GLP-1 Medications Part 2: Eating Disorder Risk, Harm, and Clinical Concerns
GLP-1 Medications Part 2: Eating Disorder Risk, Harm, and Clinical Concerns
The rapid rise in GLP-1 medications has many of us eating disorder clinicians paying close attention.
As discussed in Part 1 of this series, GLP-1 medications such as Wegovy, Ozempic, and Mounjaro primarily work by suppressing appetite through several physiological mechanisms.
At first glance, appetite suppression might seem appealing. Hunger is often framed as something to fix, control, or get rid of. In reality, hunger is a biological safety signal. It tells us when our body needs more fuel and energy.
When medications reduce or alter hunger signals, the implications can be more complex, particularly for people with current or past eating disorders.
In no way are we saying that GLP-1 medications cause eating disorders - but the type of person that may be trying to access them may be predisposed to disordered eating and the effects of the medication may exacerbate eating disorder behaviour. Dr Kate Murphy, Consultant Psychiatrist at the Queensland Eating Disorder Service (QuEDS), has similar concerns.
Eating disorders are more common than many people realise
Eating disorders affect up to 21% of Australians, making this an important clinical consideration rather than a niche issue.
Many individuals living with eating disorders already experience disrupted hunger and fullness cues after years of dieting, restriction, or attempts to override their body’s signals. Introducing a medication that further suppresses appetite may compound this disconnection from internal cues.
It’s also important to recognise that most people with eating disorders are not in underweight bodies. In fact, many individuals experiencing severe eating disorders live in larger bodies.
Because of this, it is not uncommon for clinicians working in eating disorder care to see patients with active or severe eating disorders offered or prescribed GLP-1 medications by well-meaning healthcare providers whose focus is weight management.
This creates a challenging and sometimes risky situation.
The reduction in “food noise”
One commonly promoted benefit of GLP-1 medications is the reduction of “food noise.”
On social media, food noise is often described as persistent or intrusive thoughts about food. For example, thinking about eating again soon after finishing a meal.
For some people, these thoughts can feel distressing, and the reduction of them may feel like relief.
However, in many cases, what is labelled as “food noise” may actually be physical hunger or unmet nutritional needs.
If someone is not eating enough to meet their body’s energy requirements, it is normal and expected for the brain to continue seeking food. This is a protective survival mechanism, not a personal failure.
Other factors can also increase preoccupation with food, including:
chronic dieting
rigid food rules
restricting certain foods
the “forbidden food” effect
While GLP-1 medications may temporarily reduce these thoughts, they do not address the underlying drivers and create a healthy relationship with food.
If we don’t address the underlying factors, the same challenges may return once the medication is stopped.
Weight loss medications and the thin ideal
With the easy access, advertisement and social acceptability of weight loss medications comes the normalisation of weight based beliefs and reinforces broader cultural messages about body size.
When medications that suppress appetite and facilitate weight loss become widely promoted, they can unintentionally strengthen the belief that smaller bodies are inherently more desirable or healthy.
These beliefs are already deeply embedded within diet culture and can contribute to body dissatisfaction, restrictive eating patterns, and disordered eating behaviours.
For individuals vulnerable to eating disorders, this cultural context matters.
Red flags to look for which may indicate an eating disorder while taking GLP-1 medication
If you or a loved one are taking GLP-1 medications, there are several warning signs that may indicate disordered eating behaviours or negative health impacts. Keeping an eye on these changes can help identify when additional support may be needed.
Rapid weight loss
This may look like clothes becoming loose very quickly, bones around the shoulders or sternum becoming more prominent, or visible hollowing at the temples (known as temporal wasting). These can be signs of muscle loss and potential malnutrition.
A strong fear of weight gain
This might appear as frequent or obsessive weighing, closely monitoring clothing sizes, or tying self-worth and success to weight/size.
Fear of stopping the medication
This may look like refusing to stop or reduce the medication despite significant weight loss or declining health, due to fear of weight regain.
Avoiding eating in social environments
Eating disorders often thrive in isolation. Someone may begin avoiding meals with friends, family gatherings, or events that involve food because eating feels more difficult when others are present or when food rules become more rigid.
Rigid rules around eating
This might include eating only at specific times regardless of hunger, strict calorie tracking, or feeling distressed if eating patterns change.
Avoidance of specific food groups
This can look like eliminating entire food groups such as carbohydrates, fats, sugar, or processed foods due to fear or perceived “rules” about what is acceptable to eat.
Fatigue or dizziness
Low energy intake can lead to persistent tiredness, needing frequent naps, difficulty concentrating, or feeling lightheaded when standing.
Changes in mood
Not eating enough can affect mental wellbeing, leading to increased irritability, mood swings, frustration, or feeling emotionally depleted.
Seeking support
If you’re concerned about yourself or someone close to you, support is available.
In Australia, you can contact the Butterfly Foundation National Helpline on 1800 33 4673 (1800 ED HOPE) for guidance and support.
Alternatively, you may wish to speak with an eating-disorder-informed health professional. Our dietitians at The Wholebeing Co can help explore your relationship with food and ensure your nutritional needs are being met. Contact us today.
A note on informed consent
As a practice, we are not anti–weight loss medication. However, we strongly support informed consent.
Any medication that alters appetite, hunger signals, or eating patterns should come with a clear understanding of its potential side effects, risks, and warning signs.
In Part 3 of this series, we’ll explore how people taking GLP-1 medications can protect their relationship with food and ensure their nutritional needs are met.