Are weight-loss drugs like Ozempic causing eating disorders with ‘sinister’ marketing?

New Zealand Eating Disorders Clinic director Dr Roger Mysliwiec says GLP1 drugs were being “pushed very strongly” for weight loss on social media, but also by pharmaceutical companies with sales in mind.

There was even more of a risk that people who were already at a low weight or experiencing an eating disorder could seek out these drugs because they were easily accessible, Mysliwiec says.

Whereas stimulant appetite inhibitors had been prescribed with more caution because of their side effects, with drugs like Wegovy, the short-term side effects were “moderate to mild”. This meant there was a “far more relaxed” attitude towards weight loss jabs, Mysliwiec says.

Early symptoms from Wegovy are reported to include nausea, constipation and in some cases more severe vomiting – but these are typically manageable.

Weight-loss drugs work by utilising the natural gut hormone GLP1, which signals fullness, and can slow down stomach emptying and regulate blood sugar in response to a meal.

A story by The Daily Telegraph estimated 2.5 million people are now using weight-loss jabs in the United Kingdom, with sales of Mounjaro and Wegovy up sevenfold from the year before.

A Health NZ spokesperson says the cost of Wegovy in New Zealand was about $500 per month or $17 per day.

As online companies jostle to offer their services as the most efficient and seamless way to get weight-loss drugs, could the goal shift from tackling obesity to prescribing for insecurity?

A 2021 report by Hāpai Te Hauora also found poverty increased the likelihood of obesity in New Zealand, with children living in the most socio-economically deprived areas 2.7 times more likely to have obesity than children living in less-deprived areas.

“I’ve heard of people who want to take the medication for six weeks and just go to a ball. I’ve heard this in New Zealand. So, that’s the risk,” Mysliwiec told the Herald on Sunday.

19-year-old Jade Varney fears weight-loss drugs are creeping into body image discussions among young people.

Christchurch-based student and eating disorder advocate Jade Varney, aged 19, recently heard some of her male friends talking about Wegovy or Ozempic as a way to achieve the “shredding” of extra fat in gym routines after “bulking-up” to build greater levels of muscle.

She was aware of people who had been able to “get their hands on” weight-loss drugs without difficulty.

The idea of healthy young males using Wegovy to aid an intensive gym routine marks a stark departure from the framed purpose of these drugs: the mitigation of health risks linked to rising rates of obesity.

Often, Varney says, male eating disorders flew under the radar because of stereotypes surrounding the illness.

Some Kiwis are obtaining these drugs through overseas telehealth appointments but could be at risk of damaging their health through rapid weight loss if there was no clinical supervision.

There were also secondary effects on the metabolism and body that came from unregulated or dramatic weight loss, such as a lowered heart rate, blood pressure troubles or the loss of muscle and valuable tissue in the body.

Varney spiralled into anorexia at just 15 during Covid lockdowns. She was completely “swept away” by health and wellness trends on social media and the boredom of being trapped at home.

“It was almost glorified on social media. A lot of girls I knew were entering that realm of how to lose weight, how to get skinny quick, and so I was very much caught up in it,” she says.

Varney says people with eating disorders were likely to go to extreme lengths regardless of whether weight-loss drugs existed or not, but the messaging of advertisements was “very, very alarming”.

“I can’t see any reason why people wouldn’t just look at it and watch it, then subconsciously be influenced,” she says.

Mysliwiec says GLP-1 medication had shown remarkable effects in a range of areas and had not even been fully researched yet, however, the promotion of weight-loss drugs was happening in a “sinister” way and could be fertile ground for increasing eating disorders in the population.

But these drugs do have upsides and could be beneficial in the treatment of diabetes or reduction of metabolic side effects of being on antipsychotics for a long time, which people suffering from schizophrenia require.

When it comes to urging people to go on weight loss medication, however, the marketing is increasingly personal.

Online healthcare clinic Moshy’s programme, which offers Wegovy as a prescription medicine, estimates the amount of weight a person can lose based on their body’s metrics.

Testing of its server revealed it would prompt a person sitting within a healthy weight range towards weight loss that could be considered severe or would shift the person into being underweight.

Above a graph showing the drop in weight on Moshy, the site described this outcome as “great news”. But the caveat is, the weight loss is only maintained for as long as the person keeps taking GLP-1 drugs.

A large population-based study out of Denmark in September this year found roughly half of patients who started taking semaglutide for weight loss purposes stopped within a year.

Cost was a major factor referenced in the study for the reason people were quitting the medication.

It ends up being that the users of weight-loss drugs are vulnerable to their supplier to carry out a duty of care in monitoring their condition.

Sudden price hikes to Wegovy and Mounjaro overseas because of increased demand forced many people in the United Kingdom to have to suddenly quit their use of the drugs without any tapering off, often resulting in rapid weight gain.

A HNZ spokesperson told the Herald on Sunday studies on discontinuation showed an average person regained almost two-thirds of the weight over the following year, with some suggestion this could flatten out to about 5% weight loss overall.

Mysliwiec says: “Ultimately, you end up with the same yo-yo and seesaw problem that has caused issues in the past. In terms of dieting, restriction and then overeating again.”

He added, these drugs should be prescribed and managed under medical supervision in a targeted way.

Wegovy or Ozempic could even be used in the treatment of people with eating disorders to help them recover from binge eating disorder or food addiction, but this also required supervision by a specialist doctor and extensive behavioural treatment, Mysliwiec says.

There have not yet been follow-up studies carried out into the lasting effects of these drugs after they have been consumed for a decade or longer.

But with the growing popularity of weight-loss jabs it is likely to lead to their increasing absorption into daily life, despite the concerns.

Do you need help?

Get in touch with the Eating Disorders Association of New Zealand if you need help finding a private provider in your area by phoning 0800 2 EDANZ or emailing info@ed.org.nz.

If you need urgent help, reach out to your GP or local mental health provider. Or if you need to talk to someone else:

• LIFELINE: 0800 543 354 or 09 5222 999 within Auckland (available 24/7)

• YOUTHLINE: 0800 376 633 ,free text 234 or email talk@youthline.co.nz or online chat.

• NEED TO TALK? Free call or text 1737 (available 24/7)

• KIDSLINE: 0800 543 754 (available 24/7)

Eva de Jong is a reporter covering general news for the New Zealand Herald, Weekend Herald and Herald on Sunday. She was previously a multimedia journalist for the Whanganui Chronicle, covering health stories and general news.

Sign up to The Daily H, a free newsletter curated by our editors and delivered straight to your inbox every weekday.