In recent years, there’s been a growing interest in GLP-1 medications for weight loss, with many people exploring their potential benefits. But when it comes to GLP-1s and eating disorders, the conversation becomes much more nuanced. This is an important and sensitive topic, particularly for individuals who may be struggling with their relationship with food and body image.
We want to acknowledge upfront that there is no shame in being curious about GLP-1s or even using them. People are allowed to want to feel better in their bodies. However, it’s equally important to offer clear, compassionate guidance: GLP-1s are not a treatment for eating disorders, including binge eating disorder (BED).
What Are GLP-1s?
GLP-1 (glucagon-like peptide-1) receptor agonists are a class of medications originally developed for managing type 2 diabetes. Some of the most well-known include semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda). In recent years, higher doses of these medications have been prescribed for weight loss.
On the NHS, access to GLP-1s is typically limited to those with a BMI over 35, a qualifying comorbidity, and active participation in a weight management service. Even then, availability is restricted.
How Do GLP-1s Work?
GLP-1 medications work by slowing gastric emptying, reducing appetite, and altering the brain’s reward response to food. This can result in substantial weight loss, particularly in the first year. But these are mega doses of diabetes drugs, and they don’t come without risk.
Common side effects include:
- Gastrointestinal discomfort (nausea, constipation)
- Acute pancreatitis
- Dehydration (due to reduced thirst)
- Psychiatric side effects, such as mood changes
- Concerns about thyroid cancer
These side effects can significantly impact nutritional status. Some people on GLP-1s may lose their appetite completely and struggle to eat enough. In a culture that often glorifies eating less, this can create a dangerous dynamic for those already at risk.
Weight Cycling and Long-Term Outcomes
GLP-1s are typically prescribed for up to two years. During this time, most people experience rapid weight loss, which tends to plateau after about 12 months. However, research has shown that once the medication is stopped, the majority of the weight, sometimes up to 100% of it, is regained within 18 months.
This weight cycling is not just frustrating; it’s also physiologically and psychologically harmful. It can increase the risk of metabolic issues, depression, and disordered eating behaviours.
The Overlap Between GLP-1s and Eating Disorders
Up to one-third of patients attending weight management services may have an undiagnosed eating disorder. In fact, many eating disorders, especially those with Binge Eating Disorder or Atypical Anorexia, go unnoticed or are minimised.
Binge eating disorder has physiological drivers that GLP-1s can target, such as appetite regulation. However, the emotional and psychological aspects of binge eating disorder remain unaddressed. This can sometimes lead to symptom substitution, where bingeing may be replaced with restriction or compulsive exercise.
The longest and most comprehensive studies on GLP-1s and binge eating have found that while binge episodes might initially reduce, they return over time. Treating only the binge behaviour and not the underlying psychological drivers risks BED converting into a different type of eating disorder. There is currently no evidence to support GLP-1s as a long-term treatment for binge eating disorder.
Why GLP-1s Are Not Safe for Eating Disorder Treatment
For anyone with an active eating disorder or a history of disordered eating, GLP-1s can create a “perfect storm.” The appetite-suppressing effects can reinforce restrictive behaviours. Side effects like nausea may be interpreted as success. And the weight-centric focus of these drugs can trigger or worsen body image issues.
Moreover, GLP-1s do not address the root causes of eating disorders, which often involve trauma, emotional dysregulation, and societal pressures. Without comprehensive, person-centred care, there’s a real risk of harm.
Compassionate Alternatives to GLP-1s
If you’re struggling with your relationship to food or your body, you’re not alone. And there is support that truly helps:
- Evidence-based eating disorder treatment (e.g., CBT-E, MANTRA, Guided Self Help)
- Working with a registered mental health dietitian
- Body image therapy and trauma-informed care
- Peer support and group therapy
These approaches are designed to heal, not just suppress symptoms. They address both the nutritional and emotional needs of individuals, offering sustainable recovery.
A Final Word on GLP-1s and Eating Disorders
We understand the allure of a quick fix, especially in a society that places to much value on the way that we look. However, when it comes to GLP-1s and eating disorders, we urge caution. The risks far outweigh the perceived benefits, especially when the root of the issue isn’t weight or the eating behaviour, but psychiatric illness.
We Are Here to Help
If you are currently using GLP-1s or are working with a client who is and you are unsure whether it is safe for them to be doing so, please speak with a qualified healthcare provider. And if you’re considering them, know that there are other paths to feeling better in your body.
We are here to help. Our team of specialist dietitians focuses on mental health and eating disorders. We aim to support you in becoming your healthiest and best self while helping you achieve your personal goals. You can send us a message here or find out more about our services here.
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Blog written by Han
Han is a mental health digital marketing specialist and advocate. Her passion lies in supporting others with their mental health through science communication and creativity. She has a background in mental health research and digital marketing and is also the host of the eating disorder podcast, Full of Beans.
After struggling in the corporate world, Han chose to go freelance as a mental health digital marketing specialist under her brand, Full of Beans. Her mission is to empower mental health professionals, like Mental Health Dietitians, to share their expertise and connect meaningfully with their audiences.
Han’s ultimate goal is to give a voice to individuals who have faced mental health challenges. She strives to make them feel seen, heard, and hopeful about the future. Whatever you are going through, you are never alone, someone will always listen or share your experience.
