Aging in the Age of Ozempic
If you're new here, welcome! My blog is dedicated to the intersection of cultivating an age-affirming way of living and body liberation. The body liberation community needs more inclusion of older bodies, and the pro-aging community needs body diversity and tends to uphold the thin ideal and diet/wellness culture. I'm here to discuss the issues affecting midlife and older women through a body liberation lens. If you've been here for a while, I love that you are a part of this one-of-a-kind community we are creating together!
My Thoughts On Ozempic: in brief
I've been trying NOT to add to the cacophony of opinions about Ozempic, but here we are. Just in case you missed it, Oprah decided we all needed to know about her weight loss journey with a GLP-1 medication during an hour-long infomercial during prime time (during "The Batchelor"'s slot, just in case you were wondering if women are being targeted🤔). I was going to process this mess with my clients who are experiencing a risk of relapse and rant to my friends IRL.
Then, one of my brilliant clients alerted me that Oprah is also making a big deal of turning 70. That got my attention, so here we are.
First, I have clients who are taking GLP-1s for various reasons, primarily to manage Type II Diabetes. In no way am I judging individuals who decide to use these drugs. I believe in body autonomy and want everyone to make choices that affect their bodies free of judgment and criticism, including Oprah.
Weight stigma and fatphobia are real. If you've been here for a while, I've written many times about our culture's body hierarchy. The struggle is real for Oprah, too, so I hold her with compassion (or try to).
Respect. I simply wish she would keep this to herself and spare us the exposure to this mess.
As an RD in the field of preventing and treating eating disorders for almost 40 years now, I've seen numerous weight loss drugs, surgeries, and diet trends come and go. I've been sitting across from hundreds of bodies left in the aftermath of this phenomenon my entire career.
I witness a great deal of shame, pain, grief, self-doubt, self-blame, anxiety, and depression-the emotional and psychological consequences of diet culture. Those of us who are in the eating disorder field have grown accustomed to untying the knots in our clients that are created by diet/wellness culture.
We are already starting to clean up the mess of the aftermath of GLP-1s in our clients' lives. See Mindfuckery below.
For me, the best option is a weight-inclusive approach that addresses your well-being without focusing on weight. Liberation from anti-aging and diet/wellness culture is my goal, and I will continue to support you in finding liberation.
I do not see data that gives me a reason to believe the aftermath of these GLP-1s will be any different from the "silver bullet" drugs before them.
We do not have enough long-term data to assess safety.
We do not have enough long-term data to report efficacy over time.
The side effects are being glossed over. Many stop taking GLP-1s because of the significant effect on their quality of life. Common side effects of GLP-1s include nausea, vomiting, constipation, and diarrhea. More serious side effects can include inflammation of the pancreas, gallbladder issues, kidney failure, worsening of vision, and the development of some thyroid tumors. Mental health changes such as suicidal ideation and depression are also reported.
The amount of weight lost is reported to be 5-20% of body weight.
These drugs are not accessible to most people. As a matter of fact, there is a storm brewing over accessibility between insurance companies, pharmaceutical companies, and medical providers. People cannot afford these drugs, and there is growing scarcity due to off-label uses (remember, the intended use is to manage blood sugar levels for those with Type II Diabetes).
Aging and Ozempic
I've been researching nutrition and "aging" for a while now. What I understand to be true about nutrition for our well-being as we age does not jive with what happens when taking GLP-1s.
Basically, the majority of people who are taking these drugs experience a marked decrease in appetite. My concern is that eating significantly less makes it incredibly challenging, if not impossible, to meet your nutritional needs.
Eating well to support your well-being as you age is already a challenge. Aging is already altering gut function and decreasing the absorption of many nutrients, such as B12.
Did the researchers, pharmaceutical companies, or health care community bother to consider the complications GLP-1s bring to the nutritional challenges of aging? Or is it thinness at any cost?
Body Composition
Those who care about aging and well-being consistently emphasize the importance of maintaining muscle mass as you age. Physical activity and meeting your protein needs will support your muscle mass. There are numerous reasons why muscle mass plays a significant role in your well-being as you age, including supporting balance to prevent falls, encouraging capacity to care for yourself, and even maintaining cognitive function.
When you lose weight, you lose muscle, bone mass, and body fat. Muscle and bone loss happens regardless of what type of diet you're following or whether you lose weight gradually or quickly. PMID: 30925026.
Weight Loss and Mortality
We so rarely acknowledge that weight loss is not always "healthy." As a matter of fact, weight loss is a medical "red flag" when we are older. JAMA published these findings in April 2023 :
In this cohort study of 16,523 community-dwelling healthy participants, among men, loss of 5% to 10% of body weight and loss of more than 10% of body weight was associated with a 33% and 289% increase in mortality, respectively; among women, loss of 5% to 10% of body weight and loss of more than 10% of body weight was associated with a 26% and 114% increase in mortality, respectively.
How old must we be for weight loss to stop being our holy grail?
The Mind-Fuckery Of It All
Oprah's Special addressed weight stigma and body shame and included statements like "It's not your fault." The bottom line is the language and messages of the body liberation movement are now being used to market GLP-1s. The message is that you no longer need to experience body shame IF YOU USE THESE PRODUCTS TO LOSE WEIGHT. WTAF?!
And the verbiage about these drugs bringing an end to diet culture? It's more like these drugs are throwing kerosene on the fire of diet culture.
Yes, it is not your fault, and it was never your fault that diets did not "work". But don't get it twisted; diet culture has been making you feel like it was your fault when you were not able to stay on their programs and remain hungry and deprived.
Reminder: Your body experiences hunger as a threat to your survival, and your brain experiences deprivation as punishment. Your body is beautifully designed to protect you by sending you obsessive thoughts about food, intense discomfort, and a drive to eat when your body requires refueling.
So when the very industry that is selling a new weight loss product finally tells you it is not your fault, it is like your abuser making sweet so you will stick around for more. Pure manipulation.
Oh, and just to be clear: Being in a larger body is not a disease. If you want to learn more about how bodies were pathologized, therefore opening the door to profitability, check out this episodeof The Maintenance Phase Podcast.
One of my biggest concerns is the risk that these new drugs will contribute to the onset of eating disorders and relapse. And I'm not alone. The Collaborative of Eating Disorders Organizations (CREDO) responded to the Oprah special in a statement on March 21st.
As the popularity of GLP-1s soars, the lack of consideration for the negative impact on disordered eating, and contribution to medical weight stigma and fatphobia will put lives in danger. We strongly urge healthcare providers and the community at-large to include eating disorders in this crucial conversation.
Please check out the full statement here. Eating disorders in Midlife + are a well-kept secret.
I hope this helps you navigate this potentially seductive and manipulative terrain. As always, your body is not your life's project; it is your life partner. You are never too old, and it is never too late to mend your relationship with your body.
Thank you for being here!
Love and Respect,
Deb