While scrolling Twitter late one recent night, Nylah Burton, a 27-year-old writer in Chicago, clicked on an article about Ozempic, the diabetes drug that’s increasingly prescribed off-label for people who want to lose weight. Only when she hit the website’s paywall did she pause to realize she actually had no desire to read the article.
Burton struggled with disordered eating for more than a decade, starting at age 11, and says media portrayals of thinness and extreme diets contributed to her eating issues. Her eating habits have been stable for the last year, and Burton felt no need to challenge that progress by reading about a diabetes drug taken, often unnecessarily, for weight loss.
“I was just thinking to myself, ‘You’re actually at a good place and there’s no need to revisit that,’” she says. “I don’t need to read more gory details.”
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These days, it’s hard to avoid reading about Ozempic, one brand-name for the drug semaglutide. It has been covered by numerous national news outlets (including this one) and regularly trends on social media—not because of its efficacy for Type 2 diabetes management, but because it’s become cool, in certain circles, to take the medication to lose weight. Other, similar drugs like Wegovy (another semaglutide drug, this one approved for weight management among adults with weight-related health conditions) and Mounjaro (approved as a Type 2 diabetes treatment) are also surging in popularity. And as these drugs become trendy, plastered across the internet and social media, they are adding another “flame in the dumpster fire” of diet culture and normalizing unhealthy weight loss, says Jessica Setnick, a registered dietitian and expert in eating disorders.
Research has suggested for decades that media exposure is linked to increased risks of disordered eating, so the onslaught of articles, ads, and social media posts that seem to glorify the use of drugs for weight-loss is concerning, says Jessica Saunders, an assistant professor of psychology at Ramapo College of New Jersey who studies eating disorders.
“It is probably both triggering for people in eating-disorder recovery and encouraging folks who are vulnerable to developing an eating disorder,” Saunders says. “It might be planting a lot of seeds in a way that is pretty dangerous.”
Ozempic is designed to control blood sugar among people with Type 2 diabetes. In doing so, it also suppresses appetite and slows the rate at which the stomach empties, meaning users do not need to eat as frequently. While Ozempic is not currently approved by the U.S. Food and Drug Administration for weight loss, plenty of people have found practitioners willing to prescribe it off-label for that purpose.
In a statement provided to TIME, a representative for Novo Nordisk, the company that makes both Ozempic and Wegovy, said that it “does not promote, suggest, or encourage off-label use of our medicines….We recognize that eating disorders are serious conditions and deserve specialized clinical attention from healthcare providers who treat them. We trust that healthcare providers are evaluating a patient’s individual needs and determining which medicine is right for that particular patient.”
Never mind that many of the people taking Ozempic don’t have clinical reasons to lose weight, or that it requires weekly injections and comes with the risk of side effects including nausea, constipation, diarrhea, stomach pain, vomiting, vision changes, fainting, and, possibly, thyroid cancer. It’s flying off the shelves so fast that people with Type 2 diabetes are reportedly struggling to get their doses. In December 2022 alone, 1.2 million Ozempic prescriptions were reportedly filled in the U.S.
“We are talking about explosive diarrhea, and people are saying, ‘Sign me up,’” Setnick says, referring to one potential side effect. “Somehow, we are not communicating well.”
That’s in part because many articles don’t focus on the risks of using prescription drugs for unintended purposes, Saunders says. While there are patients for whom drugs including Ozempic, Wegovy, and Mounjaro are medically appropriate and helpful, much of the buzz around them focuses on people who are using them cosmetically—a population that has not been well-studied.
“Not feeding yourself appropriately is also damaging your body, and that lens is totally missing from these articles,” Saunders adds.
Over time, extremely restrictive eating can come with complications including hormone disruption, bone loss, low heart rate, organ damage, neurological issues, and more. Extreme dieting can also result in psychological consequences, adds Dr. Wendy Spettigue, an associate professor of psychiatry at the University of Ottawa who treats young people with severe eating disorders.
“It can cause irritability, low mood, obsessiveness, rigidity, social withdrawal, difficulty sleeping, difficulty concentrating—all these side effects that people aren’t really aware of because these articles tend to normalize the idea of weight loss,” Spettigue says.
Marlene Katz, a casting director in Los Angeles who has struggled with disordered eating in the past, says articles should mention those risks, as well as how medications may fuel disordered eating if used inappropriately. Articles will “talk about how easy it is to eat one meal a day,” she says. “That’s starvation. That’s an eating disorder.”
While Katz says she doesn’t fear relapsing, she’s concerned about how the seemingly 24/7 coverage may affect those who aren’t as far along in recovery. She says news outlets should consider adding trigger warnings to their stories if they choose to focus on the off-label use of diabetes drugs.
Some people have decided it’s easier to avoid the coverage outright. Sophia Benoit, a 30-year-old writer in Los Angeles who had eating issues in the past, muted the word “Ozempic” on Twitter so she’d stop seeing posts about it.
“It’s hard, as someone who’s had eating disorders in the past, to read these articles about thin women using it to get thinner…and not feel like I need to be thinking about getting thinner again,” Benoit says. “Even though I genuinely have no desire to use this or any other weight-loss drug, I do have, in the back of my mind, the flame of an eating disorder that will always be on that says, ‘That would be great.’”
Alexandra Salerno, acting outpatient program supervisor at the Center for Eating Disorders at the University of Pittsburgh Medical Center, says people who feel triggered by the coverage should consider muting, blocking, or unfollowing social media accounts that share lots of troubling content, while following accounts that are positive. (The same goes for changing the channel when ads come up on TV or the radio.) Asking loved ones to refrain from talking about weight loss can also be helpful, she says, as can developing coping strategies—maybe taking a walk or calling a trusted friend—to use when triggers arise.
Getting unhealthy thoughts out of your head and into the open can also make a difference, Setnick says. That could mean discussing them with a friend, journaling, or seeking help from a professional, until the trigger starts to lose its power.
“You want to notice what affects you, not so that you can scour those things out of your life. Scour out the things you can, put out the flames you can, but you can’t put out everything,” Setnick says. “What we’re trying to do is say, ‘Not every piece of information that comes my way is worth my time.’”
If you need support for eating issues, call or text the National Eating Disorders Association helpline at 800-931-2237.