Is it safe for someone with an eating disorder to use a GLP-1? Spoiler alert—the answer is: We don’t know. But this blog post is an honest attempt to lay out the information that is currently available, so that you can make an informed decision about what’s best for you.

This is an important issue to discuss, since GLP-1 drugs like Ozempic and Wegovy are becoming more popular—and their impact is unprecedented. These medications are reshaping conversations about weight, food, and bodies across society, and the eating disorder recovery community is not immune to these cultural shifts. As more clients ask about or begin using GLP-1s, treatment providers are navigating complex new terrain.

One thing that we know: True eating disorder recovery involves psychological healing, not just behavior change—it’s about fundamentally transforming your relationship with food, your body, and yourself. That work cannot be outsourced to a medication.

Introduction

GLP-1s, also known as GLP-1 agonists, are medications that help lower blood sugar levels and promote weight loss. They are most commonly administered through a once-weekly injection. Common brands include Ozempic, Wegovy, Mounjaro, and Zepbound. Originally developed for Type 2 diabetes, these medications have exploded in popularity for weight loss.

Here’s what we’re facing: there is currently very little research on the safety or efficacy of GLP-1s specifically for people with eating disorders or those in recovery. We simply don’t have enough data yet. What we do have is clinical experience, an understanding of how these medications work, and emerging concerns from the eating disorder treatment community. Let’s break down what we know.

How GLP-1s Work—And Why That Matters

GLP-1 agonists mimic a naturally occurring hormone that affects appetite and digestion. They slow gastric emptying (food stays in your stomach longer), reduce hunger signals in the brain, and often create significant appetite suppression. Many people report feeling full after just a few bites, losing interest in food, or developing aversions to foods they once enjoyed.

Common side effects include nausea, vomiting, constipation, and fatigue. Some people experience more severe reactions, including gallbladder problems, pancreatitis, or gastrointestinal issues.

For someone in eating disorder recovery, these effects raise immediate concerns. Recovery requires learning to eat adequately and regularly, often independent of hunger and fullness cues that may be unreliable. A medication that chemically overrides these signals creates a fundamental conflict with recovery work.

What We Know About the Risks

While research specific to eating disorders is limited, the National Eating Disorders Association (NEDA) and eating disorder professionals have identified several concerning patterns:

Risk of Triggering or Worsening Eating Disorders

There is growing evidence that GLP-1s may trigger new eating disorders or worsen existing ones. The appetite suppression and rapid weight loss can reinforce restrictive eating patterns, increase body image preoccupation, and intensify disordered thoughts about food and weight. For someone with an eating disorder history, these medications can essentially provide a “medical excuse” to engage in restriction.

Interference with Recovery Goals

Recovery fundamentally involves normalizing eating patterns, rebuilding trust in hunger and fullness cues, and learning that adequate nutrition is necessary regardless of appetite. GLP-1s work against all of these goals. The medication makes it difficult to distinguish between eating disorder behaviors and “medication effects”—a dangerous blurring of lines.

Psychological Impact

The rapid weight changes, increased focus on food and eating, and physical side effects can trigger anxiety, depression, and intensified eating disorder thoughts. Some people report increased food fear, avoidance of social eating, and preoccupation with their changing bodies.

Physical Health Concerns

For those who need weight restoration or are medically compromised from an eating disorder, further appetite suppression poses serious health risks. The body needs adequate nutrition to heal—to restore organ function, bone density, hormones, and brain health. Fighting through medication-induced fullness to meet these needs may be impossible or unsafe.

Unknown Long-Term Effects

We don’t know what happens when a person with an eating disorder stops taking GLP-1s after extended use. Will appetite normalize? Will there be rebound effects? For someone with eating disorder vulnerability, these unknowns carry significant risk.

