Thinking about a GLP-1 like Ozempic to stop binge eating?
Here's an eating disorder dietitian's honest opinions
You don't have to choose between Ozempic and recovery, but there are a few things to consider
Who this article is for:
- You're exhausted by constant 'food noise' or thoughts about food
- You experience binge eating, and feel like you've tried everything
- You're wondering whether Ozempic or another GLP-1 might finally be the answer
- Maybe you're already on a GLP-1 and noticing the emotional eating is still there
- Or maybe you're wanting to stop a GLP-1 soon, and worried about how you'll manage
- You want to understand your options before making a decision
Read ahead to learn all the details, and if you'd like our team to help you, book in a free, no obligation chat with Director and Dietitian Emma Robertson here:
If you've spent years in a complicated relationship with food - the late-night binges, the shame spiral that follows, the desperate attempts to "get back on track" - it's completely understandable that a drug promising to quiet the noise in your head around food sounds almost too good to be true.
GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) have generated enormous excitement, and the personal stories can sure feel compelling. People describe feeling free from food for the first time. One client described starting Ozempic and asking, "Is this how normal people live every day?" - floored to realise how much of her mental bandwidth had been consumed by thoughts of food!
So why can't a drug like this cure binge eating disorder? The answer comes down to a fundamental truth: binge eating disorder isn't about hunger. And a drug that addresses hunger can only do so much.
What GLP-1 medications actually do
GLP-1 receptor agonists were originally developed to treat type 2 diabetes. They work by mimicking a naturally occurring gut hormone that stimulates insulin release, slows digestion, and - importantly - signals to the brain that you're full. These medications also appear to reduce food-related responses in the brain, quieting the constant "food noise" that people with eating disorders typically experience. In doing this, they actually also reduce enjoyment and pleasure from food. So for people who also experience depression and struggle to find things that provide genuine enjoyment, this could actually be quite a negative side effect for overall mental health.
For people whose overeating is primarily driven by alterations to physical hunger cues from a medical condition or by metabolic factors (eg, you have insulin resistance, or your blood sugar is chronically high, so you still feel hungry because your cells aren’t able to access the energy you’re eating), this can be genuinely helpful.
There isn’t much research looking at what happens to typical people with binge eating disorder who don’t have such a clear medical reason to take a GLP-1. What little research there is does point to a short-term reduction in frequency of binges (well of course!). But in my mind, this research is of no use unless it also tracks people after they stop using the drug for at least as long as they were taking it.
Anyway, here's the critical point: reducing binge episodes a bit on a drug is not the same as recovering from binge eating disorder. Those symptoms and behaviours will unfortunately likely be there waiting for you when you eventually stop taking it.
Binge eating disorder is not about physical hunger
During binge eating episodes, people often feel completely out of control — unable to stop, even when they are not physically hungry. One client of mine describes the intensity of their urges as ‘… it feels like my hand is on a hot plate, and I have to take it off immediately!’. Many people with binge eating disorder eat quickly, often alone, driven by intense emotions more than physical need.
This is the crux of the problem. Binge eating disorder is a mental health condition with deep emotional and psychological roots. Binge eating episodes are often triggered by a mix of emotional stress, interpersonal conflicts, as well as dietary restriction. Many people use food as a way to cope with stress, sadness or anxious feelings, and a degree of eating for emotional reasons is common and normal. But binge eating disorder is different. It’s nothing to do with a lack of willpower or self-discipline. It is a serious mental health disorder rooted in biology, genetics, how our bodies evolved to survive famine, cultural pressures, emotional distress, and for many people their binge eating helps them to cope with the symptoms of other mental health conditions, or past trauma.
A GLP-1 medication can reduce physical appetite. It cannot resolve unprocessed grief. It cannot address childhood trauma. It cannot change the patterns of thought and emotion that have, over years, become deeply tied to your relationship with food.
As Chevese Turner, CEO of the Body Equity Alliance and a person in recovery from both binge eating disorder and atypical anorexia (and work-famous person I’m a huge fan-girl of!), put it plainly after starting Ozempic for diabetes: "After a lifetime of using food to help manage my emotions, and then using restriction to help manage my emotions, I was always using one or the other... Even if the drug caused fewer cravings, the instinct to use food or restriction to manage emotions was still there."
