What No One Tells You About GLP-1s and Eating Disorder Recovery
GLP-1 medications are a defining moment in our culture right now. You can’t scroll social media or go to a family gathering without hearing about GLP-1s. The dominant message is that these medications are the miracle solution for weight loss. If you’re in eating disorder recovery, or simply don’t want to take these medications, the conversation can feel complicated and triggering. As an eating disorder therapist in Philadelphia, I have a lot of thoughts about this time in history.
What are GLP-1s?
GLP-1 medications were initially created for diabetes management but are now being prescribed for weight loss. Social media influencers are documenting their GLP-1 experience online, and celebrities are shrinking their bodies at alarming rates. Regular people are being prescribed these medications so it’s likely you know someone who is taking them.
These medications have shifted conversations around appetite and body size. The term ‘food noise’ entered the zeitgeist around the same time GLP-1s rose in popularity. Food noise is a phrase that is used to describe the experience of intrusive thoughts and cravings around food.
People pursue GLP-1s for many reasons, and societal pressure around bodies is very real. We are told repeatedly that our worth is tied to our appearance and body size. Everyone is affected by this, but it’s triple for BIPOC, queer, and trans folks. Weight stigma and fat phobia don’t exist in a vacuum. They overlap with other oppressive systems including racism, sexism, and transphobia.
Weight stigma leads to feelings of shame and discrimination in the workplace and from healthcare providers. Research has shown it causes harm to physical and mental health and is a large contributor to eating disorders and body image issues. For folks in larger bodies, some health conditions will go untreated because a doctor simply told them to lose weight rather than investigating the issue. Eating disorders are under diagnosed for black people and individuals who don’t fit the thin, white cisgender body type. Some healthcare providers will even recommend weight loss to individuals without screening for an eating disorder. The consequences of weight stigma are significant leading to worse health outcomes and death.
Why GLP-1s Can Trigger Eating Disorder Relapse
Weight loss medications reinforce the idea that smaller bodies are inherently better. So many people with eating disorders fear gaining weight, which can both drive the eating disorder and increase risk for relapse. Eating disorder recovery doesn’t happen in a isolation. People go to work and school where many folks are talking about dieting and GLP-1s. Dieting and weight can also be a common topic at family gatherings, especially now.
Some people recover into a larger body than they were in their eating disorder, making recovery feel complicated. It can be hard to stay on the path of recovery when you’re constantly being told that larger bodies are not okay.
Feeling Pressured to Take GLP 1s? You’re Not Alone
The popularity of GLP-1s also sends the message that anyone who isn’t thin should be taking these medications. The core of this message isn’t new. The expectation that folks in larger bodies should always be trying to lose weight has been here for a long time. As an eating disorder therapist, some of my clients have struggled with feeling comfortable eating in public out of fear of judgement. Unfortunately, this comes from actual experiences of being judged for their weight by loved ones and healthcare providers.
How Celebrity GLP 1 Use Affects Body Image and Recovery
Many of the clients I’ve worked with have found healing by following celebrities and body positive influencers in larger bodies. Seeing someone in a larger body live a full, joyful life can show that body acceptance is possible, and that being smaller isn’t necessary to find peace. As GLP-1 medications have emerged, many famous people’s body have changed with some even promoting GLP-1s as part of their brand. While their journey and their bodies aren’t about us, it can feel like a slap in the face. For some people, it can feel like a major loss to their recovery journey and can reinforce that being smaller is better. As size diversity starts to disappear, it can be hard to look outside for a sense of hope.
How Weight Loss Comments Can Impact Eating Disorder Recovery
Some people taking GLP-1 medications start getting more comments about their body and weight loss. These comments can be anything from invasive questions around what they eat, to compliments about their weight loss. For some people, all they hear is that there was something wrong with their body before they lost the weight. The constant questions about how much medications cost, what they are eating, and how many pounds they lose can increase cortisol levels and stress.
The Risks of GLP-1 Prescriptions Without Eating Disorder Screening
GLP-1s are easier to get than ever — from doctors who don't screen for eating disorders to online companies that prescribe them based on a simple questionnaire. What many people don't realize is that eating disorders affect people of all sizes, including those with anorexia. When screening gets skipped, people can be prescribed these medications without anyone catching it, causing further harm and intensifying their eating disorder.
