GLP-1 Medications and Eating Disorders: A Cautious Reflection
In recent years, GLP-1 medications such as Ozempic, Wegovy, and Mounjaro have surged in popularity. Originally developed to treat type 2 diabetes, these medications are now frequently prescribed—and often self-sought—for weight loss. In higher-income areas like ours, individuals can afford to pay out of pocket for these costly drugs, even when insurance does not approve them.
As a psychotherapist specializing in eating disorders, I hold both professional respect and deep concern for this class of medications. GLP-1s are powerful tools with immense potential. But like all powerful tools, they demand careful handling—especially in a culture that continues to conflate weight with worth.
The Medical Value of GLP-1s
To be clear: GLP-1 receptor agonists can be lifesaving. For individuals with high A1C levels, insulin resistance, or obesity-related medical conditions, these medications can improve metabolic function, reduce inflammation, and lower the risk of serious long-term complications like cardiovascular disease.
In such cases—when prescribed within the context of a thoughtful, comprehensive medical plan—their use is not only appropriate, but potentially transformative.
But There’s Another Side
More recently, I’ve seen an increasing number of individuals—some of them adolescents, others with normal or even low body weights—pursuing these medications purely for cosmetic weight loss. I’ve had clients return after years of recovery and hard-won body neutrality, panicked because their physician recommended a GLP-1 simply because they were slightly above the “ideal” BMI.
This is deeply concerning for several reasons:
Appetite suppression is often celebrated in a culture steeped in disordered eating.
Weight loss at the expense of muscle mass and nutritional adequacy is not health—it’s harm.
Individuals with a history of eating disorders are at high risk of relapse when prescribed medications that reward restriction and suppress natural hunger cues.
GLP-1s are not exempt from the long shadow of diet culture. They are often marketed in ways that reinforce the very appearance-driven ideals we work to dismantle in therapy.
The eating disorder field is still grappling with how to respond. While some individuals with binge eating disorder (BED) are being prescribed GLP-1s, these medications bypass a core component of treatment: learning to eat intuitively, listening for internal signals of hunger, fullness, satisfaction, and trust. GLP-1s can dampen or disrupt these cues entirely.
Some of my clients have felt temporarily “cured” of the intrusive food thoughts and cravings often referred to as “food noise.” But what happens when they have to stop the medication—whether due to side effects, cost, or life transitions like pregnancy? I’ve watched individuals who had built solid recovery and confident, intuitive eating patterns experience a sudden and painful resurgence of symptoms. The disruption can be devastating.
The Eating Disorder Risk
We now have growing evidence that some individuals on GLP-1 medications develop:
Obsessive thoughts about food or eating
Loss of interest in food or pleasure
Symptoms of depression
Rapid, sometimes dangerous, weight loss
Re-emergence of eating disorder symptoms—including anorexia, bulimia, and BED
These are not isolated anecdotes—they are clinical red flags that must be taken seriously.
What We Need: A More Ethical Approach
It is time for a more nuanced and ethical conversation—one that includes eating disorder clinicians, endocrinologists, primary care providers, and, most importantly, patients.
I advocate for the following:
Thorough screening for eating disorder history before prescribing GLP-1 medications
Integrated care between prescribers and mental health professionals; individuals with current or past eating disorders should only use GLP-1s under the care of an eating disorder-informed therapist
Informed consent that clearly outlines both physical and psychological risks
Public messaging that shifts away from weight-centric definitions of health and emphasizes holistic well-being
Final Thoughts
There is no one-size-fits-all solution in healthcare. But when medications with powerful metabolic effects are used in ways that may erode psychological health, it is our responsibility as clinicians to pause, reflect, and speak out.
GLP-1s are not inherently harmful. But their misuse—particularly in pursuit of thinness—can cause serious harm, especially to those vulnerable to disordered eating.
In our collective work to reduce suffering and promote true health, we must continue to ask hard questions and hold space for complexity, compassion, and courage.
If you're struggling with disordered eating or body image concerns—and feeling unsure about how to navigate medical advice—please reach out. You are not alone, and help is available.
