Barb, thank you for taking the time and bringing this topic to the forum for people to discuss. I'm sure there are people who are experiencing this and don't have the words for it. Some people may feel isolated because others have not spoken about this potential portion of an OMM journey.
I hope that everyone finds what works for them, their care team, and their future. I champion everyone finding health as they regain their lives, livelihoods, and zest for living.
Dariam, I think this topic is another thing those on GLP-1s and other OMMs might face that they don't even consider in the beginning. Unless they are hyper-aware of having had an ED previously in their lives. And yes! I do hope everyone finds their balance, sooner than later. Thanks so much for commenting.
You described my secret…. I panicked when the scale said 106 and knew my Dr appointment was in 3 days. Plotted what to wear with pockets so I could put my heavy cell phone chargers in each pocket and my plan to try to eat breakfast that morning…. I was so worried he would deny me my life changing miracle… fyi 72 yrs young, 4’10” , original BMI 44 and now 22. Started MJ Dec 2022 (before Zep not T2D)
Kat, how wonderful to read this. I know others will feel less alone because of you. How are you doing now? You can email me at my Username AT Gmail if you want to remain private. I can't thank you enough for sharing your secret. It means a lot.
This is such an important issue! Thank you for writing about it so beautifully. I am a few months into maintenance and thinking a lot about what the rest of this journey will be like as I continue to go down in dose. And I have to say, I am determined to keep my current weight -- and that feeling is VERY similar to the feeling I had when I was a 6 day a week ballet student in my teens. You can imagine what kinds of habits went along with that feeling back then!
Oh, how I understand, Kathleen. I cannot imagine what it would have been like to be a ballerina... but if it feels anything like now, I guess I am learning. Thank you for your kind words about the piece and commenting. I appreciate it very much. Really.
By removing the body’s ability to crave 8000+ calories / day, does that help confirm it was indeed a chemical problem in the body, or an emotionally-generated eating disorder? Do you have insight into this? Is it best to put a 25-year-old on this drug when the relationship with food and eating is disordered? You say “eating disorder” was not acknowledged when it didn’t fit the “calorie restriction” presentation. Beyond dieting (restriction) and movement, what would the non-pharmaceutical / non-surgical intervention look like? Anorexics are sometimes force-fed to save their lives, but long-term treatment entails extensive therapy. Does over-intake of calories have an equivalent / effective therapy intervention, or has it not been developed?
What amazingly profound questions you've asked. They are all intertwine, but I suspect you already know that.
I do not believe one thing was the reason I ate so much before. I believe I was a string-art mess of complications that ended at my being 405 lbs. Was it my tonsils being taken out at 6 years old? That seems to have been the catalyst, though research is mixed about that "causing" severe obesity. Perhaps it was being put on speed at 7 years old that threw my body out of whack. Was it my mom "teaching" me to forage by hiding candy around the house? Was it the ebb and flow of food in the house? (I call that the "Carrot and the Éclair" times... mom alternating being on a diet or gorging on éclairs and donuts.) Was it because I was sexually assaulted at 18 years old? Did I want to hide _more,_ therefore gained even more weight? Was it being put on the pill? Was it the probable early PCOS I had starting at 20 years old? Was it when I got pregnant 3 times in a row and then abruptly stopped having periods afterwards? (There was no such thing as the term PCOS back then. It would be a couple of decades before I heard about it as a syndrome.) Was it the constant diet/binge cycle I was in for decades? What did the Fen-Phen do to me when I was 35 and my diabetes was finally discovered? Did that nudge my genetics into the Type 2 Diabetes for life aspect? What about the RNY Gastric Bypass that has left me with 4 serious deficiencies I have to medically treat 20+ years later? Did the psych meds I take for Bipolar Disorder 1 kick off another storm of weight gain? (I gained 80 lbs in 4 months on Risperdal.) No therapy ever helped... and I tried every modality and type of mental therapy that came along. No supplements helped. No specific foods or diets helped.
Nothing helped until GLP-1s. As I have described with my psych meds, it is like the two electrical cords have finally been connected to each other, allowing the energy to flow in the right direction. Whether it is a GLP-1 deficiency, a glitch in my brain, or, as I suspect, the entire concoction of my life and genetics, that finally congealed with the medication and created someone somewhat biologically "normal" for the first time ever. I don't know. And while I am exploring as I write my memoir, I honestly do not care right now. All I want is to remain in this "normal" place.
