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GLP-1 weight loss medications like Ozempic, Wegovy, Juniper and Mounjaro are being widely promoted as breakthroughs. For some people, they are medically appropriate. For many others, especially those with a history of disordered eating (from yoyo dieting to diagnosed eating disorders), trauma, or body image distress, the conversation is far more complex than it appears.
This article explores the psychological, relational, and cultural impacts of weight-centred care, including the limits of BMI, the risks of appetite suppression, and why weight loss does not reliably lead to wellbeing.
If you want the key points in under one minute, skip straight to the Quick FAQ at the end.
If you want the deeper context, keep reading.
The Hidden Truth About GLP-1 Medications and Emotional Eating and Weight-Centred Care
This article is written from the perspective of a psychotherapist working with disordered eating, attachment injury, complex and developmental trauma, and what is often described as a mother wound. It is intended as a resource that can be shared when conversations about Ozempic, Wegovy, Mounjaro and similar medications arise.
This is not an anti-medicine position. It is a critique of weight-centred care, cultural fat phobia, and the growing tendency to medicalise body size without sufficient attention to psychological, relational, social, cultural and spiritual context.
The Rapid Expansion of GLP-1 Medications
GLP-1 receptor agonists were developed for the treatment of type 2 diabetes. In a very short period of time, they have been repurposed and aggressively marketed for weight loss, including to people without diabetes and with lower body mass indices.
The rapid uptake of GLP-1 receptor agonists reflects not only pharmaceutical innovation, but also the depth of cultural desperation around weight. For many people, these medications are framed as a long – awaited solution after years of dieting, shame, and medical dismissal.
History suggests we should be cautious when weight loss is presented as the primary answer to complex human distress.
We Live in a Fat-Phobic and Fat-Shaming Culture
Any discussion of weight loss drugs must begin here. We live in a society that pathologises fat bodies, equates thinness with discipline and worth, and treats weight as a moral issue rather than a neutral physical characteristic.
People internalise this pressure early. As psychologist Traci Mann notes, the desire to be thin is not benign or freely chosen. It is shaped by relentless cultural messaging, discrimination, and fear of exclusion. People will try almost anything when thinness is positioned as the gateway to health, safety, belonging, and respect.
Weight stigma itself is associated with poorer health outcomes, increased stress hormones, avoidance of medical care, depression, anxiety, and disordered eating, independent of body size.
Health, Obesity, and the Problem with BMI
Health care remains heavily organised around weight and BMI. The term obesity is frequently used as a diagnosis, and BMI continues to determine access to care, treatment pathways, and moral judgement.
Yet BMI is a deeply limited tool. A UK parliamentary review highlighted that BMI was never designed as an individual health measure. It does not account for muscle mass, age, sex, ethnicity, genetics, trauma exposure, socio – economic conditions, disability, or overall wellbeing. It performs poorly as a proxy for health and can actively mislead clinical decision?making.
Despite this, BMI continues to anchor the idea of obesity as a disease in and of itself, rather than a loose population?level correlation.
A holistic understanding of health is to consider eco – bio – soma – psycho – social – cultural – spiritual elements of wellbeing. It includes physical markers, mental health, nervous system regulation, attachment & developmental history, social connection, meaning, safety, and access to care. Weight alone tells us very little about any of this.
The History of Dieting and Intentional Weight Loss
Decades of research show that intentional weight loss has an extremely low long-term success rate. Meta – analyses consistently find that only around five percent of people lose a significant amount of weight and keep it off for two to five years.
Traci Mann’s work helps explain why. When calories are restricted, the body responds as if it is under threat. Metabolism slows, hunger hormones increase, and the brain becomes more preoccupied with food. These changes are biological survival responses, not failures of motivation or character.
The most common outcome of dieting is weight cycling. Weight cycling is associated with increased cardiometabolic risk, psychological distress, worsening body image, and higher levels of shame and self – blame.
When Medical Care Replaces Curiosity with Control
People in larger bodies frequently report that medical consultations centre almost exclusively on weight. Symptoms are attributed to size, investigations are delayed, and treatment plans begin and end with advice to lose weight.
Underlying contributors such as trauma history, attachment disruption, chronic stress, medication effects, hormonal changes, sleep deprivation, poverty, or caregiving burden are examples of that which is often not explored.
Many people with disordered eating (which includes clean eating, yo yo dieting, emotional eating all the way through to diagnosable eating disorders) and body image concerns have symptoms that have been worsened, not prevented, by repeated medical advice to lose weight. Conversely, people in thin bodies with significant eating disorders are often missed entirely because weight loss is culturally rewarded.