What if I’ve had an eating disorder in the past, but I want to pursue a GLP-1?
Medical decisions are personal and are always your choice. Since a lot of eating disorder recovery is becoming more attuned to your body cues, rapid weight loss and appetite suppression can potentially trigger relapses. Here are some helpful questions to ask yourself that might help guide your decision making:
What feels most important to me in my recovery right now?
What changes have supported my healing so far?
What feels steady vs. vulnerable in my relationship with food?
What would it look like to prioritize long-term well-being over short-term relief?
Why Eating Disorder Screening Before GLP-1s Is Essential
As an eating disorder specialist, I recommend that everyone gets screened for an eating disorder if they are starting a GLP-1. Working closely with a healthcare team that understands eating disorders will be crucial. Having a therapist and a registered dietician on the team can help you create a plan for support if ED symptoms resurface. Since GLP-1s suppress appetite, support from an eating disorder dietician can help reduce the risk for malnutrition.
Recovery in the GLP-1 Era is Still Possible.
Like I said, fatphobia and weight stigma aren’t new issues to our world. They are feeling uniquely louder right now, but they have always been there. So much of the work I do with people is to help them find self-worth in the society they have to live in. That means building confidence in themselves and letting go of the narratives that don’t belong to them. Eating disorder recovery has always been about challenging the status quo and finding the ability to trust what’s right for you. This is especially true if you’re queer, trans or BIPOC navigating eating disorder recovery.
Recovery Doesn’t Need to Be Perfect
If you’re someone who both wants to find recovery but also still wants to lose weight, that’s okay. Recovery isn’t all or nothing and sometimes it means holding space for multiple feelings all at once. While I’m not a weight loss specialist, I meet people where they are at and create a space where we can explore all those conflicting feelings with compassion. There’s a good reason why that part of you still wants to lose weight, and it’s likely rooted in wanting to protect you from some type of pain.
IFS for Eating Disorder Recovery
As an art therapist trained in Internal Family Systems (IFS), I love helping people explore every part of their eating disorder so they can understand what truly drives it. IFS is an experiential and somatic therapy approach that helps you heal the painful emotions from your past and make decisions from a more grounded place. IFS is truly a compassion-based model where you stop fighting your eating disorder and start becoming more curious about it.
Art Therapy for Eating Disorders When Words Fall Short
Eating disorders are essentially body-related issues that can disrupt our own ability to trust ourselves and what our bodies need. Art therapy can help you experience embodiment in a way that feels less threatening. The experience of pressing pencils on paper, the feel of clay in your hands, and the smell of crayons engages your senses. Making art bypasses the thinking part of your brain that wants to analyze and gets to the emotional truth. Many people I’ve supported have learned new things about themselves after seeing what they put on paper. If you’re someone who’s in your head a lot, this can be a path to both relief and clarity.
Do I need to be good at art to benefit from art therapy?
One of things I love most about art therapy is that it meets you where you are. You don’t need to be good at art or have any artistic background. The discomfort you feel is totally okay, but there is no pressure coming from outside to make something gallery-worthy. I think folks without an art background have a unique advantage because there isn’t that “artist part” in their head. For my artist clients, we work with that part in the art therapy session.
Eating Disorder Recovery for LGBTQ and Trans Individuals
Recovery hits different for queer and transgender folks. The traditional narrative of ‘loving your body’ doesn’t always resonate and can feel alienating. Controlling your body might be a way to feel safer in a world that is hostile to who you are. For some, it might be a way to achieve a body that feels more aligned with your gender. The idea of recovery can feel scary and threatening. Therapy can help you sit with these conflicting feelings and still find a way to develop confidence in who you are and to live life on your terms. For some people, recovery is about living a full life, rather than having zero symptoms and a positive body image.
Looking for Help?
I’m a queer art therapist and Certified Eating Disorders Specialist who’s passionate about helping LGBTQ people find peace with food and fulfillment in their lives. My approach is nuanced, affirming, and collaborative. You define what recovery looks to you, not me. Weight inclusive care is one of my core principles, which means I believe size diversity is not only natural, but something to be celebrated. It also means that eating disorder struggles and your worth are not defined by your weight. Healing is possible, even in the era of GLP-1’s. If you’re interested in learning more, you can book a free 20-minute consultation through my website. I’d love to support you!