I ask, because at 25, without any other chemical interventions, surgical interventions, no history of physical or sexual abuse, but definitely trauma events (including separation from caregivers at the start of life, and at key junctures in childhood) and a fat-shaming same-sex parent using strong-arm techniques (ranging from food scarcity in the house to listing all the deadly consequences of being overweight)— I wonder if the pharmaceutical intervention is the best first move, or whether it could be included as part of a multifaceted approach, including trauma therapy, CBT techniques, physical rehab (patient reports joint pain that restricts physical activity), and interventions to add experiences into life that food and eating were attempting to fulfill (social connection, meaningful contribution, purpose, etc).
Perhaps being on the medication, and experiencing the passive return to a baseline “healthy” weight would then engender the rest of the multifaceted life improvements, but I’m hesitant to encourage that.
As with restrictive eating as a disorder, copious consumption as a disorder seems to beg for not just a return to baseline healthy weight by whatever means necessary, but a comprehensive treatment of whatever led to the disordered eating initially, if there is a trauma / emotional component (is there ever NOT an emotional component?).
Why hesitant to encourage finding health and balance through meds? I find having removed the mental manipulations that the foods create, clarity is easier. Therapy is easier... easier to tease apart the different aspects needing help. With food, it's a manipulation of the mind to eat over the stress, covering the issues. I will write more soon. This is a beautiful springboard conversation. Thank you for starting it. It might be a few days. Am with daughter and grandkidlets until Christmas Day. Soon!!
I've thought more about this over the last 2 weeks, Molly. I know that these meds will eventually be used for prevention. Not *these* meds, but ones like them. Perhaps going off the GLP-1s *will* be your answer to meeting your needs. I definitely think with all your "mental co-morbidities," therapy would be incredible helpful (if you are not in any yet, of course). I did move through the different modalities as I needed them... well, trying to get them to fix me for a couple of decades, but, of course, that didn't help at all for that! It took more maturity for me to learn the "Take What You Need & Leave the Rest" idea to heart.
I really love how you have continued rolling around in my mind. I'm learning from you and I do so love to learn. Thank you.
Thank you for this. I’m not the “patient” in this scenario, I’m the invested onlooker, trying hard not to overstep my bounds as a loving source of support.
I’m also coming from the perspective of having a consistent weight since puberty, with the exception of the two times I was on hormonal birth control (oral the first time, IUD the second). I gained weight that I felt I could not control, similar to pregnancy, but without a fetus. This was clearly weight gain resulting from messing with how my body regulates appetite and synthesis.
Removing the birth control returned me to baseline weight. I was gaslit by medical professionals both times, telling me it wasn’t the birth control causing weight gain.
This was easy to assess. With the extra weight seeming to result from disordered eating, which may result from a *combination* of emotional coping mechanisms and an endemic chemical disruption, or be a stasis state begun early due to emotional trauma which then becomes endemic… either way, the drugs may be what makes shedding the weight possible.
What concerns me is the lifelong dependency, the terror of being cut off from these meds. If the patient is 25, and hasn’t done really any kind of previous regime for weight loss, I’m wondering if a combination of drug plus other supportive interventions is best, or just the drug, full stop.
For my weight gain, I removed exogenous hormones and my body did the rest, no therapy required. In the case of this 25-year-old, who has self-declared an “eating disorder” and links it to childhood events, I’m wary of putting the drug in the driver’s seat without addressing how the bus got going on this route in the first place.
If this 25-year-old was on the drug, through the chemical mechanism restored the healthy relationship with food, and concurrent therapy and social interventions that set new neural pathways in place, would patient sustain health even if drug was eventually ceased, and if that’s possible, wouldn’t this be preferable?
I see so many young people being put on pharmaceuticals to “solve” emotional turmoil of growing up, but there’s no off-ramp. They are told they will take these psychotropic drugs for life, and accept their compromised function as a result. Is excess weight always only solvable with chemical intervention? Is it always a lifetime maintenance course of the drug? Does this have a downside?
I will go out of order to those great questions, Mollie.
- I do not believe the medications restore a healthy relationship with food. I believe the medication fixes a glitch in the system that may have been caused by an infinite number of reasons... abuse, medical/life conditions (PCOS, perimenopause, pregnancy, etc.), surgeries (I know that my tonsillectomy is what triggered/screwed up my brain.), "addiction" to Ultra-Formulated Foods (I see this in kids who eat fast food all the time), medications (I gained 80 lbs. in 4 months on an anti-psychotic), and, with your example, birth control.
