Let’s Talk About Ozempic (or other weight loss drugs)
Ozempic. Ugh. It’s such a hot topic right now. Honestly, that’s not even the part I struggle with. I love a good controversial conversation.
What’s hard is that I have so much to say about it, and some of my thoughts even contradict each other. Maybe I’m confused. Maybe I just have too many tabs open in my brain about this topic. So let’s start at the beginning and try to organize the chaos.
What Is Ozempic?
Ozempic is a GLP-1 receptor agonist, a class of medications that’s actually been around for a while. It was originally developed to help people with type 2 diabetes, and it works by mimicking a hormone your gut naturally releases when you eat.
Here’s what GLP-1s like Ozempic do:
Stimulate your pancreas to release insulin when blood sugar is high
Suppress glucagon, which helps prevent unnecessary blood sugar spikes
Slow down gastric emptying and digestion
Help prevent blood sugar crashes after meals
All of these actions help stabilize blood sugar levels, which is essential for people with diabetes who struggle to do that on their own. For years, Ozempic and similar medications were considered effective and well-established in the diabetes world with little controversy.
So… How Did We Get to Weight Loss?
Eventually, researchers started looking at higher doses of GLP-1 drugs for weight loss, and surprise, they worked. But how they work for weight loss isn’t totally clear. What we do know is that slowing down digestion (also called delayed gastric emptying) makes you feel full longer, which leads to eating less.
There’s also growing research suggesting that GLP-1s affect the brain, particularly areas related to reward and cravings. Some studies show these medications can reduce brain activity in response to highly palatable foods like cookies, chips, and ice cream. This may help quiet cravings or emotional eating.
But here’s where I get a little skeptical.
Is It Really About the Brain?
Is the reduction in cravings really because of a shift in brain chemistry? Or is it just that people feel so physically full and uncomfortable that food becomes unappealing?
Think about it. If you’ve ever eaten a huge meal at a Mexican restaurant and the server asks if you want dessert, you probably grimace. Not because you don’t like dessert, but because your body is physically full and the thought of more food feels like too much. That’s what these drugs are doing. They keep food in your stomach longer. So of course cravings go down. But is that brain chemistry or just fullness?
It's Not a Metabolism Fix
There’s also a lot of misunderstanding about why these medications cause weight loss. I think many people assume it speeds up metabolism or changes the way your body burns calories. But that’s not what’s happening.
The reality is GLP-1s slow digestion so significantly, it mimics a condition called gastroparesis.
As someone who’s worked with hundreds of clients with gastroparesis, especially in the eating disorder world, I can tell you it’s not glamorous. It causes bloating, nausea, vomiting, early fullness, and a general feeling of discomfort. People eat less because they feel sick, not because they’re finally at peace with food.
Final Thoughts (For Now)
Yes, Ozempic and other GLP-1s can lead to weight loss. But the mechanism isn’t magic. It’s often rooted in discomfort. And while it may quiet the food noise temporarily, it doesn’t necessarily mean someone has healed their relationship with food. If anything, it might just be hitting the mute button.
When it comes to weight loss drugs, a topic everyone seems to have strong opinions about, I like to stick to the facts first. Facts help people make informed decisions instead of jumping straight to conclusions or hot takes.
There’s a lot more to unpack here. Ethics, access, long-term effects, and what this means for eating disorder treatment will come in another post.
