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Speaker 1: Bloomberg Audio Studios, Podcasts, radio news.

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Speaker 2: Justa heads Up. This episode includes descriptions of eating disorders

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Speaker 2: and relapse take care while listening. Drugs like ozebic and

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Speaker 2: WeGo v have skyrocketed in popularity over the past few years.

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Speaker 2: Telehealth companies have capitalized on that demand. They offer copycat

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Speaker 2: versions of the medications that are often cheaper and easier

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Speaker 2: to get, But the full picture of a largely unregulated

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Speaker 2: industry and its impact on the people who turn to

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Speaker 2: it for treatment is still coming into focus.

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Speaker 1: An important fact to consider as the use of these

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Speaker 1: drugs becomes more widespread is that they're not meant for everyone.

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Speaker 2: Madison Mueller covers pharmaceuticals for Bloomberg. Over the past few months,

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Speaker 2: she's been reporting on the ways these drugs have impacted

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Speaker 2: one group in particular, and how that impact has some

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Speaker 2: experts and doctors worried.

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Speaker 1: More and more, eating disorder specialists are saying that they're

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Speaker 1: seeing a lot of patients come in the last few

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Speaker 1: months the last year who have relapsed in their eating

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Speaker 1: disorders after getting access to one of these drugs.

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Speaker 2: For people who need these drugs the most, like diabetes patients,

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Speaker 2: the shots can be life changing, but Bloomberg's findings highlight

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Speaker 2: the ways more widespread access to the drugs can also

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Speaker 2: have downsides, and Madison's reporting raises questions about regulation, over

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Speaker 2: use and who bears the responsibility to prevent these drugs

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Speaker 2: from going to people they could harm. Today on the show,

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Speaker 2: a growing market is making weight loss shots easier to access,

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Speaker 2: but that's also introducing new risks for people with eating disorders.

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Speaker 2: This is the big take from Bloomberg News. I'm Sarah Holder.

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Speaker 2: In a few years since doctors started to widely prescribe

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Speaker 2: drugs like ozepic for weight loss, Bloomberg's Madison Mueller has

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Speaker 2: been fascinated by how the market has developed. First, surging

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Speaker 2: demand made the drugs hard to come by. There were shortages,

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Speaker 2: and for many patients, prices were prohibitive. Then telehealth companies

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Speaker 2: like Hymns and Hers entered the fray. They offered cheaper

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Speaker 2: copycats of the drugs, compounded versions, which aren't as widely regulated.

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Speaker 2: Ads from these companies are all over social media, streaming services,

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Speaker 2: you name it, and part of their cell is how

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Speaker 2: easy it can be to get a prescription.

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Speaker 1: With some of these telehealth companies. What we've seen is

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Speaker 1: it only requires you to fill out a few questions

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Speaker 1: on like an online questionnaire and someone will write you

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Speaker 1: a prescription for a drug and it's sent to your doorstep.

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Speaker 1: And obviously there are companies that have more checks in place,

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Speaker 1: you have to meet over video, you know, live with

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Speaker 1: a doctor. But for a lot of these it's just

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Speaker 1: as simple as filling out a few questions and then

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Speaker 1: you get a prescription written.

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Speaker 2: Talk a little bit about what these telehealth providers typically

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Speaker 2: ask about when they are prescribing a weight loss drug

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Speaker 2: and what they don't ask about.

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Speaker 1: So some of these telehealth companies, not all of them,

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Speaker 1: you just simply put in your weight and your BMI

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Speaker 1: and like that's the thing that qualifies you for one

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Speaker 1: of these drugs. And they ask a few more questions

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Speaker 1: about like diet and lifestyle and how much you're sleeping,

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Speaker 1: et cetera. But you can just lie about your weight.

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Speaker 1: Some companies that do have more safeguards in place will

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Speaker 1: actually send patients a scale that hooks up to their

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Speaker 1: app or to their platform. Other companies do a video

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Speaker 1: chat to like make sure that they're actually talking to

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Speaker 1: the patients and that they can see them. But for

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Speaker 1: a lot of these companies, especially the ones that have

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Speaker 1: like crop up in the last year. It's just a

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Speaker 1: few questions about how much do you weigh, do you

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Speaker 1: feel like you need to lose weight? You know, what's

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Speaker 1: your diet like, and that's kind of it.

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Speaker 2: But Madison says she's spoken to experts who say streamlining

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Speaker 2: the prescription process can put certain vulnerable populations at risk.

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Speaker 1: People who are in recovery from an eating disorder for

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Speaker 1: a certain amount of time are getting bombarded by advertisements

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Speaker 1: for these telehealth companies, and that can kind of for

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Speaker 1: someone who's in recovery from anorexia and who is used

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Speaker 1: to using food and weight as sort of like a

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Speaker 1: coping mechanism, that can be a really compelling thing for them.

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Speaker 2: Madison started looking into the experiences of people whose eating

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Speaker 2: disorders had been exacerbated or triggered by these weight loss drugs.

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Speaker 2: She met aj Jasper, a thirty eight year old from

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Speaker 2: Chicago who struggled with anorexia throughout his life and had.

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Speaker 1: Been in recovery from his eating disorder for two years,

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Speaker 1: which is like the longest period of recovery that he's

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Speaker 1: ever been in. He was doing really well. Works as

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Speaker 1: a social worker, and then he started seeing a lot

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Speaker 1: of advertisements for GLP one drugs on social media and

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Speaker 1: on Hulu. And he said that just at that time

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Speaker 1: in his life, he was facing a lot of stress

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Speaker 1: at work and in his personal life, and in the

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Speaker 1: past he knew that not eating and losing weight had

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Speaker 1: helped him feel like he was in more control of

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Speaker 1: his emotions. And so for him, just continuing to see

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Speaker 1: those ads, he was like, Okay, I'm going to try

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Speaker 1: to get access to one of these drugs.

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Speaker 2: Aj ended up ordering a prescription from Hymns.

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Speaker 1: On that particular day when he decided to do this,

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Speaker 1: he was seeing Hulu ads for Hymns and Hers and

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Speaker 1: that's why he ended up going to that company. And

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Speaker 1: so he went through filled out the questionnaire. He told

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Speaker 1: me it only took a few minutes. There were questions

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Speaker 1: on Hymns and Hers questionnaire about have you struggled with

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Speaker 1: an eating disorder? Have you struggled with behaviors like restricting

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Speaker 1: your food intake or binging and purging, And he just

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Speaker 1: put no.

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Speaker 2: A spokesperson for Hymns told Bloomberg that accurate self reporting

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Speaker 2: is critical for safe and effective treatment, just as it

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Speaker 2: is in other healthcare settings and characterized its intake form

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Speaker 2: as more than just a questionnaire. It said a healthcare

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Speaker 2: provider reviews every submission. AJ told Madison he knew he

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Speaker 2: wasn't supposed to lie about his weight and medical history

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Speaker 2: when he ordered, but he wanted the results the drug

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Speaker 2: company had advertised, and the apparent speed and ease of

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Speaker 2: access was appealing.

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Speaker 1: Within two to three business days, they were at his

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Speaker 1: front door.

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Speaker 2: And what happened when he started taking the drugs? How

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Speaker 2: did it affect his physical and mental health?

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Speaker 1: He said, imagines it felt like what a heroin addict

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Speaker 1: would feel like, like it was an immediate high for him,

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Speaker 1: because he said previously it would take him months to

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Speaker 1: reach this point where he was not eating enough to

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Speaker 1: sort of like suppress those anxious emotions that he was feeling.

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Speaker 1: But because these drugs work quickly as appetite suppressants, he

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Speaker 1: almost got that feeling like instantaneously, and so that to

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Speaker 1: him was like it was almost an addictive feeling.

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Speaker 2: And AJ told Madison that he felt like he couldn't stop.

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Speaker 1: He immediately injected like six times the recommended starting dosage,

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Speaker 1: and then he got quite sick from that because as

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Speaker 1: we know, there are side effects from these drugs, and

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Speaker 1: when you're not injecting or taking the right dosage, especially,

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Speaker 1: there can be more side effects. And so he did

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Speaker 1: that for months before he told his doctor like, hey,

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Speaker 1: there is something wrong. I'm having extreme back pain. His

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Speaker 1: doctor was really concerned, told him to go to the

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Speaker 1: hospital and he was admitted to the hospital.

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Speaker 2: After years of being in recovery, AJ had relapsed. The

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Speaker 2: toll on his body was severe. He had to stop working,

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Speaker 2: and after a week in the hospital, he was moved

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Speaker 2: into an impatient behavioral health unit and then a residential

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Speaker 2: recovery center with around the clock monitoring and a full

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Speaker 2: treatment team.

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Speaker 1: He did that for a month and then his insurance

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Speaker 1: said we won't cover your stay any longer, so he

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Speaker 1: stepped down to a lower level of care, which he's

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Speaker 1: been in for like the last two months. He was

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Speaker 1: extremely malnourished, lost forty pounds that he couldn't afford really

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Speaker 1: to lose. There was concerns that there might have been

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Speaker 1: damage to some of his organs. So it's just been

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Speaker 1: really difficult for him to feel like he was backtracking

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Speaker 1: after making so much progress.

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Speaker 2: Him says it has a quality program that involves regular

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Speaker 2: outreach to patients. Bloomberg reviewed the check in emails that

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Speaker 2: were sent to aj. AJ says he ignored them. Eating

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Speaker 2: disorder specialists told Madison that they're seeing more and more

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Speaker 2: patients like AJ who's seen a reversal in their mental

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Speaker 2: and physical health after getting access to weight loss shots.

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Speaker 2: But just how widespread is this problem and who do

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Speaker 2: ex experts say is responsible for preventing it that's coming up.

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Speaker 2: Bloomberg's Madison Muller says, the experts you've spoken with are

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Speaker 2: clear that weight loss drugs can pose a unique risk

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Speaker 2: for people with eating disorders, especially when their use goes unchecked,

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Speaker 2: But there isn't much concrete research into how widespread the

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Speaker 2: issue is.

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Speaker 1: There's hopes that there will be some studies, and some

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Speaker 1: of the doctors are trying to start studies now to

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Speaker 1: better understand the risks for patients with eating disorders, risks

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Speaker 1: of developing eating disorders in people who might have some

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Speaker 1: disordered eating behaviors, or who are seeking these drugs out

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Speaker 1: primarily for cosmetic purposes and then end up developing and

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Speaker 1: eating disorder. Right now, it's anecdotal.

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Speaker 2: While reporting on the story, Madison spoke to over half

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Speaker 2: a dozen doctors across the US who specialize in treating

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Speaker 2: people with eating disorders. They all told her they've seen

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Speaker 2: this trend in their patients.

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Speaker 1: I talked to one pediatric eating disorder doctor in New

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Speaker 1: York who said he's seen one to two cases of

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Speaker 1: eating disorders related to GLP ones like every month over

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Speaker 1: the last year. And so it's clear it's happening. To

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Speaker 1: what degree, We're not really sure.

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Speaker 2: Yet, and it's a problem that has the potential to

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Speaker 2: grow as more and more companies crop up to meet

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Speaker 2: the demand. Copycat versions of weight loss drugs like ozepic

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Speaker 2: are now being prescribed at medical spas, a seventeen billion

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Speaker 2: dollar industry where regulations very widely state to state. The

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Speaker 2: screening protocols for getting prescriptions at the spas have come

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Speaker 2: under scrutiny too, and Hymns is just one of at

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Speaker 2: least sixty telehealth companies selling weight loss shots. According to

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Speaker 2: a Bloomberg analysis.

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Speaker 1: Hymns and Hers, for example, primarily sold like erectile dysfunction

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Speaker 1: hair loss drugs, and then they started compounded GLP ones

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Speaker 1: earlier this year. So it's very clear that this is

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Speaker 1: something telehealth companies see as being a big part of

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Speaker 1: business and something that they need to jump on or

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Speaker 1: risk being sort of like left behind.

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Speaker 2: Just for telehealth companies, Hymns, Row Noom, and Henry Metz

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Speaker 2: have also spent a combined seventy one million dollars this

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Speaker 2: year on advertisements for their weight loss products, according to

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Speaker 2: data shared with Bloomberg by Media Radar.

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Speaker 1: That is something that eating disorder experts eating disorder organizations

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Speaker 1: have definitely been raising alarms about. They're really concerned about.

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Speaker 1: We know the impact of all of the cultural messaging

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Speaker 1: around thinness and dieting, like we know the impact that

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Speaker 1: that's had on our society, and so I think that

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Speaker 1: there's some concern that this will just exacerbate that further.

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Speaker 1: And I've talked to some eating disorder experts who are

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Speaker 1: concerned that we're all so like we had made some

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Speaker 1: progress toward body acceptance over the last couple of years,

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Speaker 1: slow progress, but that it was happening, and that this

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Speaker 1: is sort of taking us back a couple of steps

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Speaker 1: and is prioritizing like thinness again.

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Speaker 2: Weight loss drugs aren't going anywhere. Morgan Stanley analysts estimate

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Speaker 2: the market for copycat shots could be worth at least

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Speaker 2: two billion dollars annually and culturally. They sit at the

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Speaker 2: center of an evolving conversation about what a healthy body is,

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Speaker 2: who gets to decide that, and where people's relationship to

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Speaker 2: food and mental health intersect. Experts and doctors who Madison

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Speaker 2: spoke with echoed a similar sentiment that there's more providers

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Speaker 2: could be doing before prescribing these medications, that a lot

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Speaker 2: of this should start in a doctor's office or a

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Speaker 2: virtual screening, and that more sound guidance is better than less.

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Speaker 1: All the obesity doctors I talked to were like, absolutely,

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Speaker 1: one hundred percent. We need to be making sure that

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Speaker 1: they're asking about mental attitudes about someone's weight, how they

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Speaker 1: view themselves, how much time they spend thinking about food

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Speaker 1: and weight in their day, like things that really can

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Speaker 1: get at the mental aspect of this and how much

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Speaker 1: of a priority it is for someone.

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Speaker 2: As for Aj, he's still in treatment. When they last spoke,

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Speaker 2: AJ told Madison he wasn't doing well and couldn't speak

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Speaker 2: again for the story, but agreed to have his experience shared.

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Speaker 2: He said his priority was focusing on recovery. What do

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Speaker 2: specialists you've spoken with say that people should keep in

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Speaker 2: mind as they are navigating this new world where these

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Speaker 2: kinds of drugs are just becoming so much easier to get.

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Speaker 1: Anytime that there's a conversation about your health and you're

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Speaker 1: thinking about, you know, is this treatment right for me?

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Speaker 1: Like the important thing is to have a doctor or

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Speaker 1: a healthcare provider that you trust, that you can discuss

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Speaker 1: these things with and that you can be able to

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Speaker 1: like share or your medical history with and say is

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Speaker 1: this right for me? And get a real medical opinion.

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Speaker 1: And I think that the problem is that that's not

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Speaker 1: what's happening in a lot of cases right now. This

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Speaker 1: story isn't to say that weight loss drugs are bad.

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Speaker 1: It's just an important fact to consider as the use

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Speaker 1: of these drugs becomes more widespread, is that they're not

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Speaker 1: meant for everyone. When we're marketing these drugs on the

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Speaker 1: subway or on Hulu or whatever, like, it's just it's

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Speaker 1: a hard thing for some people. And I, you know,

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Speaker 1: doctor is an expert, say there just needs to be

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Speaker 1: more safeguards in place.

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Speaker 2: This is the big take from Bloomberg News. I'm Sarah Holder.

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Speaker 2: This episode was produced by Julia Press. It was edited

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Speaker 2: by Aaron Edwards and Rebecca Greenfield. It was fact checked

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Speaker 2: by Adriana Tapia and mixed and sound designed by Alex Huguiera.

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Speaker 2: Our senior producer is Naomi Shavin. Our senior editor is

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Speaker 2: Elizabeth Hanso. Our executive producer is Nicole beemsterbor Sage Bauman

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Speaker 2: is Bloomberg's head of podcasts. If you like this episode,

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Speaker 2: make sure to subscribe and review The Big Take wherever

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Speaker 2: you listen to podcasts. It helps people find the show.

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Speaker 2: Thanks for listening. We'll be back tomorrow