What the research actually says… or doesn’t say!
It's important to be honest about where the science stands. At time of writing (April 2026), although these drugs are well tested and effective for diabetes management, there is not enough evidence to support the use of GLP-1s to treat eating disorder symptoms. More research is required before definitive conclusions can be drawn.
The studies that do exist are small and have significant methodological limitations. The only blinded, randomised controlled trial of a GLP-1 medication for binge eating disorder involved just 27 adults. Both the treatment group and the placebo group experienced decreases in binge episodes, and while the liraglutide group showed a greater reduction, the difference between groups did not reach ‘statistical’ significance. Mind you- statistical significance is often not significant in real life terms anyway- it might mean just a couple of percent reduction in average number of weekly binge episodes. Hardly worth having for the extreme cost of the drug...
GLP-1 medications are not approved - by the TGA, or any regulatory body - for the treatment of eating disorders of any kind. They are approved for type 2 diabetes and, in higher-dose formulations, for weight loss. Although as with every other new fancy weight loss method. The results are temporary, reverse upon stopping the drug, and leave you with a further reduced metabolic rate. This is how our bodies are built to survive famine, but it’s also because GLP-1 medications seem to cause a lot of offloading of muscle mass, and muscle is something that maintains a higher metabolic rate.
Evidence also suggests it is possible that GLP-1s could exacerbate or contribute to the development of eating disorder pathology and negatively impact recovery. This is particularly concerning because the appetite suppression and dietary restriction that GLP-1s produce can be a maintaining factor in the binge-restrict cycle - the very cycle that keeps binge eating disorder going!
The binge-restrict cycle: why suppressing appetite can backfire
One of the most important - and counterintuitive - insights in eating disorder treatment is that restriction and binge eating are not opposites. They are partners.
The core concept in most treatment approaches for binge eating disorder focuses on the "diet cycle": Anyone who’s ever attempted to diet to lose weight (almost everyone? Myself definitely included!) knows that feeling of needing to eat *all the things* after a few weeks on the diet. The main physiological driver of binge eating disorder symptoms is actually just this, but usually with shorter cycles. Most people with binge eating disorder are actually restricting their food intake, or have a long history of having experienced past episodes of restriction, and that this deprivation is what leads to the loss of control involved in binge eating episodes.
*Note- there are actually 3 main forms of restriction. Total calories is obvious. Skipping a major nutrient source (like poor old carbs!) is a less obvious one. The third: mental restriction. Yep, you can still be eating the feared or trigger foods, but the part where you feel extreme guilt afterwards and silently vow to stay away from them in future? That lights up brain pathways that helped us survive in a pre-agricultral world. Hyperfocus and constantly thinking about those foods that were coming to the end of their growing season helped us meet nutrient needs and increased our chance of surviving. Food guilt and remorse trips the same wires as actual restriction! Anyway, back to the story...
When a GLP-1 medication suppresses your appetite significantly, it can inadvertently re-create the conditions of restriction — leaving the emotional drivers of binging completely unaddressed, and potentially priming the body and mind for a more intense return of symptoms when the medication is stopped or becomes unaffordable. And the unaffordable part is highly likely!
With a month of Tirzepatide costing up to $700, staying on the drug for the recommended minimum of 2yrs will set you back over $16000- yikes! A comprehensive course of treatment with the Liberation Clinic’s dietetics and psychology team over a 2yr period is not likely to add up to that! But WILL give you skills that last your lifetime
While GLP-1 medications can suppress physical hunger, they do nothing to address the underlying emotional triggers - meaning that when people stop the medication, binge eating can return, sometimes worse than before, due to the body having experienced yet another long episode of what it understands to be famine.
The risk is especially high if you have a history of restriction. In one documented case, a woman who had been treated for anorexia as a child was later prescribed Tirzepatide for diabetes and other health conditions. The medication helped her metabolic health, but also appeared to reignite old restrictive patterns - prompting over-exercise and secretive continued dosing even after her doctor stopped the prescription. Importantly, this can happen at any body weight! ‘Atypical’ anorexia nervosa is the diagnostic category representing essentially cases of anorexia nervosa in people who don’t meet the very emaciated extremely low BMI criteria- which is actually MOST cases of anorexia that we see at the Clinic! Really, after a couple of decades in this work I believe they’re one and the same illness. The only difference between anorexia and ‘atypical’ anorexia is semantics due to weight bias in medicine! And unfortunately, people with atypical presentations are far less likely to have their illness detected (they’re often congratulated), and by the time they reach out for support, they’re often more mentally and physically unwell.
