Review by Shakima Tozay DSW, MSW, LICSW, CCM
Mary Anne Cohen, a psychotherapist and director of the New York Center for Eating Disorders, has written a psychoeducational guide addressing general readers’ questions about the physical and psychological effects of injectable and oral GLP-1 medications, such as Ozempic. With growing media attention on GLP-1s for weight loss, Ozempic for Smarties is particularly relevant for social workers supporting clients in medical and behavioral health care settings, where awareness of both the short- and long-term impacts of these medications is essential.
Cohen, a clinical supervisor, professional speaker, and author of three books on emotional eating, brings decades of therapy experience to this subject. In 1982, she coined the now widely-used term “emotional eaters” to describe individuals struggling with dysfunctional eating patterns. Her clear and engaging writing, organized into five concise chapters, makes the book accessible to both general readers and professionals. The Introduction situates GLP-1s within the historical and current controversies surrounding their use and offers a timeline showing how they evolved from diabetes treatments to popular weight loss aids.
A particularly strong chapter is Chapter 3, where Cohen outlines the “Three Stages of Psychotherapy” experienced by individuals using GLP-1s. The Honeymoon Stage involves a newfound sense of control and accomplishment around eating behaviors. The Disillusionment Stage emerges when users confront the drug’s limitations in addressing deeper emotional issues, illustrated through three case examples from Cohen’s practice. The Adjustment and Ongoing Stage encourages individuals, once weight loss plateaus and emotional triggers surface, to identify the next steps in their healing. Cohen emphasizes that this final stage offers the best opportunity to address unresolved trauma.
Cohen’s central argument is that while GLP-1s may support weight loss, they do not resolve underlying emotional or psychological struggles that food has historically masked. Healing requires ongoing work that addresses both physical and emotional well-being. Drawing on research, case narratives, and her extensive professional experience, she encourages psychotherapists to explore the psychological aftermath of these medications, an aspect often overlooked by both practitioners and general audiences.
This book broadened my understanding of the emotional complexities associated with weight loss medications, especially for individuals with eating disorders. Cohen raises important considerations for mental health practitioners treating this population. Practitioners can use her framework to help clients understand the stages of psychotherapy associated with GLP-1 use and collaborate with them to develop a Personal Comprehensive Strategy, as outlined in Chapter 5.
A key message is that GLP-1s are not a magic solution for issues rooted in trauma, self-esteem, or self-worth. By normalizing problematic relationships with food and challenging the appeal of quick fixes, Cohen offers a timely and useful resource. I recommend Ozempic for Smarties to social work practitioners engaged in micro-level practice with clients navigating eating disorders, interpersonal trauma, or body-image concerns. Its concise structure, clinical insight, and practical guidance make it worth reading and sharing widely.
Reviewed by Dr. Shakima L. Tozay, LICSW, MSW, CCM, PMH-C, an Independent Clinical Social Worker licensed in Washington State. She obtained her Doctor of Social Work degree from the University of Alabama School of Social Work. With more than 18 years of clinical experience, she has an extensive background in military and Veteran social work practice.