One recent change to the pharmaceutical market is “direct to consumer” prescriptions. This moniker means that people can buy their own medication without a prescription or real guidance from a prescriber. The pharmaceutical companies’ capitalist drive for profit has transcended even the sacred breach of medicine to begin to allow people to choose their own drugs.
The newfangled experiment in medications recently extended to the GLP-1’s with all the attendant risks of self-diagnosis and self-guided treatment.
From the solo practitioner physician, I can see that the road to this point does not seem to be intentional. Shortages of the GLP-1’s initially due to underestimating the wild success of these medications led the government to allow for pharmacies to compound the drug, essentially bypassing the patent, so pharmacies could mix their own version and sell it at a discounted price.
Once that door opened, there does not seem to be a way to close it. The exact reasons for not closing the loophole are unclear. It could be the market forces, exceedingly high demand or the cultural conceit to overvalue thinness at all costs.
There still is the brand version of GLP-1’s that health insurance will cover, but people who want to try the drugs for any reason can find a cheaper version at a multitude of online shops. The barrier to prescription is minimal: a short call with a medical practitioner, who won’t question the reasons to try the drugs, followed by a prescription. As long as one pays, unlimited prescriptions at a dose of your choice awaits. There is no assessment of medical need or risks, just access to powerful drugs whose long-term effects are still very much unknown.
This next step in the GLP-1 experiment is surprising and has caught many people off guard. It’s hard for doctors to push back against a market that consumers have access to and have to accept that many people will be dosing their own GLP-1’s.
Gradually, people are turning to the drugs in the short-term as a weight loss tool rather than an ongoing medication. They are increasing and lowering their dose at will while experimenting with how their body responds to the drug. The potential outcomes and risks remain unknown.
What does this mean for people with eating disorders? How will this affect the presentation and treatment? How does a person in recovery cope with this reality? I’ll try to answer these questions in the next post.
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