People with atypical anorexia nervosa or bulimia nervosa may be misdiagnosed as having binge eating disorder (I've seen it so many times), complicating the decision to prescribe GLP-1 medications. Without sensitive and compassionate screening by a Credentialed Eating Disorder Clinician, these people may be prescribed a drug that actively worsens their condition.
When a GLP-1 could be helpful
We've spent a lot of time in this article looking at all of the things a GLP-1 can't do, and raising your awareness of the potential for harm. But what about those times when it does help? In my opinion, there are two main sets of circumstances when a GLP-1 drug can be a useful adjunct to BED treatment from a credentialed dietitian and psychologist:
- You might not meet diabetic criteria yet, but you experience insulin resistance as well as binge eating disorder. Especially if you have Polycystic Ovarian Syndrome (PCOS).
Insulin resistance (IR) is a tricky thing. The blood tests can be a 'blunt instrument' according to an endocrinologist I know, and don't always reflect how much you're feeling the impact of impaired insulin sensitivity. Put simply, when you have IR, it reduces the efficiency of transfer of the energy you've eaten from your blood to inside of your cells (where it needs to be in order to power your body). So you might still be feeling tired, depleted, brain foggy, and getting signals that you need more fuel! Even if your blood glucose is normal. The way this interacts with binge eating disorder is that you feel more frequent, and more intense 'cravings' for food, with or without actual physical hunger. In this situation, a drug that improves insulin sensitivity is often going to make a noticeable difference to your ability to feel both full and satisfied by the food you eat.
2. You have severe binge eating disorder, and you feel overwhelming urges to eat that you have to act on immediately.
If you have severe binge eating disorder (diagnosed by someone qualified who has also excluded other eating disorders), then sometimes it can be really hard to work on creating a space (even of a minute or two) between feeling the urge to binge, and acting on it. This space is important, because it's what give us time to work on skills you're learning in treatment. What a GLP-1 can do here is to buy us that time by turning down the intensity of the binge urge, so that it could become more tolerable to delay acting on it. And I do mean 'buy' the time- pun absolutely intended! Sometimes this is the effect, but I've also worked with clients who haven't felt much difference in intensity of their urges, so I don't want to say it's definitely what you personally would experience.
Now, I want to clarify that in my almost 2 decades of this work, it's only the last couple where we've even had the luxury of a GLP-1 to potentially speed us past the 'ability to tolerate a small window between urge and action' step- there are definitely other ways to get here- and they don't necessarily take a long time! But if you identify with that feeling of not being able to delay acting once the urge hits, especially if it's not your first attempt at treatment, this could be a good conversation to have with our team or your doctor. Importantly, you'll still need support to do all the other steps involved with binge eating disorder recovery, as discussed above! And you'll need your team of a Credentialed Dietitian and Psychologist to lead the way.
- Of course I need to clarify that I'm not a medical doctor, and not qualified to recommend any drug. If this makes you feel you might be a good candidate for GLP-1 therapy- please discuss everything this article raises for you with your doctor.
What if I just want to lose some weight first, then I'll feel more ready to work on my relationship with food?
Although it's actually not about GLP-1's, I wanted to add this point, because it's such a strong theme among almost all of our new clients seeking support with binge eating. This is such a huge topic on its own, but I wanted to touch on it here and let you know it's a really normal feeling to have. I's important to acknowledge that in many cultures, losing weight actually does mean that the world treats you differently. Weight stigma negatively affects us all, regardless of actual body size, but for those of us in larger bodies there is real discrimination that affects all facets of our lives.
This is a good time to remind you that our team always take an agnostic stance, and although we're a non-diet/ Health at Every Size aligned clinic, we still encourage these conversations about discomfort in your body, and body based discrimination.
