Why Women With Eating Disorders Are Turning to Ozempic

“I think about food every second of the day. Nothing quiets the thoughts,” says Jennifer B., a 29-year-old from Costa Mesa, California. She has battled bulimia since middle school. Despite years of cycling through recovery and relapse—including painful stints of self-induced vomiting that can damage teeth and the esophagus—she’s never found lasting relief from the disorder’s grip. Hoping to silence the food noise that has ruled her life for so long, she recently began giving herself weekly GLP-1 shots.

In Salt Lake City, 30-year-old Julie (a pseudonym) also felt like Ozempic was the answer to her prayers. She had a history of atypical anorexia—meaning she met all the qualifications for anorexia nervosa, except that she wasn’t underweight. After years of restriction followed by weight gain, Julie hoped the meds could mean the end of the mental spreadsheets and guilt spirals that accompanied every meal: “No more obsessive calorie counting or excessive exercise!”

For women like Jennifer and Julie—who’ve spent years trapped in the exhausting mental Olympics of disordered eating—GLP-1 medications like semaglutide (sold as Ozempic, Rybelsus, and Wegovy) promise the unthinkable: an “off” switch for food noise. These medications work by mimicking a hormone that regulates hunger, essentially telling the brain, “We’re full, thanks,” while slowing digestion to match. So as counterintuitive as it sounds, could weight-loss drugs be a key to curbing eating disorders?

Recent studies offer a few green flags. A 2023 retrospective cohort study in Obesity Pillars found that patients receiving semaglutide showed greater reductions in binge eating symptoms compared to those taking other anti-obesity medications. (Interestingly, patients who got a combo of semaglutide plus another drug didn’t show any additional benefit.) That said, a review in the International Journal of Eating Disorders reminds us how little we actually know. The few existing studies have many limitations—small sample sizes, short durations, and methodological flaws abound. And there are zero studies examining how these medications affect people with anorexia or bulimia.

Rachelle Heinemann, an eating disorder specialist based in New Jersey who hosts the podcast Understanding Disordered Eating, acknowledges that medications like semaglutide might help people who have specific hormonal or insulin-resistance issues—that “small subset of people with binge eating where it’s not solely because of restriction.” But taking a wider view, she worries that the meds reinforce a cultural obsession with thinness that may contribute to eating disorders. As celebrities get impossibly and universally slender, the message is that thinner is better. “We’re confirming the idea that losing weight is the way to get healthy,” Heinemann says.

The GLP-1 experience also varies wildly depending on which eating disorder is at play. For those with restrictive eating disorders like anorexia, these medications have the potential to throw gasoline on an already dangerous fire—amplifying the very behaviors that put patients at risk for cardiac complications and electrolyte imbalances that can be fatal.

For people with binge eating disorder, weight-loss drugs might temporarily reduce those episodes through appetite suppression—but they do nothing to treat the emotional reasons for binging in the first place. As for those with purging behaviors, the medications’ signature side effects of nausea and stomach discomfort can actually trigger more self-induced vomiting as people try to find relief.

For Julie, her relationship with semaglutide slid from promising to problematic. “I started relying on semaglutide and my Adderall to suppress my appetite in a way that became very disordered,” she admits. “There were weeks when I’d only eat one or two full meals, and many days when I consumed maybe 300 to 400 calories. The line between using it in a healthy versus unhealthy way is very thin.”

Despite her doctor’s enthusiastic praise for her weight loss, blood tests confirmed Julie was malnourished. Julie and a friend on similar medication half-joked about having scurvy—complete with hair loss, exhaustion, chronic pain, and bleeding gums.

Patient experiences like this have left some clinicians and researchers concerned about the complex interplay between GLP-1s and disordered eating patterns. With minimal research, and explosive popularity, experts find themselves in uncharted territory, trying to determine when these medications might help someone recover from destructive eating patterns versus when they might reinforce them—or create new problems entirely.

Given the nuance involved, physician input is critical when people with eating disorders use Ozempic-like drugs. Yet the meds are ridiculously easy to obtain without it. Between telehealth services and online weight-management platforms, patients can secure prescriptions faster than pizza delivery, often without disclosing their full medical history. “People living in larger bodies who have atypical anorexia often get these prescriptions without any screening for existing eating disorders,” says Dr. Kim Dennis, MD, co-founder, CEO, and chief medical officer at SunCloud Health, a network of eating disorder treatment centers. “These patients may already be malnourished despite their size.”

Jennifer admits she ordered her semaglutide through an online service without consulting her regular doctor. “I haven’t spoken to my doctor about it, only because I’ve had such negative experiences with medical professionals and my eating disorder,” she explains. That lack of trust is common. Most primary care providers have almost no training in eating disorders and are simply not equipped to recognize warning signs or provide appropriate monitoring. Let’s say the medication works beautifully. Appetite normalizes, binges disappear, weight stabilizes. Great! Now, can you stay on it forever?

“What the medication does is completely shut down the entire reward system,” says Heinemann. “But the second you remove this drug, it comes back with a vengeance. The body’s going to want more food because it’s been starving for so long, and the person doesn’t really know how to regulate themselves.”

Jennifer is already contemplating this dilemma: “I was hoping to only be on it for a short time, but if the benefits are what I expect, then I will continue to stay on it.” Forever is a long time to be giving yourself weekly injections, but then again, so is forever battling an eating disorder.

Stef (a pseudonym), a 35-year-old from Oneonta, New York, would be more than happy to stay on Ozempic forever. She traces her eating disorder back to age 9, “when my parents put me on WeightWatchers.” This began a cycle of restricting and binging that continued into her twenties. By 23, she had developed bulimia and was purging and overexercising daily. In her thirties, she shifted toward binge eating disorder and gained weight. Finally, after Stef was diagnosed with diabetes last year, her doctor suggested Ozempic, explaining that it could help manage food cravings without involving the kind of calorie counting that might trigger bulimic behaviors.

She says it’s helped immensely. “The biggest change has been the food noise going away,” Stef says. “The cravings are gone. I can have a single cookie and be happy with that, and that has never happened before. It’s also helped with other issues; I’ve been dealing with a crippling shopping addiction for years, and with Ozempic, the urge to spend isn’t a monkey on my back anymore.”

For anyone considering Ozempic-like drugs while managing eating disorders, experts and patients stress a few non-negotiable guardrails. Be completely transparent with your health care providers about your eating disorder history—all of it, not just the sanitized version. “Be sure to work with professionals who understand both eating disorders and these medications, so you can talk through exactly what the risks and benefits may be, so you have truly informed consent,” Dr. Dennis says.

Have a realistic conversation with yourself about whether you’re prepared for potential long-term use, both financially and emotionally. And perhaps most importantly, stay brutally honest about whether you’re using the medication to manage your disorder or maintain it. As Julie bluntly puts it: “You need to be able to stop and say ‘Yeah, I’m using this drug to fuel my disorder’ and be willing to make adjustments.” Which is easier said than done when you’re in the thick of an eating disorder.

Jennifer’s perspective captures the hope and ambivalence many feel. “I know that many people have negative things to say about GLP-1s and how ‘it is the easy way out,’” she says. “But they don’t understand there are people like myself who are seeking more than that.”

If you or someone you know has an eating disorder, support and resources are available at ANAD’s free helpline (1-888-375-7767) and the National Alliance for Eating Disorders (866-662-1235).