Eating Disorder Treatment After the Demise of Body Positivity

The onslaught of GLP-1’s in our culture has left the body positivity movement in the distant past and reignited the drive for thinness.

The growing movement of acceptance of all different body types, especially in women, had opened the door for new directions in eating disorder treatment. Body image distortion, the most persistent and stubborn symptom of any eating disorder, was a bit less powerful when the cultural acceptance of varied body types grew. People were more likely to consider different clothing sizes and less ashamed of the changes in their bodies that accompanies recovery.

The new class of medications promoting weight loss and the micro-economies around them spawned a renewed and even more powerful focus on thinness. People who never had eating disorders suddenly lost extreme amounts of weight. Influencers peddling body positivity suddenly showed up dozens of pounds smaller. Any variation in model body shapes vanished.

Amidst the about face in media images of women’s bodies, the eating disorder treatment world has backtracked greatly. Patients with all sorts of eating disorders, and in all shapes and sizes, gravitated shamelessly to finding any way to procure these drugs. Physicians and various medical-adjacent industries prescribed them readily, often with minimal or even no clinical indication.

The drive to find eating disorder recovery disappeared behind the promise of weight loss, minimal “food noise” (euphemism in the eating disorder world for any sign of hunger) and a magical cure for any eating disorder.

It has been harder as a clinician to encourage people down the emotionally challenging and time consuming journey of recovery. More and more people seek this new magical cure and are less likely to acknowledge and seek actual help for their eating disorder.

As the GLP-1’s lead to food restriction and potentially induce an eating disorder, even in those never sick before, I wonder what kind of devastation these drugs may leave in their wake. I have touted the potential uses of these drugs in recent posts because I don’t want to dismiss new, powerful drugs with clear medical benefit, but I am just as concerned about the negative outcomes.

My focus now is to acknowledge these new medications and recognize their benefit in manipulating the gastrointestinal hormonal system. However, the clinical community must also focus on eating disorder treatment that has not changed.

Clinicians who treat people with eating disorders need to stay true to treating this population. No medication has ever cured an eating disorder, and GLP-1’s are no exception. People who benefit from these drugs have already made headway in recovery. Eating disorder treatment entails the hard work of therapy, meal planning and food counseling with a dietitian and a long term process in order to help people get well.