Those people were idiots saying it wasn't the birth control that caused your weight gain. I was a midwife and birth worker for 32 years and saw contraceptives cause extraordinary amounts of weight gain. Any chemical that enters our bodies can create that weight imbalance. Depo-Provera shots were/are the worst. I watched women gain 20 lbs. an a couple of months. Often. I will say you were very blessed and lucky to go back to baseline. Not everybody does.
- I believe therapy should be required *before* going on the medications as well as during. These are requirements before getting Weight Loss Surgery. I can't figure out for the life of me why this isn't required for the meds. I believe it should be required to see a Registered Dietician at least quarterly.
- The medications do not fix anything with regards to an eating disorder. Myself as an example, I had no issues with food choices for 3 years and then, when I got a second cancer diagnosis in June 2024, I found myself "trance eating." I didn't realize I was (what people would call) stress eating until I had done it a couple of times. On the Downsized Cruise in June, I stood at the buffet and ate 6 pieces of pizza, not tasting a thing, just shoveling it in. I remembered what I had done the next morning and that was when I realized I *really* had some eating issues that had not been addressed and began with a new therapist specifically on these trance-eating experiences.
- I am on psychotropic medications for life for Bipolar Disorder 1. Whenever I tried to go off, I was hospitalized or should have been. I gladly take my psych meds to stay sane. Who knows what caused *that* glitch in the brain? Did it happen when I was an embryo? Because of abuse? Trying to tease apart every "abnormal" experience and what might have caused it is impossible. Again, I have been in therapy since I was 18 years old, continuously. I'm almost 65 years old and still have no definitive answers. Looking for one would be pointless time wasted. Do I medicate everything? Of course not. But to keep myself alive? Absolutely.
If you are okay with it, this might be a good springboard post... I would not use your name, but would love to write about young people taking the meds, the way our psych system always seems to want to medicate to tamp down "unacceptable" behaviors, and what the meds might look like long-term in younger folks. Also the combination of therapies being crucial. Thoughts?
I really want to thank you for exploring this with me, and being so forthcoming with your own history.
I’d be glad if you wrote more about adolescents and young adults and their use of “mood disorder” medications. I live in a progressive area, and find that at this point, nearly every family I know personally with GenX parents / GenZ kids has at least one, if not all, of the kids on psych meds for a mental health diagnosis. And it’s not for lack of therapy. These kids have been trained to focus on their own emotional state for as long as they can remember, often seeing professionals. When I read Abigail Schrier’s latest, “Bad Therapy,” it seemed to be a book every parent ought to get a copy of.
Excessive consumption of calories and being at an unhealthy weight is not covered in that book, but I think calorie restriction is. I personally didn’t know one person in my class of 1986 (I went to a high school where there were about 550 in each graduating class) who had a health-threatening eating disorder, or took psych meds. GenZ seems over-identified with their negative emotional states and discomfort, and the girls even have a sense of pride in being unwell, posting their diagnoses and prescriptions on social media.
So I’m really, truly perplexed about what might help a stoic 25-year-old male who likely comes by their excess calorie consumption through a combination of genetic predisposition; loss; severance / interruption of care / relationship with primary caregiver at various junctures; social isolation during and after covid; joint pain; shame; and years of training a body into a maladaptive insulin response through overeating.
This young person does not want to be so big, but hasn’t really taken on any kind of action to address it constructively. When I watch broadcast TV, half of the ads seem to be for these weight loss drugs, so I’m sure it’s a huge industry. The people in the ads are not GenZ, though… they are GenX. I agree with you, any medical intervention for weight loss, whether it is surgical or pharmaceutical, ought to be part of a protocol that begins with exploratory therapy, identifying what, if any, needs the patient attempts to meet with food that might be met in other ways. Every person I’ve spoken to who carries excess weight has talked about “eating their feelings,” but I don’t know what that means to them. That phrase is a signal to me, though, that while a drug may arrest the cycle of craving excess calories from a purely somatic angle, the mind may or may not re-regulate its patterns as a result. This is what concerns me most, especially for a young person. If the brain is plastic enough at that young stage to be “retrained” into healthier patterns as an adjunct therapy, and the drug could be temporary and ceased eventually, then some kind of exploratory therapy, plus physiotherapy, plus “life coaching” might be advisable before starting the medication, and during. My best guess.
I know that’s not how it’s being done right now, perhaps by anyone. The drug is a “magic bullet,” and it worries me.
