At this point, it feels like everyone is talking about GLP-1s, the so-called “miracle drug” that often results in rapid weight loss. GLP-1s, often known by brand names such as Ozempic, Wegovy, or Zepbound, are a new class of medications that help regulate blood sugar and often result in weight loss. While they are an FDA-approved treatment for type II diabetes and weight management, they are not an approved treatment for eating disorders. And if you are someone with a history of eating disorders or disordered eating, discussions about GLPs can be really challenging to navigate.
How do GLPs work?
GLPs work by stabilizing blood sugar and reducing a person’s appetite and food cravings, particularly for calorically dense, high-fat food. They slow down gastric emptying, so food remains in the stomach for longer, which prolongs feelings of fullness. They also reduce the impact of dopamine, which reduces the brain’s reward response to high carbohydrate and sugary food. People often report the reduction of “food noise,” meaning that they spend less time thinking about food. In addition to diabetes and weight loss, evidence shows that GLPs are helpful in reducing the risk of heart attacks, strokes, kidney disease, and sleep apnea.
Are GLPs approved for eating disorder treatment?
No. Eating disorder treatment is complex and individualized, but usually contains a few key elements, including: tuning into the body’s natural hunger and fullness cues, eating regular meals and snacks, and learning your body’s set point weight. Since the use of GLPs dulls hunger and fullness cues and makes it more challenging to eat regular meals, it often works against stated treatment goals. Delayed gastric emptying and prolonged feelings of fullness can be triggering for many people, which can increase eating disorder symptoms. Furthermore, while most people experience rapid weight loss on GLPs, they often quickly regain the weight back if they stop using them. This perpetuates weight cycling, which can be particularly harmful for people with eating disorders.
What about for Binge Eating Disorder (BED)?
No. While there are a small number of studies showing a reduction in binges for people with BED, far more research is needed to draw any conclusions.
What should I consider if my doctor recommends I take a GLP?
Any decision regarding medication should be made in tandem with your doctor, after carefully weighing the risks and benefits. It is important for your doctor to be eating disorder-informed so they can make the best recommendation for you. If you do decide to take a GLP medication, it is important to learn as much as possible about the medication (including side effects), engage in regular monitoring, and work with a multidisciplinary team of professionals who know your eating disorder history. It is also important to engage in other parts of eating disorder treatment and prevention as well, including learning emotional regulation skills that will help you establish a better relationship with food.
