May 5, 2025

Lack of Guardrails Over Weight Loss Drugs Fueling Resurgence in Eating Disorders

By Rebecca Appleman, RD

The existence of “weight loss drugs,” such as Ozempic, Zepbound, Mounjaro, Wegovy, Saxenda and others, has changed the way society sees obesity, diabetes, and other related conditions. People using these medications have largely reported a positive experience regarding the impact on their weight, as most have achieved a lower weight status than they could have achieved without the assistance of the medication.

However in the past several months, there have been sobering – but not at all surprising – articles about one of the risks of the widespread use and liberal prescribing of these types of drugs: they are fueling a resurgence in eating disorder relapse, particularly among those who have struggled with anorexia or other restrictive eating tendencies.

Guardian Article: Ozempic is hailed as a miracle drug. But how does it affect people with eating disorders?

What’s Happening?

As experts in the treatment of eating and weight disorders, our team at Appleman Nutrition does not actively or exclusively pursue weight loss with clients and instead favors the achievement of a stable, healthy weight through balanced eating and work toward a normal and peaceful relationship with food.  We believe that healthy bodies come in a range of shapes and sizes and we reject the idea that there is only one ideal body type.

What’s happening with drugs like Ozempic and the others mentioned above, is an example of one of the challenges of celebrating “weight loss” at any cost and for any reason – especially, seemingly quick and seemingly *easy* weight loss.  People with disordered eating histories who have worked so hard to overcome their disordered thinking and eating may often feel conflicted regarding others’ use of weight loss medication that they believe simply “induces the anorexia” from which they are told they need to heal.

Of course, no responsible clinician advocates for anorexia or promotes anorexic behaviors, but in the mind of someone who has struggled with restrictive eating tendencies in an effort to lose weight and manipulate body shape and size, the widespread recommendations for use of these weight loss medications sometimes feel that way, as they induce a significant reduction in appetite and often quick weight loss.  We hear from our clients working in recovery that their experience of body positivity and the acceptance of health at every size is also in conflict.  One client shared with us that “health at every size was only relevant when people struggled to be thin. Now anyone can be thin with these medications.” And further, we hear this expression,  “I don’t want to be the one person who is overweight just because I should heal from my eating disorder.”

Attracted to the idea of losing body weight with less effort, some people that had recovered from anorexia are finding themselves relapsing. They are also finding how easy it is to be prescribed weight loss medications without a detailed doctor’s exam, often through the use of TeleHealth.

You can read the article here.

Patients that once overcame anorexia (or any eating disorder) are able to fill out a form, lie about their history/BMI, and obtain a prescription for these drugs that others are touting as “miracles” despite their risks and despite the fact that these medications are not empirically based solutions for the treatment of Anorexia or any other eating disorder.

There is meaningful evidence to support that Ozempic and other GLP-1s – combined with smart nutrition counseling and possibly psychotherapy – can be an effective tool for certain qualifying individuals that have worked closely with their doctor and are in need of medically assisted weight loss as well as shifts in abnormal lab work.

And for those people, these mediations may be life changing and prolonging.  We support the responsible use of these medications.  At the same time, we believe it is also important that we put better guardrails on prescribing these medications which can be dangerous when made easily accessible for those with eating disorders and those at risk for them.