As an anti-diet dietitian, I believe in bodily autonomy and compassionate care.
That means, you, and only you have autonomy over your choices with your body. And I support your choices. I don‘t necessarily have to agree with your choices, but I support you making the choice that feels right for you. I believe, only you know what that is.
The last thing I ever want, is for my clients to fear talking to me about diet/weight loss thoughts due to fear of judgment. “This isn’t the right way to be an intuitive eater? I’m failing. She’ll make me feel bad.” <the inner dialogue most of my clients have when the diet-y thoughts come up. And I always respond when I hear these thoughts in session with: 1. You’re brave to share with me. 2. Those thoughts are so normal - look around you!? 3. I don’t judge you - can we talk about it some more? I’m curious and want to learn more.
So, this past year when conversations about Semaglutide (Wegovy/Ozempic) started to come into session, I was very careful of how I responded.
Here‘s what I tell my clients when they ask me about this medication:
Semaglutides (a class of medications) have been around for a very long time for diabetes. This medication isn’t new, but the dosage which is being used for Ozempic/Wegovy is much higher than for diabetes alone, and that medication is new to the market, has limited research.
Full consent matters - understanding what this medication means for you now, and for the long run is incredibly important. You should always be given the time to explore all of this and ask as many questions as needed. Being a conscious consumer matters for your overall wellbeing.
Limited research - We have limited research on the longevity of this medication and what happens to your body after being on it for more than 2 years1. And, for the weight loss to be maintained, the medication needs to be continued long-term or chronically. So, only you know how you feel about that.
Here’s what I also know:
I only have lived experience living in a body with unearned thin privilege. I do not have lived experience living in a larger body. And I believe you when you tell me the stories of oppression and stigmatization you’ve felt living in a larger body, and how much pain you’ve encountered and how badly it sucks. I will always try my best to learn from you and with you. That’s my job.
So, I can empathize that if there was a “magic“ medication being offered at the doctor‘s office - by my doctor (who must have my “best“ interest in mind for my health) for weight loss, I can absolutely understand the allure of this.
And yet, I also do believe there is more to understand as a patient about the side effects, limited body of research, and outcomes taking this medication (ie. wt regain when stopping).
Lastly, an important question I offer up to any of my clients considering this medication:
If you were to take this medication and not achieve the results you were promised, would you still be okay with taking it and the financial/physical/time ramifications it takes?
And only you know the answer to this.
What other questions do you have lingering about this medication? I’d love to hear in the comments.
Garvey, W.T., Batterham, R.L., Bhatta, M. et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med 28, 2083–2091 (2022). https://doi.org/10.1038/s41591-022-02026-4