Different Diagnoses, Different Considerations

• Anorexia Nervosa and Atypical Anorexia: GLP-1s are generally considered inappropriate during recovery, particularly during weight restoration. The appetite suppression directly opposes treatment goals and creates medical risks.
• Bulimia Nervosa: There’s concern that GLP-1s may replace binge/purge behaviors with restriction, rather than addressing the underlying psychological issues. This isn’t recovery—it’s trading one dysfunctional pattern for another.
• Binge Eating Disorder: This is the most complex scenario. Some research has explored GLP-1s for BED, but critical questions remain: Are they treating the binge eating behavior or just suppressing all eating? What happens when the medication stops? Are the underlying psychological drivers being addressed? Without comprehensive eating disorder treatment alongside medication, the risks may outweigh potential benefits.
• ARFID: For those with already limited intake due to sensory sensitivities or lack of interest in food, GLP-1s would likely worsen restriction and increase food aversions.

Questions to Explore with Your Treatment Team

If you’re considering GLP-1s or are currently taking them, here are essential questions to discuss with your therapist, dietitian, and physician:

• What is motivating my interest in this medication? Is it rooted in health concerns, eating disorder thoughts, or internalized weight stigma?
• Where am I in my recovery? Am I stable, or am I still actively working on eating disorder behaviors and thoughts?
• Is there a genuine medical necessity (like Type 2 diabetes), or is this primarily about weight loss?
• How will I distinguish between medication side effects and eating disorder behaviors?
• What are the criteria for stopping the medication if problems arise?
• Am I prepared to be completely honest with my treatment team about any eating disorder thoughts or behaviors that emerge?
• What alternatives exist that don’t carry these risks?

Red Flags to Watch For

If you are taking GLP-1s, these warning signs suggest the medication may be interfering with recovery:

• Using medication effects as justification to eat less than planned or skip meals
• Feeling relief at having a “medical reason” not to eat
• Increased eating disorder thoughts about food, weight, or body image
• Return of any eating disorder behaviors (restriction beyond medication effects, purging, excessive exercise, body checking)
• Hiding eating patterns or medication use from your treatment team
• Rapid or excessive weight loss
• Increased anxiety around food or eating situations

If you notice any of these, talk to your treatment team immediately.

What About Medical Necessity?

Some people with eating disorder histories also have conditions like Type 2 diabetes or significant cardiovascular risk where GLP-1s may be medically indicated. This doesn’t make the decision simple—it makes it more complex. Even with genuine medical need, the risks to eating disorder recovery must be carefully weighed. Often, alternative treatments exist that don’t involve appetite suppression.

Any decision to use GLP-1s in this context requires close collaboration between your full treatment team, including specialists who understand both your medical condition and your eating disorder history.

The Bottom Line: Educate Yourself and Get Support

We can’t tell you definitively whether GLP-1s are safe for a person with an eating disorder—because adequate long-term GLP-1 data does not yet exist on this population. What we can tell you is this:

• The risks are real. The mechanisms of these medications conflict fundamentally with eating disorder recovery principles.
• Individual factors matter immensely. Your diagnosis, recovery stage, history, support system, and motivations all play a role.
• You need professional support. This is not a decisi
• on to make alone or without full disclosure to your treatment team.
• Recovery must remain the priority. True recovery involves psychological healing and a transformed relationship with food and your body—work that a medication cannot do.

If you’re considering GLP-1s, take time to explore what’s underneath that desire. Work with your therapist on body image, internalized weight stigma, and what health and wellbeing actually mean to you. Engage with your dietitian about how to support your body without restriction. Be honest about eating disorder thoughts that may be influencing your decision.

If you’re already taking GLP-1s, monitor yourself carefully and maintain open communication with your treatment team. Be willing to discontinue the medication if it’s interfering with your recovery—your long-term wellbeing is worth more than any short-term effects.

Recovery is possible, and it’s worth protecting. Arm yourself with knowledge, surround yourself with support, and make decisions that honor the work you’ve done to heal.

Disclaimer

This blog post is for informational and educational purposes only and does not constitute medical advice. The relationship between GLP-1 medications and eating disorder recovery is complex and highly individual. If you are in eating disorder recovery or treatment and are considering GLP-1 medications, or if you are currently taking GLP-1s and have concerns about eating disorder symptoms, please consult with your treatment team, including your physician. Do not start, stop, or change any medication without medical supervision.

 

 

If you’re struggling with an eating disorder, the Evolve team is here to support you.

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