GLP-1 Medications (Ozempic et al.) Indicate a Possible Medical Cause for Eating Disorders

One intriguing effect of the GLP-1 agonists is the decrease or disappearance of “food noise,” coined last year on social media after the explosion of the use of these medications.

It is not a clinical term. The simplest description of food noise is ruminative thoughts about food. This noise can vary widely from the struggle to choose what to eat, consistent thoughts about food much of the day to constant obsessions about food and weight.

A common effect of the GLP-1’s is to decrease thoughts about food—not an obvious result of a class of medications intended to alter the gastrointestinal hormonal system.

Although it’s clear that hunger, fullness and digestion would change after taking these medications, similar alterations in thought patterns was not to be expected.

For people with eating disorders, the GLP-1’s can have a similar effect of changing food thought patterns. This unexpected benefit may very well be beneficial for recovery and also may open doors to new ways to conceive of these illnesses.

Just as interesting, many people with eating disorders do not notice any change in food thoughts with these medications—another clue that eating disorders are likely a group of similar illnesses rather than just one disorder.

The cognitive effect of the GLP-1’s imply that some eating disorders might be related to dysfunction in the GI hormonal system, which then causes symptoms around consistent eating and digestion. Other eating disorders may not be related to this system.

However, the new medications—the first of many similar drugs to come—are likely a much less nuanced approach to the GI hormonal system than anyone with an eating disorder would need. The risks of weight loss, slowed gastrointestinal motility, impaired digestion and potential broad hormonal changes are very risky for people with eating disorders.

GLP-1’s can be used off label for specific eating disorders now only if the clinician takes into account the underlying risks since this class of medications is still new.

At this point, I remain hesitant to use these medications broadly for people with eating disorders. The two situations where they have been helpful are intractable binge eating disorders and metabolic dysfunction from chronic eating disorders. Over time, there is a high likelihood that the GLP-1’s will shed light on the cause of some eating disorders and new treatment directions.

Treating eating disorders as both psychiatric and medical in nature may very well be the future of eating disorder treatment.