The introduction of weight loss drugs such as semaglutide and tirzepatide, widely known by their brand names Ozempic and Mounjaro, has been hailed as one of the most significant medical breakthroughs in recent years. By the end of last year, approximately 1.5 million people in the UK were estimated to be using these injectable medications, contributing to a collective reduction of millions of kilograms of excess weight across the population. However, emerging concerns from mental health professionals highlight potentially serious psychological consequences associated with the widespread and often unsupervised use of these drugs.

Dr Jo Silver, a psychologist specialising in eating disorder treatment and the lead psychological therapist at Orri, an eating disorder clinic, has raised a red flag about the rising incidence of disordered eating linked to the inappropriate use of these medications. In an interview with The Independent, she explained that although these drugs were originally developed for individuals with morbid obesity, their availability has expanded in a way that now includes people without morbid obesity, diabetes, or unhealthy body fat levels.

“The risks and side effects [of these drugs] are well outweighed by the long-term health benefits” when used by people with severe obesity, Dr Silver noted. However, she emphasised that the current assessment procedures for prescribing these drugs remain relatively lax. “It seems everybody knows someone who is on the jabs. It has been normalised – and it’s everywhere,” she added. The drugs are often accessed without comprehensive psychological evaluations, enabling individuals with undiagnosed or undisclosed eating disorders or body image issues to begin treatment without adequate support.

The concern stems primarily from the way these medications function to suppress appetite, which interrupts natural bodily signals related to hunger and satiety. Dr Silver warned that this mechanism carries the risk of creating or exacerbating disordered eating behaviours. “Rapid weight loss is a risk factor for developing an eating disorder,” she said, stressing that the psychosocial rewards of weight loss can become addictive, particularly for individuals who initially start the medication due to severe obesity but then find themselves unable to stop.

Dr Silver is also critical of how weight loss drugs have been promoted as a “cure-all” for physical and psychological well-being. She pointed out that obesity is a complex condition involving both physical and psychological elements, and noted that current research offers limited evidence to support claims that these drugs address underlying psychological issues, such as binge-eating disorder. “There has been a lot of talk in the press about the way these drugs manage ‘food noise’—intrusive thoughts about food—but that doesn’t deal with the root of those thoughts,” she said.

The drugs’ ability to suppress physiological hunger may risk obscuring important emotional or psychological triggers that manifest as overeating. Dr Silver explains that there are two forms of binge eating: physiological, caused by hunger, and psychological, caused by anxiety or emotional distress. “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,” she added.

Further complicating the issue is the impact on societal attitudes towards body image. Dr Silver highlighted how the easy availability and visible results of these drugs have reinforced narrow ideals about body shape and desirability. This has reportedly contributed to increased comparison, jealousy, and judgment among friends and family members. “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?’; ‘She hasn’t lost weight, maybe she should try it?’” she remarked.

There is also social stigma surrounding the use of these medications, with some individuals regarding their use as a “lazy way out,” which can lead patients to hide their drug use from partners and friends. Dr Silver noted that this secrecy, along with side effects such as irritability, can strain personal relationships and contribute to isolation and emotional distress.

While regulation of these weight loss drugs has been tightened since their introduction in the UK, Dr Silver remains concerned about the cultural shifts they have prompted. “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,” she said.

Dr Silver cautioned that even those who are medically suitable for these treatments should approach them carefully, given the possibility of long-term dependency and the fact that weight is rarely solely a consequence of overeating. Her comments underscore the importance of comprehensive psychological support alongside medical treatment for obesity.

The Independent is reporting these insights from Dr Silver, who calls attention to the complexity of weight loss journeys and the unintended consequences of rapidly accessible pharmaceutical solutions.

Source: Noah Wire Services