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Justa heads Up. This episode includes descriptions of eating disorders and relapse take care while listening. Drugs like ozebic and WeGo v have skyrocketed in popularity over the past few years. Telehealth companies have capitalized on that demand. They offer copycat versions of the medications that are often cheaper and easier to get, But the full picture of a largely unregulated industry and its impact on the people who turn to it for treatment is still coming into focus.
An important fact to consider as the use of these drugs becomes more widespread is that they're not meant for everyone.
Madison Mueller covers pharmaceuticals for Bloomberg. Over the past few months, she's been reporting on the ways these drugs have impacted one group in particular, and how that impact has some experts and doctors worried.
More and more, eating disorder specialists are saying that they're seeing a lot of patients come in the last few months the last year who have relapsed in their eating disorders after getting access to one of these drugs.
For people who need these drugs the most, like diabetes patients, the shots can be life changing, but Bloomberg's findings highlight the ways more widespread access to the drugs can also have downsides, and Madison's reporting raises questions about regulation, over use and who bears the responsibility to prevent these drugs
from going to people they could harm. Today on the show, a growing market is making weight loss shots easier to access, but that's also introducing new risks for people with eating disorders. This is the big take from Bloomberg News. I'm Sarah Holder. In a few years since doctors started to widely prescribe drugs like ozepic for weight loss, Bloomberg's Madison Mueller has been fascinated by how the market has developed. First, surging demand made the drugs hard to come by. There were shortages,
and for many patients, prices were prohibitive. Then telehealth companies like Hymns and Hers entered the fray. They offered cheaper copycats of the drugs, compounded versions, which aren't as widely regulated. Ads from these companies are all over social media, streaming services, you name it, and part of their cell is how easy it can be to get a prescription.
With some of these telehealth companies. What we've seen is it only requires you to fill out a few questions on like an online questionnaire and someone will write you a prescription for a drug and it's sent to your doorstep. And obviously there are companies that have more checks in place, you have to meet over video, you know, live with a doctor. But for a lot of these it's just as simple as filling out a few questions and then you get a prescription written.
Talk a little bit about what these telehealth providers typically ask about when they are prescribing a weight loss drug and what they don't ask about.
So some of these telehealth companies, not all of them, you just simply put in your weight and your BMI and like that's the thing that qualifies you for one of these drugs. And they ask a few more questions about like diet and lifestyle and how much you're sleeping, et cetera. But you can just lie about your weight. Some companies that do have more safeguards in place will actually send patients a scale that hooks up to their
app or to their platform. Other companies do a video chat to like make sure that they're actually talking to the patients and that they can see them. But for a lot of these companies, especially the ones that have like crop up in the last year. It's just a few questions about how much do you weigh, do you feel like you need to lose weight? You know, what's your diet like, and that's kind of it.
But Madison says she's spoken to experts who say streamlining the prescription process can put certain vulnerable populations at risk.
People who are in recovery from an eating disorder for a certain amount of time are getting bombarded by advertisements for these telehealth companies, and that can kind of for someone who's in recovery from anorexia and who is used to using food and weight as sort of like a coping mechanism, that can be a really compelling thing for them.
Madison started looking into the experiences of people whose eating disorders had been exacerbated or triggered by these weight loss drugs. She met aj Jasper, a thirty eight year old from Chicago who struggled with anorexia throughout his life and had.
Been in recovery from his eating disorder for two years, which is like the longest period of recovery that he's ever been in. He was doing really well. Works as a social worker, and then he started seeing a lot of advertisements for GLP one drugs on social media and on Hulu. And he said that just at that time in his life, he was facing a lot of stress at work and in his personal life, and in the past he knew that not eating and losing weight had helped him feel like he was in more control of
his emotions. And so for him, just continuing to see those ads, he was like, Okay, I'm going to try to get access to one of these drugs.
Aj ended up ordering a prescription from Hymns.
On that particular day when he decided to do this, he was seeing Hulu ads for Hymns and Hers and that's why he ended up going to that company. And so he went through filled out the questionnaire. He told me it only took a few minutes. There were questions on Hymns and Hers questionnaire about have you struggled with an eating disorder? Have you struggled with behaviors like restricting your food intake or binging and purging, And he just put no.
A spokesperson for Hymns told Bloomberg that accurate self reporting is critical for safe and effective treatment, just as it is in other healthcare settings and characterized its intake form as more than just a questionnaire. It said a healthcare
provider reviews every submission. AJ told Madison he knew he wasn't supposed to lie about his weight and medical history when he ordered, but he wanted the results the drug company had advertised, and the apparent speed and ease of access was appealing.
Within two to three business days, they were at his front door.
And what happened when he started taking the drugs? How did it affect his physical and mental health?
He said, imagines it felt like what a heroin addict would feel like, like it was an immediate high for him, because he said previously it would take him months to reach this point where he was not eating enough to sort of like suppress those anxious emotions that he was feeling. But because these drugs work quickly as appetite suppressants, he almost got that feeling like instantaneously, and so that to him was like it was almost an addictive feeling.
And AJ told Madison that he felt like he couldn't stop.
He immediately injected like six times the recommended starting dosage, and then he got quite sick from that because as we know, there are side effects from these drugs, and when you're not injecting or taking the right dosage, especially, there can be more side effects. And so he did that for months before he told his doctor like, hey, there is something wrong. I'm having extreme back pain. His doctor was really concerned, told him to go to the hospital and he was admitted to the hospital.