Like all other approaches to weight loss though, what the research shows us 1-2yrs after stopping a GLP-1 drug, is that most - if not more - weight is regained. Studies have shown that (again, like any other method of weight loss, deliberate or not), the faster that weight is lost, the greater proportion of that lost weight is muscle. For GLP-1 drugs, up to 40% of lost weight can be from muscle mass. This is important to understand, because loss of muscle means a lower resting metabolic rate on ceasing the drug. Meaning you now need less food than you previously did to maintain your weight. And you're not as strong as you used to be, which also makes daily life that bit harder!
So again, it doesn't mean that it's always a bad idea to take the drug, but it's important to know weight regain is a likely outcome a few years down the track, especially if you're considering taking the drug for only a shorter period of time.
I also want to assure you that improved body image is actually not dependent on losing weight first. Good body image is actually a set of skills that you can learn when you're ready. Our team don't consider anyone fully recovered from their eating disorder until they've made peace with their body- because body dissatisfaction is one of the biggest relapse triggers!
What actually works
The good news is that binge eating disorder responds really well to evidence-based treatment with a skilled care team.
In my experience, the best and most effective treatment for binge eating disorder involves (you guessed it!) a dietitian and a psychologist, both with the extra training and years of supervised practice it takes to have achieved the ‘Credentialed Eating Disorder Clinician’ qualification.
The reason treatment works best with a dietitian and psychologist team is that binge eating disorder has both physiological drivers of the behaviours, and emotional ones. It’s pretty hard to work on the emotional drivers when your body is screaming out for its’ needs to be met. And, although you can absolutely start with the physiological drivers, it’s pretty hard to unpack all of the emotional reasons and learn new thinking styles/ new coping skills/ recover from trauma… the list goes on… without psychological support.
And a quick note about the CEDC Dietitian part: Lots of people have seen a generalist dietitian before, and say ‘I already know what I should be eating’, because their past experience with dietetics was to be given some education and meal plan ideas and sent on their merry way. (And this is fine for many health conditions- no shade to my general dietitian colleagues!). An eating disorder dietitian is vastly different. There’s a whole page on our website here about what it’s like to work with an ED dietitian here, but the short version is this: We’re far less focussed on the ‘what’ to eat- most of our clients have more than enough nutrition knowledge to last their lifetime- we’re far more focussed on the ‘why’, ‘when’, ‘how do I know how much’ questions. Then, once your binge urges are less strong, we can work on teaching you how to reconnect with those early, gentle, subtle hunger and fullness cues that you likely haven’t felt for many years.
We’ll also help you unpack those many and often conflicting diet rules or beliefs you’ve picked up over the years, and help you form new ones that serve you, and align with what you really value and how you want to take care of yourself once you’re free of the eating disorder. Then, we can help you work on building body image skills (that one’s often shared between dietetics and psychology- whoever gets to it first!), to give you resilience in recovery and stop body dissatisfaction and discomfort from being a relapse trigger down the track.
If you're considering a GLP-1 medication , we can walk alongside you
None of this means GLP-1's are always harmful or always wrong. For some people - particularly those managing type 2 diabetes or cardiovascular disease alongside disordered eating - the calculus is more complex.
If you struggle with binge and emotional eating, and you’re considering a GLP-1, our team would love to walk alongside you and help you to make an informed decision (if you’re still tossing up), help you learn new skills while the food noise is quieter (if you've already started taking one), or prepare to stop the medication if you've been taking one for a while and want to feel ready to stop. And if you decide to try the old-fashioned way with dietetic and psychological support first- we’re on board for that too!
What this article is pushing back against is the idea - fuelled by social media, by viral testimonials, and sometimes by well-meaning but under-informed clinicians - that Ozempic or Mounjaro can be a shortcut to recovery from binge eating disorder. It can’t address years or decades of using food to manage emotions. It can’t rework the thought patterns that drive shame and secrecy around eating. It can’t teach you to respond differently to stress, loneliness, or conflict.
Those things take time, support, and the right kind of help. But they are definitely possible, and our team see these quiet, private, real, lasting success stories every day. You can be one of them, with or without medication support.
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I really hope you’ve found this article helpful! I very much welcome all questions, feedback, and honest opinions.
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