On January 15th, 2025, Monte Nido Vice President of Medical Services, Joel Jahraus MD, CEDS, FED, FIAEDP hosted “The GLP-1 Dilemma: Exploring the Intersection of Weight Loss Success and Eating Disorder Risks,” an informative webinar discussing a topic that is at the forefront of many conversations in the healthcare field.
The Status of GLP-1s and Their Unique Characteristics
- People with and without diabetes are rushing to obtain this class of medications for weight loss, creating shortages
- GLP-1s can cause additive effects to the medical state of those with eating disorders, including appetite suppression, weight loss, nausea and vomiting, etc.
- Currently over 120 weight loss medications in development
- GLP-1 participates in the regulation of blood sugar (glucose)
- GLP-1 also ensures the bata cell insulin stores are replenished to prevent exhaustion during secretion
- Effective in short term weight loss – the STEP 2 study of semaglutide with life-style changes showed 33.7 lbs of weight loss with the medication vs. 5.7 lbs without it at 68 weeks. Eventually, the weight plateaued and actually increased thereafter, which mitigated the overall weight loss
Weight Stigma, Weight Loss Medications, and Eating Disorders
- GLP-1s intensify discussions about weight loss that cause many living in larger bodies to express a sense of hopelessness in “fat-focused” conversations
- It is time to consider how to handle significant numbers of clients coming into eating disorder treatment programs on GLP-1s
- Clinicians need to consider what clients have been through with societal impact and weight stigma when making the ultimate decision regarding these medications. Consider their eating disorder diagnosis and risks of continuing these medications. Ultimately, the risks may be too substantial.
- There are no current FDA approved medications to treat BED specifically
- As long as the client meets reasonable criteria for a GLP-1 prescription, it is the client’s choice as to whether they want to continue to use this medication while in BED treatment. Clients should also be aware of the potential risks of engaging in treatment with these medications.
- Weight loss medications are dangerous for children as they are in a vulnerable period for the development of low self-esteem and eating disorders
Balancing GLP-1s for Medical Use and Social Impacts
In his presentation, Dr. Joel Jahraus explored the role of weight loss medications in society and in eating disorder treatment as the integration of these medications is now a reality within the eating disorder field. Understanding the medical impacts of GLP-1s and navigating their usage in a weight stigma-based society is integral to considering this timely dilemma.
Citations:
Cooper DM, Rothstein MA,Amin A, Hirsch JD, and Cooper E. Unintended consequences of glucagon-like peptide-1
receptor agonists medications in children and adolescents: A call to action. Journal of Clinical and Translational Science 7: e184, 1–4. doi: 10.1017/cts.2023.612
White GE, Shu I, Rometo D, Arnold J, Korytkowski M, Luo J. Real-world weight-loss effectiveness of glucagon-like peptide-1 agonists among patients with type 2 diabetes: A retrospective cohort study. Obesity (Silver Spring). 2023 Feb;31(2):537-544.
Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I; STEP 2 Study Group. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021 Mar 13;397(10278):971-984. doi: 10.1016/S0140-6736(21)00213-0. Epub 2021 Mar 2. PMID: 33667417.