Barb, thank you for taking the time and bringing this topic to the forum for people to discuss. I'm sure there are people who are experiencing this and don't have the words for it. Some people may feel isolated because others have not spoken about this potential portion of an OMM journey.
I hope that everyone finds what works for them, their care team, and their future. I champion everyone finding health as they regain their lives, livelihoods, and zest for living.
Dariam, I think this topic is another thing those on GLP-1s and other OMMs might face that they don't even consider in the beginning. Unless they are hyper-aware of having had an ED previously in their lives. And yes! I do hope everyone finds their balance, sooner than later. Thanks so much for commenting.
You described my secret…. I panicked when the scale said 106 and knew my Dr appointment was in 3 days. Plotted what to wear with pockets so I could put my heavy cell phone chargers in each pocket and my plan to try to eat breakfast that morning…. I was so worried he would deny me my life changing miracle… fyi 72 yrs young, 4’10” , original BMI 44 and now 22. Started MJ Dec 2022 (before Zep not T2D)
Kat, how wonderful to read this. I know others will feel less alone because of you. How are you doing now? You can email me at my Username AT Gmail if you want to remain private. I can't thank you enough for sharing your secret. It means a lot.
This is such an important issue! Thank you for writing about it so beautifully. I am a few months into maintenance and thinking a lot about what the rest of this journey will be like as I continue to go down in dose. And I have to say, I am determined to keep my current weight -- and that feeling is VERY similar to the feeling I had when I was a 6 day a week ballet student in my teens. You can imagine what kinds of habits went along with that feeling back then!
Oh, how I understand, Kathleen. I cannot imagine what it would have been like to be a ballerina... but if it feels anything like now, I guess I am learning. Thank you for your kind words about the piece and commenting. I appreciate it very much. Really.
By removing the body’s ability to crave 8000+ calories / day, does that help confirm it was indeed a chemical problem in the body, or an emotionally-generated eating disorder? Do you have insight into this? Is it best to put a 25-year-old on this drug when the relationship with food and eating is disordered? You say “eating disorder” was not acknowledged when it didn’t fit the “calorie restriction” presentation. Beyond dieting (restriction) and movement, what would the non-pharmaceutical / non-surgical intervention look like? Anorexics are sometimes force-fed to save their lives, but long-term treatment entails extensive therapy. Does over-intake of calories have an equivalent / effective therapy intervention, or has it not been developed?
What amazingly profound questions you've asked. They are all intertwine, but I suspect you already know that.
I do not believe one thing was the reason I ate so much before. I believe I was a string-art mess of complications that ended at my being 405 lbs. Was it my tonsils being taken out at 6 years old? That seems to have been the catalyst, though research is mixed about that "causing" severe obesity. Perhaps it was being put on speed at 7 years old that threw my body out of whack. Was it my mom "teaching" me to forage by hiding candy around the house? Was it the ebb and flow of food in the house? (I call that the "Carrot and the Éclair" times... mom alternating being on a diet or gorging on éclairs and donuts.) Was it because I was sexually assaulted at 18 years old? Did I want to hide _more,_ therefore gained even more weight? Was it being put on the pill? Was it the probable early PCOS I had starting at 20 years old? Was it when I got pregnant 3 times in a row and then abruptly stopped having periods afterwards? (There was no such thing as the term PCOS back then. It would be a couple of decades before I heard about it as a syndrome.) Was it the constant diet/binge cycle I was in for decades? What did the Fen-Phen do to me when I was 35 and my diabetes was finally discovered? Did that nudge my genetics into the Type 2 Diabetes for life aspect? What about the RNY Gastric Bypass that has left me with 4 serious deficiencies I have to medically treat 20+ years later? Did the psych meds I take for Bipolar Disorder 1 kick off another storm of weight gain? (I gained 80 lbs in 4 months on Risperdal.) No therapy ever helped... and I tried every modality and type of mental therapy that came along. No supplements helped. No specific foods or diets helped.
Nothing helped until GLP-1s. As I have described with my psych meds, it is like the two electrical cords have finally been connected to each other, allowing the energy to flow in the right direction. Whether it is a GLP-1 deficiency, a glitch in my brain, or, as I suspect, the entire concoction of my life and genetics, that finally congealed with the medication and created someone somewhat biologically "normal" for the first time ever. I don't know. And while I am exploring as I write my memoir, I honestly do not care right now. All I want is to remain in this "normal" place.
I wish I knew the answers, but I don't.
Great questions, Mollie!!
