Weight Loss Medications and Eating Disorders: What You Should Know
- Evgeniya Zhukovskaya
- 2 days ago
- 7 min read
Eating disorders have the highest mortality rate among psychiatric conditions - 5% of patients die within four years of diagnosis.
The NHS's recent approval of medications like semaglutide has created huge interest and demand. These medications need careful evaluation, especially when we have eating disorder rates that doubled from 3.5% to 7.8% over the last several years. These treatments help 60-70% of users to lose weight, but they could also trigger or make existing eating disorders worse.
Understanding Weight Loss Medications
How GLP-1 medications work
Your body responds to GLP-1 medications in several ways. They target specific areas of your brain to reduce appetite 2. The food in your stomach moves more slowly to your intestines, which helps you stay full for longer 26. Your body also produces more insulin while reducing glucagon, and this helps keep your blood sugar stable 27.
Common types available in the UK
The NHS provides several options of GLP-1 medication:
Wegovy (Semaglutide): A weekly injection that helped people lose 12% more body weight than those who didn't take it 26
Saxenda (Liraglutide): You take this injection daily to manage your weight long-term 28
Mounjaro (Tirzepatide): Adults 18 and over can take this weekly injection to manage their weight 25
Xenical (Orlistat): This tablet works differently by limiting how much fat your body absorbs 26
Expected effects on the body
Patients who took semaglutide lost an average of 15% of their body weight in 68 weeks. Moreover, these medications can improve health markers. People who take them often have lower blood pressure, better blood glucose levels, and improved cholesterol levels 2.
Keep in mind that you need to pair these medications with healthy eating and regular exercise 26.
Weight loss results vary based on your personal situation and the support you get from your healthcare team 26. Research shows that you might gain the weight back after stopping the medication, which proves that lifestyle changes should be made a priority 26.
The most common side effects include nausea, diarrhoea and constipation with 48.6% of people reporting these symptoms 5. However, most side effects are mild or moderate and usually go away without stopping the treatment.
Risk Factors for people with an Eating Disorder
Weight loss medications create a serious risk if you have an eating disorder. The amount of people who develop an eating disorder has more than doubled in recent years - from 3.5% to 7.8%.
How these drugs affect existing eating disorders
These medications change how your body handles hunger and fullness signals. This makes them dangerous if you've struggled with disordered eating 7. The drugs can trigger severe relapses that need more intensive care than previous episodes.
The medications often cause gastroparesis, which slows down the digestive system. This condition might continue even after you stop taking the medication 7. You might feel uncomfortably full, nauseated, and throw up involuntarily - symptoms that look just like certain eating disorders.
The risk of weight regain after stopping these medications creates another challenge. This can lead to emotional distress and might trigger disordered eating behaviours 8. .
Warning signs to watch for
Medical experts highlight several vital warning signs that show potential problems:
Physical Changes
Noticeable weight fluctuations 9
Gastrointestinal complaints
Dizziness upon standing
Sleep disturbances
Feeling constantly cold
Look out for negative thoughts about food and body image, excessive weight checking, and increased anxiety around eating 7. You might also withdraw from social situations, especially those involving food 10.
The medications can make existing eating disorder thoughts and behaviours worse due to their effects on appetite and weight loss 11. These medications often appeal to people because they work quickly, which increases the risk of misuse without doubt.
Research shows that people who take weight loss medications are more likely to receive an eating disorder diagnosis within a year.
Medical Screening Requirements
A full medical evaluation helps determine if these treatments match your health needs and safe for you.
Essential health checks
Healthcare providers must complete detailed screening tests before prescribing weight loss medications. These tests may include blood pressure, pulse rate, and muscle strength 14. Your doctor needs to monitor these signs regularly because changes might indicate health risks.
Primary screening requirements include:
Full blood count and chemistry tests
An assessment of the liver and kidney function
Blood pressure measurements
Muscle strength evaluations
Core temperature checks
Your BMI determines how often you need blood testing.
When to avoid these medications
These medications don't work for everyone. You should avoid weight loss medications if you have:
Severe kidney disease
Class IV heart failure
Severe liver disease
History of pancreatitis
Severe gastroparesis
Active eating disorders
The Collaborative of Eating Disorders Organisations stresses the need for mandatory screening for conditions like anorexia, bulimia, and binge eating disorder.
