Rachel Garrett Mercer remembers the day she was diagnosed with Type 1 diabetes.
“The first thing my doctor told me was that I ‘didn’t look diabetic’,” she said. “Looking back, it’s hard to imagine anyone saying that, because diabetic doesn’t look like one thing. Everybody is different.”
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Following her diagnosis, Mercer’s day-to-day life completely changed. She was placed on an insulin pump and a continuous glucose monitor to help manage her insulin, but as she describes it, the disease is not a “set it and forget it” type thing. She has to count carbs after every meal, snack and vitamin, and adjust insulin based on hormones at each phase of her cycle. If she plans to exercise, she has to look at her blood sugar reading hours before to determine if she needs to eat or give herself insulin. She also has to be aware of the weather, as hot and humid days can make her blood sugar spike. But she also found that as her life changed, her body did too.
“I’ve had my own share of mental health struggles around my weight,” she said. “When I was diagnosed, I was very thin. But as my body regulated itself after insulin injections, I put back on the weight and then some. Going from looking at myself in the mirror as a thin person to being at my heaviest has been challenging.”
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For people with diabetes, weight gain and negative body image can be devastating — as they are also faced with blame over their disease by an uneducated general public. But coupled with the pressures from pop culture and diet trends that promote rail thin body types as ideal, the struggle can be all but impossible to handle.
“The shame that still surrounds diabetes is something that I’m personally so passionate about,” Mercer said. “I see young girls who withhold their insulin, because lack of insulin in a type 1 diabetic often means you’ll lose weight as you go into diabetic ketoacidosis, your body literally starves itself. This diabulimia is incredibly dangerous.”
And she’s not alone. Approximately 91 percent of all women are unhappy with their weight, with one in two adolescent girls seeing themselves as having weight problems, according to the International Journal of Eating Disorders.
And we are seeing these trends in younger girls more and more due in large part to social media and celebrity-endorsed diets. One trend that has gained substantial popularity in the last year is the use of Ozempic, a diabetes drug that boosts insulin sensitivity and suppresses appetite, which can lead to weight loss. The trend emerged on TikTok (an app with a history of being a home to pro-eating disorder content) and the drug has faced shortages that coincide with its exploding notoriety for being a sort of miracle drug for weight loss.
“Ozempic is an FDA approved medication for Type 2 diabetes,” said Catherine Prato-Lefkowitz PhD, MBA, MSN, RN. “It’s a GLP-1 receptor agonist which means it lowers fasting and after eating blood glucose by stimulating insulin secretion. Insulin is needed to get the sugar inside of the cells in the body. Insulin helps blood sugar enter the cells so it can be used for energy.”
The drug’s intended purpose is to help diabetics manage their insulin levels, and it’s perfectly legal for a health care provider to prescribe Ozempic off-label for weight loss purposes. But celebrities recently citing extreme weight loss have shown a direct correlation with a spike in Google searches for the prescription. Following the 2022 Met Gala, searches for “ozempic” reached an all-time high, followed by even higher numbers the week after, when Kim Kardashian shared her results from a body scan showing how she cut her body fat by 7 percentage points in the last year, down to 18 percent.
We almost never know with certainty what exact methods celebrities use to look the way they do, but it’s almost always with a combination of resources and measures that are financially inaccessible to most people. From liposuction to botox to full-fledged reconstructive surgeries, there’s very little plastic surgeons can’t do to alter someone’s appearance.
And while correlation doesn’t equal causation, the bottom line is that more and more young women are looking to emulate the body types their celebrities have and planning to do so through a quick fix or by whatever means necessary.
“Weight loss takes time,” said Prato-Lefkowitz. “Everyone wishes there were a ‘magic pill’ that people can take to lose weight. The safest method to go about weight loss is to talk with your provider, agree on a healthy eating plan for your body, and create small goals that are realistic and achievable.”
As of early October, on TikTok, #Ozempic has 210.8 million views, an increase of 155.2 million since the end of April. The hashtag #OzempicWeightLoss is second, with 78.6 million views, and, #OzempicChallenge, referring to a weight-loss challenge using the drug, is third, with 2.2 million.
Diabetics need drugs like Ozempic to regulate their blood sugar, and when prescribed by a doctor, the drug can be life saving. But for non-diabetics, the use of the drug can have side effects that can cause major health concerns and are worth avoiding all together.
“There are side effects with any medication, but for Ozempic they might include: gastrointestinal issues, headache, dizziness and fatigue,” said Prato-Lefkowitz. “Since this medication can slow digestion other medication absorption may be affected.”
The drug is also known to cause pancreatitis, changes in vision, low blood sugar and kidney failure.
The US Food and Drug Administration and government has not released any information or guidance to health care providers on prioritizing the medication for diabetics, but Ozempic’s manufacturer has advised that the shortage will continue until the end of December 2022. While the American Society of Health-System Pharmacists and the independent information website Drugs.com are also reporting an Ozempic shortage in the US due to increased demand.
There has always been a market for weight loss solutions, but as social media continues to thrive and celebrities continue to not disclose the bevy of procedures and resources they use to achieve their look, more and more young people will seek out dangerous options.
“So often, society wants to say that diabetics are lazy and make jokes,” said Mercer. “But I think you’d be surprised at how many people want to take care of their bodies and just don’t have the tools or resources. Or they do and still get judged. So, when you have someone who wants to take care of themselves — and are doing it — and suddenly something like the Ozempic shortage occurs, that’s a big problem.”
Before you go, check out our favorite quotes to inspire positive attitudes about food and body image:
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Rachel Garrett Mercer remembers the day she was diagnosed with Type 1 diabetes.