I ask, because at 25, without any other chemical interventions, surgical interventions, no history of physical or sexual abuse, but definitely trauma events (including separation from caregivers at the start of life, and at key junctures in childhood) and a fat-shaming same-sex parent using strong-arm techniques (ranging from food scarcity in the house to listing all the deadly consequences of being overweight)— I wonder if the pharmaceutical intervention is the best first move, or whether it could be included as part of a multifaceted approach, including trauma therapy, CBT techniques, physical rehab (patient reports joint pain that restricts physical activity), and interventions to add experiences into life that food and eating were attempting to fulfill (social connection, meaningful contribution, purpose, etc).
Perhaps being on the medication, and experiencing the passive return to a baseline “healthy” weight would then engender the rest of the multifaceted life improvements, but I’m hesitant to encourage that.
As with restrictive eating as a disorder, copious consumption as a disorder seems to beg for not just a return to baseline healthy weight by whatever means necessary, but a comprehensive treatment of whatever led to the disordered eating initially, if there is a trauma / emotional component (is there ever NOT an emotional component?).
I appreciate your thoughts on this.
Why hesitant to encourage finding health and balance through meds? I find having removed the mental manipulations that the foods create, clarity is easier. Therapy is easier... easier to tease apart the different aspects needing help. With food, it's a manipulation of the mind to eat over the stress, covering the issues. I will write more soon. This is a beautiful springboard conversation. Thank you for starting it. It might be a few days. Am with daughter and grandkidlets until Christmas Day. Soon!!
I've thought more about this over the last 2 weeks, Molly. I know that these meds will eventually be used for prevention. Not *these* meds, but ones like them. Perhaps going off the GLP-1s *will* be your answer to meeting your needs. I definitely think with all your "mental co-morbidities," therapy would be incredible helpful (if you are not in any yet, of course). I did move through the different modalities as I needed them... well, trying to get them to fix me for a couple of decades, but, of course, that didn't help at all for that! It took more maturity for me to learn the "Take What You Need & Leave the Rest" idea to heart.
I really love how you have continued rolling around in my mind. I'm learning from you and I do so love to learn. Thank you.
Thank you for this. I’m not the “patient” in this scenario, I’m the invested onlooker, trying hard not to overstep my bounds as a loving source of support.
I’m also coming from the perspective of having a consistent weight since puberty, with the exception of the two times I was on hormonal birth control (oral the first time, IUD the second). I gained weight that I felt I could not control, similar to pregnancy, but without a fetus. This was clearly weight gain resulting from messing with how my body regulates appetite and synthesis.
Removing the birth control returned me to baseline weight. I was gaslit by medical professionals both times, telling me it wasn’t the birth control causing weight gain.
This was easy to assess. With the extra weight seeming to result from disordered eating, which may result from a *combination* of emotional coping mechanisms and an endemic chemical disruption, or be a stasis state begun early due to emotional trauma which then becomes endemic… either way, the drugs may be what makes shedding the weight possible.
What concerns me is the lifelong dependency, the terror of being cut off from these meds. If the patient is 25, and hasn’t done really any kind of previous regime for weight loss, I’m wondering if a combination of drug plus other supportive interventions is best, or just the drug, full stop.
For my weight gain, I removed exogenous hormones and my body did the rest, no therapy required. In the case of this 25-year-old, who has self-declared an “eating disorder” and links it to childhood events, I’m wary of putting the drug in the driver’s seat without addressing how the bus got going on this route in the first place.
If this 25-year-old was on the drug, through the chemical mechanism restored the healthy relationship with food, and concurrent therapy and social interventions that set new neural pathways in place, would patient sustain health even if drug was eventually ceased, and if that’s possible, wouldn’t this be preferable?
I see so many young people being put on pharmaceuticals to “solve” emotional turmoil of growing up, but there’s no off-ramp. They are told they will take these psychotropic drugs for life, and accept their compromised function as a result. Is excess weight always only solvable with chemical intervention? Is it always a lifetime maintenance course of the drug? Does this have a downside?
I will go out of order to those great questions, Mollie.
- I do not believe the medications restore a healthy relationship with food. I believe the medication fixes a glitch in the system that may have been caused by an infinite number of reasons... abuse, medical/life conditions (PCOS, perimenopause, pregnancy, etc.), surgeries (I know that my tonsillectomy is what triggered/screwed up my brain.), "addiction" to Ultra-Formulated Foods (I see this in kids who eat fast food all the time), medications (I gained 80 lbs. in 4 months on an anti-psychotic), and, with your example, birth control.
