I’m a psychologist – here’s why people should think twice before taking Ozempic

New weight loss drugs work by switching off your appetite but, says leading psychological therapist Jo Silver, turning off your body’s signals without more support could be very dangerous – for you and those around you

Many users could become addicted to the psychosocial reward of weight loss (Getty)

The arrival of weight loss drugs has been one of the big medical breakthroughs of the decade so far. By the end of last year, approximately 500,000 Britons were already taking injected semaglutide or tirzepatide, popularly known as Ozempic and Mounjaro. Collectively, our population has lost millions of kilos in excess weight because of these so-called miracle drugs. But at what cost?

As a psychologist specialising in the treatment of eating disorders, I predict a dangerous side effect that nobody is discussing: we are facing a tsunami of disordered eating as a result of their inappropriate use.

Weight-loss jabs were designed to help morbidly obese people lose weight, and for these individuals, the risks and side effects are well outweighed by the long-term health benefits. But they are no longer being accessed only by this group.

People who are not morbidly obese, do not have diabetes and have a completely healthy body fat composition are also getting hold of them easily. Although there have been amendments to the assessment process, it is still rather loose. It seems everybody knows someone who is on the jabs. It has been normalised – and it’s everywhere.

We are being bombarded by success stories of women who have reached their dream weight when they were completely healthy to begin with. Online forums are packed with tips about how to “microdose” the drug to achieve the perfect physical form.

It’s so simple to access that psychologists like me can no longer be certain whether the clients we treat for eating disorders are using the drug – making the work we do much harder.

The lack of strict regulation is building up a problem for the future. The screening assessment to check whether a person might be a good candidate psychologically is still limited, and although dispensers ask if the patient has an eating disorder or a history of body dysmorphia, there are ways to access the drugs without full disclosure of one’s medical history.

What’s more, anyone can be vulnerable to an eating disorder – and the way these drugs work is the perfect cocktail for creating disordered eating in the future. It stops you feeling hungry, and that stops you from getting to know your body and its signals. Rapid weight loss is a risk factor for developing an eating disorder, and I worry about those people who do start off severely obese but then become addicted to the psychosocial reward of weight loss and find they can’t stop.

When the National Institute for Health and Care Excellence approved these drugs in the UK, it consulted a multidisciplinary medical team including psychologists. Obesity is not just a physical issue; it is a psychological one, too. Eating disorders are not really about food or weight at all. Yet now these jabs are sold as a cure-all – just lose some weight and your life will be better – even though at this stage there is only very limited research to support the idea that they help people with issues such as binge-eating disorder.

‘The way these drugs work is the perfect cocktail for creating disordered eating’ (Getty/iStock)

There are two forms of overeating: physiological binges, caused by hunger, and psychological binges triggered by anxiety and emotional upset. Switching off your appetite is a huge decision; turning off your body’s signals without more support could be a very dangerous place to be. We want people to be able to listen to their bodies, to understand them, and to have a relationship with them, not to cut that relationship off. Even for those who are microdosing, that is a serious risk – especially if they are planning to use the drug for a long time.

There has been a lot of talk in the press about the way these drugs manage “food noise”, which is what we used to call intrusive thoughts about food. Some people are constantly thinking about food, and Ozempic and Mounjaro help them to remove some of these thoughts. The problem is that it doesn’t deal with the root of the problem. Whether it’s related to anorexia or overeating, we want to know why someone is thinking about food all the time. What is that really about?

Are those who are medically good candidates for the jabs also getting the psychological help that should go along with them, to reset their relationship with food and with their body? I’m unconvinced. This “quick fix” is only making people even more vulnerable to future crises.

Weight loss jabs are sold as a ‘cure-all’ but they don’t address the issues of disordered eating (iStock)

Meanwhile, the widespread use of weight-loss jabs is reinforcing the corrosive idea that there is only one way to look that is desirable. We’re now a million miles from it being OK to have a curvy body. These social pressures are even causing issues within families and among friends. The use of drugs – whether openly or in secret – and the rapid weight loss that comes with it can bring about a lot of comparison and envy.

Rather than turning energy away from our physical presence, it is forcing people to focus on it more aggressively. There is now daily chatter about weight, and food noise between friends and within our communities. People are starting to look at one another’s bodies much more, and they are passing judgement and commenting on them: “She’s lost weight! Is she on Ozempic?” or “She hasn’t lost weight; maybe she should try it?”

The result is that people who are a normal weight and are not on the jab – because they really don’t need it – are feeling upset about not achieving the weight loss that others are, when this might all be unnecessary.

There is judgement of those who use it, too: people are now talking about a drug that was designed as a medical device as a “lazy way out”, with all the connotations that come with that. Some people feel so embarrassed about this that they take it secretly, hiding their prescription from partners, family members and friendship groups.

One of the potential side effects of Ozempic is irritability, which may be to do with blood sugar – and in personal relationships that can cause huge strain, particularly if one partner has no idea of the cause behind it.

This hidden use of body-altering drugs can produce shame and distance, and it can even fracture relationships. If you’re used to going out for dinner with a friend and they’re suddenly only eating half a portion, you could be left with the feeling that something is missing, and the confidence within that friendship may not be what it used to be.

Regulation of weight loss jabs has been tightened slightly since they were first released in the UK, which is a step in the right direction – but culturally, it feels like we’re going backwards.

So, before you jump on the bandwagon, please remember that this miracle drug is far more than it first seems. Even if you are overweight and you are medically a good candidate, remember that you’re unlikely to be the size you are just because you’re eating too much – and that once you’ve started the drug, there is a possibility that you’ll find it impossible to stop.

Dr Jo Silver is the lead psychological therapist at Orri, the eating disorder treatment clinic

As told to Hannah Fearn