It is hard to go a day without hearing about GLP-1 medications. Drugs like semaglutide (sold as Ozempic and Wegovy) and tirzepatide (sold as Mounjaro) are all over the news, social media, and celebrity interviews. These medications are FDA-approved to help manage type 2 diabetes and, for some people, obesity (Cleveland Clinic). When a physician prescribes and monitors them, they can play an important role in medical care. But for someone who is struggling with an eating disorder, a GLP-1 is not a substitute for eating disorder treatment.
What GLP-1 Medications Actually Do
These medications are not all the same. Semaglutide is a GLP-1 receptor agonist, meaning it mimics a single natural hormone in the body: GLP-1. Tirzepatide is a dual agonist that targets two hormones, GLP-1 and GIP, both of which affect appetite and blood sugar (Cleveland Clinic). According to the Cleveland Clinic, GLP-1 agonists help the pancreas release insulin, slow how quickly the stomach empties, and act on areas of the brain that control hunger, so people feel full sooner and eat less. Even for their approved uses, the Cleveland Clinic notes that "GLP-1 agonists alone can't treat Type 2 diabetes or obesity."
What these medications are not designed to do is treat the reasons someone is struggling with food. The National Institute of Mental Health describes eating disorders as "serious illnesses marked by severe disturbances in a person's eating behaviors." They involve thoughts, emotions, and beliefs about food, weight, body shape, and self-worth. A medication that turns down hunger does not address shame, perfectionism, anxiety, or the fear of gaining weight.
Why We Are Concerned About Appetite Suppression and Restriction
For people with restrictive eating patterns, the idea of a drug that makes it easier not to eat can be appealing for the wrong reasons. An eating disorder may already tell someone that hunger is a weakness and eating less is an achievement. From a treatment perspective, we worry that a medication that quiets hunger can make restriction feel easier, which is the opposite of what recovery requires.
Not getting enough fuel has real physical consequences. The National Eating Disorders Association (NEDA) explains that when the body is undernourished, it begins breaking down its own tissue for energy, and "muscles are some of the first organs broken down." NEDA also lists dizziness or fainting, a drop in body temperature, difficulty concentrating, and brittle hair that falls out among the possible effects of restriction.
Hair loss has also been reported by people taking GLP-1 medications. The American Academy of Dermatology says dermatologists believe this thinning is linked to the sudden weight loss people experience on these drugs, though more research is needed. Changes like these can be upsetting, and you should discuss them openly with both your doctor and your therapist.
What About Binge Eating?
Researchers are studying whether GLP-1 medications could help people with binge eating disorder. One 2023 retrospective study in Obesity Pillars found greater reductions in binge eating scores among patients prescribed semaglutide than among those prescribed other medications. Because it reviewed existing patient records rather than testing the drug in a controlled trial, more research is needed.
For now, the American Psychiatric Association's eating disorder guideline, as summarized by the American Academy of Family Physicians, states that binge eating disorder is best treated with cognitive behavioral therapy (CBT) or interpersonal psychotherapy, with medication added in some cases. In other words, therapy remains a core part of care.
Any decision about medication should be made with a physician who knows your full history, including any history of disordered eating. If you are considering a GLP-1 and have struggled with food in the past, it is worth having that conversation openly.
The Cultural Message Behind the Trend
Part of what makes this moment difficult is the message that often surrounds these medications. When dramatic weight loss is celebrated without any conversation about health, it reinforces the idea that a smaller body is always the goal and that any way of getting there is acceptable. For people who are vulnerable to eating disorders, including teens and young adults, we believe that message can be harmful.
Recovery is not about finding a faster way to eat less. It is about building a relationship with food and your body that is flexible, nourishing, and no longer controlled by fear.
Signs It May Be More Than a Medication Question
If you or someone you love is using or seeking out a GLP-1, it may be worth looking more closely if you notice:
Using the medication without medical supervision, or buying it from unverified online sources (the FDA has warned about counterfeit and unapproved GLP-1 products)
Feeling relief or pride at not being hungry, or anxiety at the thought of hunger returning
Skipping meals or eating far less than your body needs
Continued preoccupation with weight, body shape, or calories, even after weight loss
Hair loss, dizziness, feeling cold, trouble concentrating, or other physical changes
Low mood, irritability, or withdrawal from friends and activities
A history of an eating disorder that was never fully treated
What Actually Helps
According to the National Institute of Mental Health, "eating disorders can be treated successfully." At The Smith Counseling Group, our therapists use approaches including cognitive behavioral therapy for eating disorders and, for children and adolescents, family-based treatment. You can learn more on our eating disorder treatment page.
Because eating disorders can occur alongside anxiety, depression, and trauma, we take an integrated approach. Our anxiety treatment and psychotherapy services address the emotional patterns connected to disordered eating. For parents who are worried about a teen, our family-based therapy can help the whole family support recovery.
If you are struggling, there is nothing shameful about wanting relief. You deserve lasting relief and care that treats the whole person.
The Smith Counseling Group provides eating disorder treatment at our Maryland office for clients from Maryland, Washington, DC, Bethesda, Chevy Chase, Northern Virginia, and Montgomery County. Telehealth is available to Maryland residents. Contact Us to Talk With a Therapist.