Finding the right healthcare team
Your treatment requires coordinated care from multiple specialists:
An obesity specialist
Psychologist/Psychotherapist specialising in disordered eating
A nutritional professional specialising in disordered eating and eating disorders
Your healthcare team should communicate on a regular basis to coordinate your treatment plan 16. Regular consultations with eating disorder specialists help assess ongoing risks and benefits throughout your treatment journey.
Managing Treatment Safely
Creating a monitoring plan
Self-monitoring is the life-blood of successful weight management. Research shows that consistent self-monitoring relates to weight loss success at both 18 weeks and 52 weeks. Your monitoring plan should track your weight regularly and keep detailed records of how your body and mind respond to the medication.
A complete monitoring schedule has:
Daily food and medication tracking
Weekly weight measurements
Monthly progress reviews with healthcare providers
Quarterly health assessments
Your healthcare providers need to review your progress at 3 and 6 months 18 to determine if the medication still works for you. Electronic diaries and smart scales can send data straight to your healthcare team. Studies show that electronic monitoring methods often result in better adherence rates.
Building support systems
A good support system includes:
Professional Support: Your healthcare team has to include specialists who specialise in both, weight management and eating disorders 7.
Personal Support: Your family and friends play a significant role in your recovery. Research shows that treatment that includes family members improves outcomes 4. They help you stick to regular eating patterns and offer emotional support during tough times.
Beat's helpline offers specialised support throughout your treatment 19. Honest communication with your support network helps to spot problems early. Regular check-ins with your healthcare provider let them adjust your care plan effectively.
Non-medication approaches
Cognitive behavioural therapy (CBT) is the most prominent approach for eating disorders 20. It helps people develop coping skills and change unhealthy thought patterns. Family-based treatment (FBT) is another powerful approach mostly used with children and young people. The treatment typically takes 18-20 sessions over a year 4. FBT recognises family members' vital role in recovery without blaming anyone involved.
Interpersonal psychotherapy (IPT) provides another evidence-based solution. Studies show that IPT helps improve symptoms in both individual and family settings 21.
Lifestyle modifications
Long-term recovery needs complete lifestyle changes beyond traditional diet and exercise. Studies show that successful recovery includes:
Physical Self-Care
Regular physical activity (150-180 minutes weekly of moderate exercise)
Adequate sleep patterns
Consistent meal planning 22
Mental Well-being
Stress management techniques
Regular relaxation practices
Positive self-talk 23
Self-monitoring plays a significant role in recovery. Research shows that frequent self-monitoring results in better outcomes 22.
Conclusion
Weight loss medications pose major challenges for people with a history of eating disorders. Medical evidence reveals these treatments can trigger or worsen disordered eating patterns. Professional guidance becomes vital before you start any weight management programme.
Professionals trained in eating disorders can help you to create a personalised treatment plan that fits your needs. Book a free 30-minute consultation call today to explore your options in a safe and supportive environment.
FAQs
Q1. Are weight loss medications safe for individuals with eating disorders?
Weight loss medications can be risky for those with eating disorders. They may trigger or worsen existing conditions, potentially leading to severe relapses. It's crucial to consult with eating disorder specialists before considering these medications.
Q2. What are the common types of weight loss medications available in the UK?
The NHS offers several approved GLP-1 medications, including Wegovy (Semaglutide), Saxenda (Liraglutide), Mounjaro (Tirzepatide), and Xenical (Orlistat). Each medication has different administration methods and effects on the body.
Q3. What screening is required before starting weight loss medication?
Before prescribing weight loss medications, healthcare providers should conduct comprehensive screening tests. These include full blood count, liver and kidney function assessments, blood pressure measurements, muscle strength evaluations, and potentially an ECG for individuals with a low BMI.
Q4. What are some non-medication alternatives for managing weight and eating disorders?
Evidence-based alternatives include Cognitive Behavioural Therapy (CBT), Family-Based Treatment (FBT), and Interpersonal Psychotherapy (IPT). These approaches, combined with lifestyle modifications and working with eating disorder specialists, can offer sustainable recovery pathways.
Q5. How can I safely monitor my progress if I'm using weight loss medication?
Safe monitoring involves creating a comprehensive plan that includes daily food and medication tracking, weekly weight measurements, and regular progress reviews with healthcare providers. It's also crucial to build a strong support system, including both professional healthcare providers and personal support networks.
References
[2] - https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/wegovy
[3] - https://bsw.icb.nhs.uk/wp-content/uploads/sites/6/2022/06/OHFT-ED-Primary-Care-Briefing-July-21.docx
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