My friend Sarah left me a tearful voicemail eight weeks after giving birth. I'm a clinical psychologist specializing in postpartum depression and psychosis, but mental health was not Sarah's issue. There was postpartum weight gain.
Sarah told me she needed help. She gained 40 pounds during her pregnancy, but was still 25 pounds overweight. “I go back to work and I can’t look like this,” she said. “I need to take Ozempic or something. But do you know if it's safe?”
Great question. Unfortunately, researchers don't have an answer yet. On December 1, the World Health Organization published its first recommendations for the use of GLP-1 receptor agonists. such as Ozempic, known generically as semaglutide. One of the notable policy proposals in this report is not to prescribe GLP-1 to pregnant women. Unfortunately, the report does not say anything about the use of the drug in postpartum women, including breastfeeding women.
There was recent Danish study this has led to medical recommendations prohibiting the drug from being prescribed to pregnant or breastfeeding patients.
My friend didn't want to hear any of this. All I could do was convince her to talk to her own doctor.
Sarah is not alone. In my practice, I have noticed a trend of women using GLP-1 for weight loss after childbirth. The ideal body shape for new mothers at warp speed “return” has re-emerged despite mental health propaganda aimed at abolishing the archaic pressures of martyrdom in motherhood. GLP-1 is sold and distributed in pharmacies such as candy. And judging by their popularity, there is nothing sweeter than the feeling of being thin.
New motherhood can be a stressful time for the body and mind, but nature has also prepared us for incredible growth during this time. Contrary to the myth about “mother’s brains” being blown apart, new neuroplasticity research shows that the mother's brain rewired for enormous creativity and problem solving.
How might GLP-1 influence these dynamics? We just don't know. We know that these drugs cause changes well beyond weight loss, potentially including psychiatric effects such as fight against addiction.
Beyond the physical effects, this points to an important unanswered research question: What effect, if any, does GLP-1 have on a woman's brain as it rewires itself to tune in to and care for the newborn? What about on an infant? If GLP-1 affects the pleasure center of the brain and your brain rewires itself to feel great pleasure from a baby's cooing, I can't help but wonder if this will be weakened. When a new mother wants to get a prescription for GLP-1 to help her baby lose weight, her doctor must highlight these unknowns.
These drugs may someday become a useful tool for new mothers. GLP-1 helps many people suffering from more than just obesity. My colleague was born with high blood pressure and cholesterol. She worked out every day and followed a pescatarian diet. Nothing changed until she added GLP-1 to her regimen, bringing her blood pressure to a healthy 120/80 and getting her cholesterol levels under control. My brother, an otherwise healthy young man who was recently diagnosed with rare idiopathic lymphedema in his left leg, is considering GLP-1 to treat inflammation and may be given another chance to improve his quality of life.
I hope that GLP-1 will continue to help those in need. And I urge everyone, especially new mothers, to proceed with caution. A healthy appetite for nutritious food is natural. This food gives us strength to walk the dogs, swim along the coastline, climb through the deciduous forest. He models health and balance for the young people who watch us for tips on how to live a healthy lifestyle.
Nicole Amoyal Pensac, a clinical psychologist and researcher, is the author of Anxious: How to Calm an Anxious New Mom with the Power of the Postpartum Brain.