After years of being in recovery, AJ had relapsed. The toll on his body was severe. He had to stop working, and after a week in the hospital, he was moved into an impatient behavioral health unit and then a residential recovery center with around the clock monitoring and a full treatment team.
He did that for a month and then his insurance said we won't cover your stay any longer, so he stepped down to a lower level of care, which he's been in for like the last two months. He was extremely malnourished, lost forty pounds that he couldn't afford really to lose. There was concerns that there might have been damage to some of his organs. So it's just been really difficult for him to feel like he was backtracking after making so much progress.
Him says it has a quality program that involves regular outreach to patients. Bloomberg reviewed the check in emails that were sent to aj. AJ says he ignored them. Eating disorder specialists told Madison that they're seeing more and more patients like AJ who's seen a reversal in their mental and physical health after getting access to weight loss shots. But just how widespread is this problem and who do ex experts say is responsible for preventing it that's coming up.
Bloomberg's Madison Muller says, the experts you've spoken with are clear that weight loss drugs can pose a unique risk for people with eating disorders, especially when their use goes unchecked, But there isn't much concrete research into how widespread the issue is.
There's hopes that there will be some studies, and some of the doctors are trying to start studies now to better understand the risks for patients with eating disorders, risks of developing eating disorders in people who might have some disordered eating behaviors, or who are seeking these drugs out primarily for cosmetic purposes and then end up developing and eating disorder. Right now, it's anecdotal.
While reporting on the story, Madison spoke to over half a dozen doctors across the US who specialize in treating people with eating disorders. They all told her they've seen this trend in their patients.
I talked to one pediatric eating disorder doctor in New York who said he's seen one to two cases of eating disorders related to GLP ones like every month over the last year. And so it's clear it's happening. To what degree, We're not really sure.
Yet, and it's a problem that has the potential to grow as more and more companies crop up to meet the demand. Copycat versions of weight loss drugs like ozepic are now being prescribed at medical spas, a seventeen billion dollar industry where regulations very widely state to state. The screening protocols for getting prescriptions at the spas have come under scrutiny too, and Hymns is just one of at least sixty telehealth companies selling weight loss shots. According to a Bloomberg analysis.
Hymns and Hers, for example, primarily sold like erectile dysfunction hair loss drugs, and then they started compounded GLP ones earlier this year. So it's very clear that this is something telehealth companies see as being a big part of business and something that they need to jump on or risk being sort of like left behind.
Just for telehealth companies, Hymns, Row Noom, and Henry Metz have also spent a combined seventy one million dollars this year on advertisements for their weight loss products, according to data shared with Bloomberg by Media Radar.
That is something that eating disorder experts eating disorder organizations have definitely been raising alarms about. They're really concerned about. We know the impact of all of the cultural messaging around thinness and dieting, like we know the impact that that's had on our society, and so I think that there's some concern that this will just exacerbate that further.
And I've talked to some eating disorder experts who are concerned that we're all so like we had made some progress toward body acceptance over the last couple of years, slow progress, but that it was happening, and that this is sort of taking us back a couple of steps and is prioritizing like thinness again.
Weight loss drugs aren't going anywhere. Morgan Stanley analysts estimate the market for copycat shots could be worth at least two billion dollars annually and culturally. They sit at the center of an evolving conversation about what a healthy body is, who gets to decide that, and where people's relationship to
food and mental health intersect. Experts and doctors who Madison spoke with echoed a similar sentiment that there's more providers could be doing before prescribing these medications, that a lot of this should start in a doctor's office or a virtual screening, and that more sound guidance is better than less.
All the obesity doctors I talked to were like, absolutely, one hundred percent. We need to be making sure that they're asking about mental attitudes about someone's weight, how they view themselves, how much time they spend thinking about food and weight in their day, like things that really can get at the mental aspect of this and how much of a priority it is for someone.
As for Aj, he's still in treatment. When they last spoke, AJ told Madison he wasn't doing well and couldn't speak again for the story, but agreed to have his experience shared. He said his priority was focusing on recovery. What do specialists you've spoken with say that people should keep in mind as they are navigating this new world where these kinds of drugs are just becoming so much easier to get.
Anytime that there's a conversation about your health and you're thinking about, you know, is this treatment right for me? Like the important thing is to have a doctor or a healthcare provider that you trust, that you can discuss these things with and that you can be able to like share or your medical history with and say is this right for me? And get a real medical opinion. And I think that the problem is that that's not
what's happening in a lot of cases right now. This story isn't to say that weight loss drugs are bad. It's just an important fact to consider as the use of these drugs becomes more widespread, is that they're not meant for everyone. When we're marketing these drugs on the subway or on Hulu or whatever, like, it's just it's a hard thing for some people. And I, you know, doctor is an expert, say there just needs to be more safeguards in place.
This is the big take from Bloomberg News. I'm Sarah Holder. This episode was produced by Julia Press. It was edited by Aaron Edwards and Rebecca Greenfield. It was fact checked by Adriana Tapia and mixed and sound designed by Alex Huguiera. Our senior producer is Naomi Shavin. Our senior editor is Elizabeth Hanso. Our executive producer is Nicole beemsterbor Sage Bauman is Bloomberg's head of podcasts. If you like this episode, make sure to subscribe and review The Big Take wherever
you listen to podcasts. It helps people find the show. Thanks for listening. We'll be back tomorrow