Other researchers are documenting similar concerns. A 2023 analysis of adverse-event reports submitted to the U.S. Food and Drug Administration found that misuse reports for semaglutide were four times higher than for other GLP-1 drugs at the time. Those misuse rates were comparable to those for phentermine-topiramate (Topamax), a combination weight-loss stimulant drug.
“These medications [GLP-1’s], they are extremely useful, extremely important. They are a breakthrough,” says Fabrizio Schifano, a psychiatrist at the University of Hertfordshire in England and co-author of the study. But “some people who are the vulnerable clients, including [those with] eating disorder[s], may have side effects and consequences.”
(The unexpected health benefits of Ozempic and Moujaro.)
Not everyone agrees that an eating-disorder history should automatically exclude a patient. Clinicians who specialize in obesity medicine, such as Jesse Richards at the University of Oklahoma in Tulsa, argue that the benefits may outweigh the risks for some patients. “I would say that it would be very important in patients with a history of disordered eating to monitor them, but that the potential health benefits may outweigh the risks in patients that these medications are being used on label,” he says.
In a statement, Novo Nordisk, developer of semaglutide, said “we recognize that eating disorders are serious conditions and deserve specialized clinical attention from healthcare who treat them. Patient safety is our top priority at Novo Nordisk. We stand by the safety and effectiveness of our GLP-1 medicines when used as prescribed and work closely with the U.S. Food and Drug Administration to continuously monitor the safety profile of our medicines.”
Eli Lilly, maker of tirzepatide, similarly stated, “Mounjaro and Zepbound (tirzepatide) are indicated for the treatment of serious chronic diseases. Lilly does not promote or encourage use of any Lilly medicine outside of its FDA-approved indication.”
GLP-1 drugs and binge eating
While some people with disordered eating over-restrict, others can binge to deal with stress or difficult emotions. Amanda Lightbody, founder of The Rainbow Crosswalk, a nonprofit Pride organization in New Brunswick, Canada, remembers using food as a child to calm herself down during moments of anxiety or uncertainty. Between 0.6 and 1.8 percent of women and 0.3 and 0.7 percent of men worldwide are estimated to meet the criteria for the disorder.
As she got older, Lightbody sought treatment after her bingeing began affecting her health. “When my medical results started coming back with liver issues, I said, ‘Okay, I need to stop this, and I need to find help, because I cannot do it on my own.’” In addition to therapy, she was also prescribed Ozempic to bring her blood sugar down.
Cognitive therapy helped identify triggers, but she says Ozempic also reduced her urge to binge. “The drug provides me a feeling of satiation, so I don’t crave as much,” she says.
(Mindful eating vs. intuitive eating: Which one is right for you?)