Do Ozempic and Other Weight Loss Drugs Help or Harm Eating Disorders? Exploring the Complex Impact
Weight loss medications like Ozempic and Rybelsus gain traction, but their effects on patients with eating disorders raise significant concerns. While these drugs can reduce binge eating in certain individuals, they may worsen food avoidance behaviors and foster an unhealthy obsession with weight loss. As the popularity of these medications rises, experts emphasize the need for further research and enhanced screening for eating disorders.
When Penny Gautreaux began her journey with Rybelsus, an oral form of semaglutide, she quickly experienced unwanted side effects. “I noticed stomach pain and gastrointestinal distress almost immediately,” Gautreaux shared, stating that she started the medication in spring 2023 to manage her type 2 diabetes. This discomfort led her to lose interest in food altogether. “No food sounded appetizing,” she noted.
Weeks into the treatment, Gautreaux, who previously managed to overcome disordered eating habits, found herself slipping back into old behaviors. She became increasingly uninterested in food, even experimenting with how long she could go without eating. When she realized she had lost 12 pounds, she felt an unwelcome “thrill sensation” that triggered memories of her past struggles. Ultimately, Gautreaux chose to stop taking the medication.
“The severity of physical side effects, along with the complete disinterest in food, was simply too much for me to deal with and maintain my recovery,” she explained. Despite understanding her diabetes was a serious concern, she was aware that continuing the medication could lead to more damaging behaviors.
Gautreaux is among the estimated 15 million Americans who have used medications like Rybelsus, Ozempic, or Wegovy, all of which belong to the class known as glucagon-like peptide-1 receptor agonists (GLP-1). Originally developed for type 2 diabetes, many of these drugs have also received approval for weight loss. They are known to suppress hunger and lower body mass index.
For individuals with eating disorders, the drastic changes brought about by GLP-1s can trigger unique psychological responses. Although there is limited research on this topic, some studies suggest that GLP-1 medications can aid recovery from binge eating—a primary factor in disorders like binge eating disorder and bulimia nervosa.
Nonetheless, anecdotal evidence reveals a troubling trend: these medications can also amplify unhealthy thoughts surrounding eating. Elizabeth Wassenaar, MD, a regional medical director at the Eating Recovery Center, indicated that she has observed patients who have previously recovered from an eating disorder relapse after starting a GLP-1. Some of these patients even faced complications such as low blood pressure and bradycardia due to malnutrition.
The connection between GLP-1 use and worsening eating disorders raises vital questions about patient suitability for these medications, as well as how healthcare providers can effectively support patients navigating changes in their relationship with food.
How GLP-1s Might Worsen Eating Disorders
GLP-1 medications act by mimicking hormones that regulate insulin and help manage blood sugar levels. At the same time, these molecules influence brain regions connected to appetite control, slowing stomach emptying and reducing hunger.
Individuals on GLP-1s often experience weight loss within weeks, typically shedding at least 5% of their body weight after three months. While common side effects include nausea and gastrointestinal discomfort, psychiatrist Brad Smith, MD, explains that these medications can also exacerbate food avoidance in some cases.
- Disordered Eating Aggravation: For those with conditions like anorexia or bulimia, these effects may reinforce unhealthy eating patterns and heighten obsessive thoughts about food.
- Behavioral Manifestation: Some patients may continue taking GLP-1s, even if their condition worsens—effectively lengthening their struggle with disordered eating.
- Lack of Awareness: Patients may not even recognize their own eating disorders before beginning treatment.
Take the example of Jerry, who discussed the possibility of using GLP-1s with his doctor in 2021 to manage type 2 diabetes. Neither recognized his history of disordered eating. After several months on Ozempic, Jerry found himself obsessing over small details of his food consumption, ultimately leading to a diagnosis of atypical anorexia.
Research Into a Possible Cure
Despite potential risks, researchers are investigating how GLP-1s might positively impact patients with binge eating disorders. A study from 2024 involving 229 participants indicated that those with binge eating disorder experienced fewer episodes after taking GLP-1s for a few months.
This potential has been mirrored in Helen Purves’ experience. After battling binge eating disorder from a young age, Purves found success with Mounjaro, a GLP-1 medication. “I realized how badly my eating disorder ruled me. Now I’m so much less hung up on what I want to eat,” she recounted.
While some studies suggest that GLP-1s may benefit compulsive eaters, Wassenaar cautions that existing research is small and short. Currently, no GLP-1s are FDA-approved specifically for treating eating disorders.
Moving Forward
Experts agree that more research is necessary to understand how GLP-1 medications affect those with eating disorders. A spokesperson from Novo Nordisk, which manufactures several GLP-1 offerings, stated that their products aren’t indicated for treating eating disorders.
As popularity grows, doctors should proactively educate their patients on these medications. This includes screenings to identify vulnerabilities related to eating disorders. Effective patient-provider communication is crucial, especially as GLP-1s impact mental and physical health.
Ultimately, experts stress that as the landscape of weight loss medications evolves, it’s worth scrutinizing how they shape societal perceptions of ideal body types. With this ongoing exploration, healthcare providers have an opportunity to address the complex interplay between weight loss drugs and eating disorders.
