GLP-1 Informed Consent

​As part of our commitment to full, informed consent, we want to provide a compassionate, balanced perspective on GLP-1 agonist medications, such as Ozempic, Wegovy, and Mounjaro. These medications were originally developed to manage type 2 diabetes but have more recently been prescribed for weight loss. While they may offer benefits for some individuals, it’s important to consider all aspects—including potential risks—so you can make an informed decision that aligns with your overall well-being.

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Understanding the Side Effects

Many people experience side effects with GLP-1 medications. In clinical trials, up to 74% of participants reported gastrointestinal issues such as nausea, vomiting, diarrhea, and abdominal pain. More serious risks include gastroparesis (delayed stomach emptying), pancreatitis, kidney disease, and a black box warning for thyroid cancer. The FDA has also noted concerns regarding an increase in suicidal ideation and intestinal blockages associated with these medications.

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Eating Disorder Considerations

If you have a history of an eating disorder (ED) or disordered eating, it is especially important to consider how appetite-suppressing medications may impact your recovery and relationship with food.

• Increased risk of restriction and malnutrition – When hunger cues are diminished, it can be easier to under-eat, even unintentionally.

• The ED voice may get louder – Appetite suppression can reinforce restrictive thoughts and behaviors, making recovery more challenging.

• Losing recovery progress – While a suppressed appetite might feel like "control," it can lead to a return of disordered patterns.

• Lack of research on ED risk – There is limited data on how these medications affect ED development or relapse risk, resulting in significant unknowns.

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The Unknowns of Long-Term Use

Current studies on GLP-1 medications for weight loss only follow patients for about two years, meaning the long-term safety and efficacy are not yet fully understood. History has shown that several FDA-approved weight-loss medications, such as Fen-Phen and Belviq, were later removed from the market due to serious health concerns. Your long-term health matters, and we encourage thoughtful consideration when making decisions about medications with limited long-term data.

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Weight Loss and Health: A Compassionate Perspective

 

Many people are told that losing weight will automatically improve health, but research suggests that weight cycling (losing and regaining weight) can have negative health effects. We also know that weight loss itself does not guarantee improved well-being. These medications often show initial weight loss followed by regain, which can create a frustrating cycle of hope and disappointment.

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This cycle may look like:

1. Experiencing initial weight loss and minimizing side effects.

2. Regaining weight but feeling shame, guilt, or pressure to continue the medication.

3. Underreporting of long-term risks, including ED relapse, due to stigma and lack of discussion.

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Additionally, weight stigma in health care can contribute to poor health outcomes, independent of body size. You deserve compassionate, weight-inclusive care that honors your whole health—not just a number on the scale.

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Questions to Consider Before Starting GLP-1 Medications

Before making a decision, it may be helpful to reflect on these questions:

• Are there underlying health concerns that could be addressed more directly?

• Do the potential side effects outweigh the benefits for me?

• Could this medication trigger disordered eating thoughts or behaviors?

• If I set weight aside, what would meaningful health improvements look like for me?

• Do I need support in caring for my body as it is right now?

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If you choose to take these medications, self-awareness and ongoing check-ins are key—especially if you have a history of eating concerns.

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Signs That This Medication May Not Be Supporting Your Well-Being:

• Increase in eating disorder thoughts – Are you thinking more about food rules, restriction, or body size?

• Desire to severely restrict food – Are you avoiding meals or feeling guilty for eating?

• Minimizing side effects to prioritize weight loss – Are you ignoring nausea, fatigue, or emotional distress because weight loss feels "worth it"?

• Worsening mental health – Have you noticed an increase in anxiety, depression, or self-harm thoughts since starting the medication?

• Frequent vomiting after eating – Is nausea or appetite suppression leading to regular vomiting?

 

If you find yourself struggling with any of these, please know that you are not alone. Your well-being is more than a number on the scale, and your health encompasses so much more than weight.

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Alternative Approaches to Health

At Beyond, we believe in a compassionate, weight-inclusive approach to well-being. If your goal is to support your health, there are evidence-based strategies that do not focus on weight loss, including:

• Joyful Movement: Engaging in physical activity that feels good and supports your energy and strength.

• Nourishment: Prioritizing balanced, satisfying meals that honor your body’s needs and hunger cues.

• Mental Health Support: Addressing weight stigma and cultivating self-care through therapy, community support, or mindfulness practices.

• Sleep Hygiene: Establishing consistent, restful sleep routines that support overall health.

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How Can an Eating Disorder Dietitian and Eating Disorder Therapist at Beyond

Support You While Taking a GLP-1?

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If you are considering or currently taking GLP-1 medications, our eating disorder dietitians and eating disorder therapists are here to walk alongside you with compassion and care. We offer:

• Nutritional support to ensure your body receives the nourishment it needs to thrive.

• Guidance for navigating ED thoughts that may arise, helping you make choices rooted in self-care rather than fear.

• Holistic health support to monitor and address any side effects or concerns, keeping your whole-body well-being a priority.

 

 

You are not alone. Your health, recovery, and relationship with food matter—always. We are here to support you in making the choices that align with your values, needs, and overall well-being.

 

 

References

Medical Students for Size Inclusivity. (2023, Nov.). GLP-1 Agonist Medications: Informed Consent Resource. https://sizeinclusivemedicine.org/glp1/

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Unresearched GLP-1 Agonist Practices
https://weightandhealthcare.substack.com/p/unresearched-glp-1-agonist-practices

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FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss
https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss