Laura Hall was doing everything right. After a lifetime of profound struggles with compulsive eating, the Fort Worth, Texas, resident had finally put together all the pieces of a healthy lifestyle. She was eating a plant-based diet and had cultivated healthy exercise habits. Around 2017, she hit her goal weight. But last year, at age 52, Laura found herself putting on menopausal weight and didn’t seem able to stop gaining. And though she had largely gotten her binge eating under control, and she was satisfied with her wholesome diet, the compulsion to overeat still haunted every meal. When she asked her doctor about semaglutide, the blockbuster weight loss drug sold as Ozempic and Wegovy, she wasn’t an obvious candidate for it. The drug is not recommended for people without diabetes or those who do not have a clear medical reason to lose weight, and Laura only wanted to lose about 30 pounds. Experts do not know if patients like Laura can use semaglutide safely. RELATED: Everyday Health’s Survey and Special Report: Weight Loss Reframed As it turned out, semaglutide didn’t just help her get to her goal weight — it freed her from the intrusive and obsessive thoughts around food that had plagued her for decades. “I never knew how to create ease around food and my body, and now I have it,” Laura says. Semaglutide, she says, was “the last piece of the puzzle.” A Lifetime of Compulsive Eating Laura’s compulsive eating had an early and very traumatic beginning: “I was sexually abused as a kid, and food was my coping mechanism. I started overeating when I was very, very young.” She also grew up in a genetic and cultural environment that seemed primed to encourage unhealthy eating habits. “My entire family is obese,” she says. One grandparent, who died of the complications of type 2 diabetes, weighed about 400 pounds. Laura spent much of her adolescence with bulimia , repeatedly binging on food and then purging (making herself vomit). In college, she stopped vomiting but pivoted to exercise bulimia, working out “excessively,” she describes, to compensate for her compulsive eating. “I was still bulimic, but I wasn’t throwing up,” she explains. When she looks back, she’s shocked “at the amount of abuse I put my body through just so I could eat a bunch of s***.” The binge eating never went away, and as she aged, Laura saw her weight fluctuate depending on how much time she devoted to working out. In her early thirties, Laura taught aerobics, raced bikes, and competed in triathlons. But a career shift cut into her exercise time, and “that’s when the weight just piled on,” she says. Laura took drastic action. She had lap band surgery, a procedure in which doctors place a silicone band around the stomach to reduce its capacity. At only 200 pounds and not yet clearly suffering from obesity-related health issues, Laura was not an ideal candidate for the procedure. Her insurance wouldn’t cover it, and she paid for the surgery out of her own pocket. Lap band surgery is supposed to reduce hunger levels. According to the Cleveland Clinic , “the upper stomach pouch will fill up quickly, making you feel fuller faster.” Ideally, the size reduction allows patients to eat fewer calories with relative ease. But Laura sometimes kept eating even when she wasn’t hungry, and the belt around her stomach only made her binge eating even more problematic. “If you eat too much, it displaces the lap band, and then you can’t eat anything — you can’t even keep water down. It’s a miserable experience,” she says. “I overate to the point where it slipped, and I had to get revision surgery, not once but twice.” It was a financial disaster for Laura. She had to cash out retirement funds to help pay for the additional procedures, and when she decided that she should have the band permanently removed, she couldn’t afford to have it done. Eventually, she flew to San Diego and crossed the border to Mexico, where a Tijuana clinic offered lap band removal surgery for a fraction of the price she would have paid in the United States. Losing Weight the Hard Way In early 2016, Laura weighed about 180 pounds, “heavier than I wanted or needed to be,” she says. A confluence of factors — including the death of her mother, a grueling experience, and the introduction of a community-led healthy living Blue Zones Project initiative in Fort Worth — finally inspired Laura to make healthy changes. “I made a major lifestyle shift. I started eating a whole-foods, plant-based diet and stopped drinking alcohol. My weight dropped to about 125 pounds within a year,” she says. “I’d make one small change every few weeks. It wasn’t about weight — it was about health, and that was a new thing for me.” Though her family initially mocked and doubted her, Laura stuck with the changes and is still enjoying her new diet today. “That was my life, and I was happy. It’s a good way to live,” she says. But it was never easy. Though Laura was able to manage her eating compulsions for the first time in her life, “it was a constant, white-knuckle struggle — constant,” she describes. An Extra 30 Pounds Like so many others, Laura gained more than a few pounds during the pandemic. But when she got back on track with her good habits, the weight simply would not come off. She attributes the difficulty to the hormonal shifts characteristic of the menopausal transition , which are known to affect metabolism and cause weight gain. “I was doing the exact same movement and eating routine, but I had 30 extra pounds on,” she says. “It doesn’t sound like much, but it was a lot to me.” Despite her fastidious lifestyle, Laura was gaining about two pounds per month. This caused immense frustration because she was sure that she was making healthy diet and exercise choices. It seemed clear that she’d never again approach her goal weight without some kind of medicinal help. Finally, inspired by a friend’s success, she asked her doctor about semaglutide, the blockbuster weight loss drug originally developed to treat type 2 diabetes. Laura didn’t satisfy any of the established medical criteria for semaglutide: She doesn’t have diabetes and at this point was only barely overweight. Semaglutide is associated with a large number of side effects and risks , both known and suspected. These risks could be increased in patients who are not medically qualified to use the drug in the first place. Some experts, for example, are concerned by evidence that semaglutide causes excessive muscle loss, as reported by Diabetes Daily, and a recent CNN investigation identified especially severe cases of stomach paralysis known as gastroparesis. European regulators, meanwhile, are investigating reports that the drug has caused self-harm and suicidal ideation . Although her doctor was willing to write her an off-label prescription, Laura couldn’t afford the $1,000 per month out-of-pocket cost. To find affordable semaglutide, Laura turned to the internet, which hosts a growing network of online healthcare providers and weight loss programs offering less expensive compounded weight loss drugs with only a bare minimum of medical oversight. Laura took advantage of one supplier’s carelessness by fibbing on her intake form: “I added a few pounds and took off an inch of height, so I’d be sure to qualify,” she admits. Experts have cautioned against using less scrupulous online healthcare providers , and the U.S. Food and Drug Administration has warned that compounded forms of semaglutide may lack the proven safety or efficacy of Ozempic and Wegovy. But for Laura, the medicine has been transformative. Food Noise Relief Laura proclaims that semaglutide ended her lifelong battle with compulsive eating “immediately. The food noise in my head shut the f*** up for the first time in my life.” Others have experienced the same relief. They say that semaglutide is helping silence their food noise. Although there’s no precise definition or measurable medical standard, food noise refers generally to intrusive thoughts and preoccupations about food. Laura spent most of her life obsessing over what she ate or was about to eat. “It’s a freedom that I never thought I’d have,” she says, stifling tears. “I’ve been struggling with this since I was 8 years old. That’s a lot of years. I’m 52 years old — do the math.” Semaglutide doesn’t just suppress hunger; it appears to have an effect on the brain’s reward system, too. Researchers believe that semaglutide could be a powerful anti-addiction drug , and anecdotal reports indicate that it may help quell compulsive behaviors such as nail-biting and binge shopping. On the flip side, some have found that squelching the desire for food takes the joy out of eating and isn’t worth it. For Laura, her relief from food preoccupations has allowed her to reevaluate the history of her own diet failures. In recent years, for example, Laura experimented with intermittent fasting and blamed herself when the trendy eating pattern did not help assuage her compulsive tendencies. “I thought it was my fault that fasting wasn’t easy,” she says. Now she believes that her failures were chemical — an imbalance that semaglutide helps correct — rather than the result of insufficient willpower or commitment. Better Living Through Chemistry With her food noise and appetite suppressed, Laura easily lost the 30 pounds she wanted to lose. She’s holding steady at about 125 pounds. Now that Laura has hit her goal weight, how long does she intend to use semaglutide or a related drug? “Forever,” she says She’s happy with where she is now in her weight loss journey. “Life doesn’t have to be as hard as I’ve made it. Who says it has to be hard? Semaglutide makes it easy for me,” she says. “I’m gonna let it be easy.” Everyday Health ‘s Weight Loss Reframed Survey queried 3,144 Americans nationwide ages 18 and older who had tried losing weight in the previous six months. The study was fielded between July 10 and August 18, 2023, across demographic groups, genders, and health conditions. Survey recruitment took place via an online portal, in app, and via email. The margin of error for the sample size of 3,144 is +/-1.7 percent at a 95 percent confidence level.