Those people were idiots saying it wasn't the birth control that caused your weight gain. I was a midwife and birth worker for 32 years and saw contraceptives cause extraordinary amounts of weight gain. Any chemical that enters our bodies can create that weight imbalance. Depo-Provera shots were/are the worst. I watched women gain 20 lbs. an a couple of months. Often. I will say you were very blessed and lucky to go back to baseline. Not everybody does.
- I believe therapy should be required *before* going on the medications as well as during. These are requirements before getting Weight Loss Surgery. I can't figure out for the life of me why this isn't required for the meds. I believe it should be required to see a Registered Dietician at least quarterly.
- The medications do not fix anything with regards to an eating disorder. Myself as an example, I had no issues with food choices for 3 years and then, when I got a second cancer diagnosis in June 2024, I found myself "trance eating." I didn't realize I was (what people would call) stress eating until I had done it a couple of times. On the Downsized Cruise in June, I stood at the buffet and ate 6 pieces of pizza, not tasting a thing, just shoveling it in. I remembered what I had done the next morning and that was when I realized I *really* had some eating issues that had not been addressed and began with a new therapist specifically on these trance-eating experiences.
- I am on psychotropic medications for life for Bipolar Disorder 1. Whenever I tried to go off, I was hospitalized or should have been. I gladly take my psych meds to stay sane. Who knows what caused *that* glitch in the brain? Did it happen when I was an embryo? Because of abuse? Trying to tease apart every "abnormal" experience and what might have caused it is impossible. Again, I have been in therapy since I was 18 years old, continuously. I'm almost 65 years old and still have no definitive answers. Looking for one would be pointless time wasted. Do I medicate everything? Of course not. But to keep myself alive? Absolutely.
If you are okay with it, this might be a good springboard post... I would not use your name, but would love to write about young people taking the meds, the way our psych system always seems to want to medicate to tamp down "unacceptable" behaviors, and what the meds might look like long-term in younger folks. Also the combination of therapies being crucial. Thoughts?
I really want to thank you for exploring this with me, and being so forthcoming with your own history.
I’d be glad if you wrote more about adolescents and young adults and their use of “mood disorder” medications. I live in a progressive area, and find that at this point, nearly every family I know personally with GenX parents / GenZ kids has at least one, if not all, of the kids on psych meds for a mental health diagnosis. And it’s not for lack of therapy. These kids have been trained to focus on their own emotional state for as long as they can remember, often seeing professionals. When I read Abigail Schrier’s latest, “Bad Therapy,” it seemed to be a book every parent ought to get a copy of.
Excessive consumption of calories and being at an unhealthy weight is not covered in that book, but I think calorie restriction is. I personally didn’t know one person in my class of 1986 (I went to a high school where there were about 550 in each graduating class) who had a health-threatening eating disorder, or took psych meds. GenZ seems over-identified with their negative emotional states and discomfort, and the girls even have a sense of pride in being unwell, posting their diagnoses and prescriptions on social media.
So I’m really, truly perplexed about what might help a stoic 25-year-old male who likely comes by their excess calorie consumption through a combination of genetic predisposition; loss; severance / interruption of care / relationship with primary caregiver at various junctures; social isolation during and after covid; joint pain; shame; and years of training a body into a maladaptive insulin response through overeating.
This young person does not want to be so big, but hasn’t really taken on any kind of action to address it constructively. When I watch broadcast TV, half of the ads seem to be for these weight loss drugs, so I’m sure it’s a huge industry. The people in the ads are not GenZ, though… they are GenX. I agree with you, any medical intervention for weight loss, whether it is surgical or pharmaceutical, ought to be part of a protocol that begins with exploratory therapy, identifying what, if any, needs the patient attempts to meet with food that might be met in other ways. Every person I’ve spoken to who carries excess weight has talked about “eating their feelings,” but I don’t know what that means to them. That phrase is a signal to me, though, that while a drug may arrest the cycle of craving excess calories from a purely somatic angle, the mind may or may not re-regulate its patterns as a result. This is what concerns me most, especially for a young person. If the brain is plastic enough at that young stage to be “retrained” into healthier patterns as an adjunct therapy, and the drug could be temporary and ceased eventually, then some kind of exploratory therapy, plus physiotherapy, plus “life coaching” might be advisable before starting the medication, and during. My best guess.
I know that’s not how it’s being done right now, perhaps by anyone. The drug is a “magic bullet,” and it worries me.