maybe an excessive fear of regaining the weight or not being thin enough,” says Mills, who has a PhD in psychology.
One issue, she said, is that doctors and psychologists don’t always agree on the best approach to weight loss.
For example, Mills says she believes people can be healthy at any size and encourages her clients to embrace that perspective.
“I preach that to my patients, and yet it’s at odds with this kind of hype and hysteria about a drug that makes weight loss really easy.”
A “valuable” drug for some
But for doctors of diabetes patients, weight loss may be a desirable byproduct of using Ozempic.
“We have an obesity epidemic. That’s why we have a diabetes epidemic,” said Dr. Stuart Harris.
He is a professor in the Department of Family Medicine at Western University’s Schulich School of Medicine and Dentistry and Medical Director of the Primary Care Diabetes Support Program at St. Joseph’s Health Care in London, Ont.
“From a purely clinical perspective of diabetes[Ozempic]is a very valuable remedy in our toolbox.”
And, he said, Ozempic can be safely prescribed to someone with an eating disorder if proper precautions are taken.
“If I know someone has a history of binge eating or mental health issues, I’m going to be a lot more judicious and careful about whether I even start this therapeutic option, or how I do it, or how I monitor them,” Harris said.
“I’m very selective and careful in all the people I put this therapy on, but especially in people I’m concerned about where there might be more negative outcomes associated with eating disorders in people.
He said he doesn’t want to point fingers, but he knows not every doctor does this.
“You [can] just walk into a health promotion clinic that sells diets and other lifestyles and stuff and they just give you a prescription without knowing who you are or what your clinical history is. “Then I think that’s where people run into trouble,” he said.
Columnists from CBC Radio6:31 a.mBody positivity and coolness
Sad and scared
Cheryl Rasband said she still isn’t sure if she’ll try Ozempic as her psychiatrist suggested.
Although she’s much happier living without an eating disorder, she’s not sure she won’t relapse with the pressure she feels to take diet pills.
“It’s so sad that he’s catching me after all these things my eating disorder has done and bringing it back.”
She also fears she is not the only one struggling with this difficult decision.
“If it’s questioning me, and all the other people who are like me questioning what their values are and what their priorities are for this publicly-imposed weight loss drug, I feel scared for the population as a whole.”
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