Ozempic and Eating Disorders: What Is the Connection?

For many people, figuring out the right weight for their body is a challenge. Public health campaigns emphasize that extra weight is a risk factor for many health conditions. But weight isn’t the only indicator of health. And many causes of weight gain are outside a person’s control. 

As medications like Ozempic become more popular, there are concerns about their effects on a person’s relationship with food and their body. This could be particularly problematic for people who are prone to disordered eating. Around 8% of women and 2% of men will be diagnosed with an eating disorder at some point in their lives. And many others may struggle without a formal diagnosis. 

Here, we’ll cover how Ozempic affects people with eating disorders or who are at risk for them.

Can Ozempic cause eating disorders?

Ozempic probably doesn’t directly cause eating disorders. But it may make disordered thoughts around food and body image worse for some people. This can happen in a few different ways:

• Restriction: Ozempic naturally lowers appetite and can reduce how much you eat. This may trigger or surface compulsive thoughts and behaviors around restrictive eating. 

• Purging: Nausea and vomiting are common side effects of Ozempic. For people with a history of bulimia or purging, this could theoretically worsen or reactivate these behaviors.

• Weight cycling: Also called “yo-yo dieting,” this is a repeated pattern of losing weight and then gaining it back again, which can harm physical and mental health.

Many people gain weight when they stop taking weight-loss medications like Ozempic. Sometimes they gain back more weight than they lost. Medications like Ozempic are made to be taken for years. But that’s not always possible because of side effects or cost. This can lead to repeated episodes of weight changes.

Weight cycling is hard on your body. People whose weight goes up and down have a higher risk of cardiovascular disease. They’re also more likely to have a negative self-image or feel depressed. These feelings can fuel more attempts to lose weight in an unhealthy way.

Some people use medications because they have a fear of gaining weight. This can be true even if their weight is in a healthy or low range, or if they think they need to lose weight to fit a certain image. This can be one sign of an eating disorder.

What are the different types of eating disorders?

It may be hard to predict how Ozempic will affect people with eating disorders, because eating disorders are not all the same. Many people with eating disorders have symptoms that overlap across several types. 

The three main classes of eating disorders are:

• Anorexia nervosa: People with anorexia nervosa typically have an extreme fear of gaining weight. They may restrict their food, exercise too much, or take weight-loss medications in ways that risk their health. 

• Bulimia nervosa: People with bulimia nervosa try to get rid of calories they have eaten. They may use laxatives or make themselves vomit. This often happens after binge eating, but not always. 

• Binge eating disorder: People with binge eating disorder have episodes where they eat much more food than feels comfortable. We cover how Ozempic may affect binge eating disorder in more detail below.

Can Ozempic help those with binge eating disorder?

Some health professionals believe that medications like Ozempic could help people at higher weights who have binge eating disorder. This is the most common eating disorder in the U.S. And it can take a significant toll on both mental and physical health.

Ozempic may help to reduce cravings and overeating. This is an active area of research, and a lot of the current evidence comes from people’s experiences. Many people who take a glucagon-like peptide-1 (GLP-1) medication say it helps to reduce the “food noise,” or the constant, repeating thoughts around food.

GLP-1 medications also seem to change proteins released by the gut that affect appetite and cravings. These proteins are often out of balance in people with eating disorders. Because of this, the medications may help reduce the frequency of binge eating episodes. Larger research trials are needed to know how effective and safe these medicines are for people with this condition.

Should people avoid Ozempic if they might have an eating disorder?

If someone has a history of an eating disorder, it doesn’t mean they can’t take Ozempic. But it’s important to discuss this decision with a trusted healthcare professional who knows their history. And if they chose to take Ozempic, they should also have the right support in place to address any challenges around food or body image that may come up while taking the medication.

Some people should avoid Ozempic if they’re at an average or below-average weight. Remember that Ozempic is approved for diabetes, not weight loss. It’s a GLP-1 receptor agonist, like other weight-loss medications. So, it can lead to weight loss too. But that weight loss could be dangerous for someone who is at risk for unhealthy weight loss.

Ozempic — and other GLP-1 agonists — may not be safe for people whose weight is considered above average either. Many people in larger bodies are malnourished from extreme dieting and can still have anorexia. We’re just starting to learn just how common restrictive eating disorders are in people at higher weights. In fact, anorexia may be two to three times more common in higher-weight individuals than people who are below weight. 

Everyone’s situation is different, so treatment decisions should be made on an individual basis. GLP-1 agonists may be part of a supervised treatment plan for some people in larger bodies who want to lose weight. They may also help with binge eating. But they could be risky for others with different forms of eating disorders. 

Weight-loss medications should be taken with medical guidance. And they should be part of a complete program to help you find a comfortable weight. By themselves, very low-calorie diets, weight-loss surgery, or weight-loss medications rarely lead to sustained weight loss. Nutrition, exercise, and mental health support are all part of a complete plan.

If you or someone you care about is having difficulties with thoughts or behaviors about food or weight, it’s time to talk with a health professional. There are many forms of treatment that can help.

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Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified physician since 1999. She was a full-scope family physician (inpatient, outpatient, obstetrics, and office procedures) in the Cook County Ambulatory Health Network for 15 years.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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