An oral version of Ozempic is on the horizon—is it a risk for patients with eating disorders?
Key Takeaways
Industry Buzz
“I fear semaglutide is going to aggravate a lot of peoples' eating disorders, and unscrupulous doctors (or easily bullied doctors) are going to exacerbate this.” — Doctor on Reddit @BallerGuitarer
Eli Lilly has announced promising phase 3 trial results for a new oral medication that could rival Ozempic in the fight against weight gain. []
The drug, called Orforglipron, is an oral form of a GLP-1 receptor agonist, the same class of medication used in Ozempic. While Ozempic has made waves for its weight loss potential, Orforglipron may be the next big thing—offering similar benefits in an easier-to-swallow pill.
Related: People are taking a diabetes drug for weight loss—no, it's not OzempicMore about Orforglipron
This isn’t the first oral GLP-1 treatment. Ozempic already has an oral sibling: Rybelsus, which contains semaglutide, the active ingredient in Ozempic. However, Rybelsus has largely been prescribed for managing A1C levels in diabetics, rather than for weight loss.
While Rybelsus does its job in controlling blood sugar, it doesn't have the same impact on shedding pounds as its injectable counterpart. The oral version simply didn’t cut it for weight loss.
So, what makes Orforglipron different? Clinical results suggest it could help patients lose an average of 16 pounds, which is a pretty significant win in the weight loss arena.
Misuse of weight-loss drugs in those with EDs
But some physicians are sounding the alarm on the rising misuse of effective weight-loss drugs by patients with eating disorders. And for those looking for a less intimidating option than injections, an an oral pill may make the drug more approachable.
Research indicates that nearly half of patients using semaglutide drugs are doing so specifically for weight-loss. This can be dangerous for certain individuals, including those who don't need to lose weight, those who have an eating disorder such as anorexia nervosa, or those who are at risk for developing one. []
People with anorexia, driven by an intense fear of gaining weight, may misuse weight loss medications in ways that severely jeopardize their health. []
What you can do as a doctor
It’s important to note that some patients with eating disorders, such as anorexia and bulimia, might not fit the clinical definition of "underweight" or "obese" based on BMI.
Individuals with eating disorders, at any weight, may struggle with distorted perception of their body—they may feel like they need to lose weight despite being clinically healthy.
They may not appear to need a weight-loss prescription based on their outward appearance or routine testing, but they could be struggling with an unhealthy relationship with food and body image.
Ozempic and other weight-loss drugs are not confined to doctor's offices; many patients are obtaining prescriptions from medical spas and online pharmacies or other means. [] Some websites offer them without also requiring a prescription, allowing individuals with anorexia to bypass standard medical screenings and obtain the drugs.
If you suspect a patient has been disreputably prescribed a weight-loss drug, try to approach the situation with sensitivity and care. Consider asking these patients about sources for prescriptions during a routine medical exam, without making the patient feel judged.
It’s important to make them aware of the risks of obtaining meds outside of regulated healthcare settings, due to the potential for counterfeit drugs, incorrect dosages, and lack of proper medical oversight. Patient education on these issues can help build trust and ensure their safety.
Related: Can Ozempic worsen or trigger eating disorders?