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Beyond Weight-loss Drugs

  • Eating

Warning: This blog is not trying to entice you to take a weight-loss drug. Nor is it meant to dissuade you from taking one. My purpose is to share what ED recovery and 35 years of experience as an ED therapist tell me about these hot new drugs. 

For a while I’ve been working with two dysregulated eaters who are, respectively, on Ozempic or Mounjaro. Both have lost significant weight, suffer few side effects, and for the first time in recent memory are enjoying ongoing feelings of regulated hunger and fullness. To say their inner lives have changed dramatically is no exaggeration.

Unless they don’t intend to rely on either drug for life because they don’t care to take medication they absolutely don’t need, or because the cost is prohibitive (or both), consider what might happen when they stop taking it. From what I’ve read, hunger and fullness and dysregulated eating return to pre-drug levels, followed by weight gain.

So, first, if you plan on taking either drug for life (or, to mix metaphors, whatever drugs are coming down the pike in their wake), you’d better have deep pockets. In spite of some initial discounts, prices vary depending on the drug, provider, and whether or not you have topnotch health insurance. If my readings on the internet are correct, you may pay any of the following monthly amounts: $1200-1500, $915.17, $25, or $1087. 

Second, you’ll need an airtight plan for eating more “normally” when you’re off the drug. The good news—the very good news—is that after taking the drug, you know you can eat only when hungry and stop when full because you’ve been doing just that for however long you’ve been on the drug. It’s like opiate-addicted folks staying clean on, then coming off Methadone or Suboxone. They’ve been clean and now know what it feels like as well as understanding what they must do to not pick up their habit again.

What Ozempic and Mounjaro teach you is that you don’t have to eat every time you have the urge, especially if it’s not actual hunger you’re feeling. You can pause and ask yourself what you do want to do, which includes saying no to food as you’ve been doing on the drug. You can take the same pause in approaching fullness by asking yourself as you’re eating if you’re starting to feel less hungry or more satiated. You know you can stop because you did it on the drug. 

I’d love to see these drugs come with a training on the skills of “normal” eating. Then if you chose to take them, you could taper off and still have a shot at eating “normally.” But, sadly, to make profits, the drug-makers prefer to keep you hooked for life.