GLP-1 Medications as the New Dieting Paradigm
GLP-1 medications are often framed as fundamentally different from dieting. While the mechanism differs, the cultural and psychological logic is strikingly familiar.
The core assumption remains that weight loss equals health.
Emerging evidence shows that once GLP-1 medications are stopped, weight regain is rapid and substantial. Systematic reviews and follow – up phases of major trials demonstrate that most people regain all or most of the weight within 18 to 24 months. Cardiometabolic improvements such as blood pressure, cholesterol, and blood glucose also return to baseline.
In fact, weight regain after stopping GLP-1 medications appears to occur faster than after behavioural weight loss programmes.
This suggests that, like dieting, these medications will likely require lifelong use to maintain effects, raising serious questions about cost, equity, sustainability and informed consent.
Psychological and Mental Health Impacts
Alongside physical side effects, there is growing concern about psychological consequences. Pharmacovigilance data from Europe and Australia has identified reports of depression, anxiety, mood changes, and suicidal ideation associated with GLP-1 receptor agonists, particularly semaglutide and liraglutide.
Proposed mechanisms include disruption to dopamine pathways involved in reward, motivation, and emotional regulation. For individuals with a history of trauma, disordered eating including emotional, binge and compulsive eating, or mood vulnerability, these effects may be more pronounced.
There are also reports of a shift from food preoccupation to weight and progress monitoring, fear of regain, and compulsive checking behaviours. This mirrors eating disorder cognition rather than resolving it.
Advertising, Telehealth, and Vulnerable Populations
Eating disorder peak bodies have raised concerns about the marketing of medical weight loss treatments through telehealth platforms, including aggressive social media advertising and sales – based promotions.
There is concern that people with current or past disordered eating are being targeted or inadequately screened, with limited continuity of care and insufficient psychological monitoring.
Appetite suppression and numbing the brain preoccupation with food does not treat binge eating, emotional eating, or compulsive eating at their roots. When the medication stops, the underlying drivers remain.
Trauma, the Mother Wound, and Emotional eating
For anyone who has suffered with food, weight and body image concerns, the eating concern is not primarily about food. It is often about trauma in the body, negative thoughts (internalised from the environment), feelings & needs (that have not been seen, heard and met) safety, comfort and regulation.
The mother (and father) wound refers to early experiences of misattunement, emotional neglect, or caregivers whose own feelings and needs eclipsed those of the child. When distress is not met with consistent soothing, the body learns to regulate through whatever is available. Food often becomes a reliable source of comfort and grounding.
Later in life, this can look like emotional eating, binge eating, compulsive eating or chronic disconnection from hunger and fullness cues. Weight gain is not the problem. It is the signal.
No medication can replace the slow work of building an internal secure base, an internal caring and regulating presence, and a relationship with the body grounded in trust rather than control.
Some Bodies are Simply Bigger
It is essential to say this plainly. Human bodies come in a wide range of shapes and sizes. Not all weight gain is pathological. Not all larger bodies are unhealthy. Not all attempts to change body size are necessary or helpful.
Pathologising and medicalising size creates harm.
The Alternative: HAES as a Public Health Position, Not Just a Therapy Stance
Importantly, the previously mentioned UK parliamentary review did not argue against health care. It argued for better health care. It called for a shift away from weight-centred models toward weight-inclusive, evidence-based approaches that improve outcomes by focusing on sustainable behaviours, trauma-informed care, and the social determinants of health, rather than pursuing weight loss outcomes that rarely last.
This aligns closely with a Health at Every Size approach, which reframes health as something that can be supported at any body size. HAES shifts the focus from weight to wellbeing and prioritises:
- Compassionate, non-stigmatising medical care
- Attachment repair and nervous system regulation
- Supportive nutrition without restriction or moral judgement
- Joyful, functional movement rather than punitive exercise
- Social connection, meaning, safety, and belonging
- Trauma-informed psychotherapy
For many people, the work is not about shrinking the body. It is about healing the relationship with it. It is about restoring trust in hunger and fullness cues, developing safer ways to regulate thoughts and emotions, repairing attachment injuries, and building an internal sense of worth that is not contingent on body size.
A practical question that can be helpful in medical settings is this: What would you recommend if I were in a thin body presenting with the same concern?
This question gently exposes how often weight becomes the diagnosis, rather than one piece of a much larger, more human picture.
Quick FAQ: GLP-1 Weight Loss Medications, Emotional Eating and Weight-Centred Care
Are Ozempic, Wegovy and Mounjaro safe for people with eating disorders?
Caution is needed. Appetite suppression does not treat emotional, binge, or compulsive eating and may worsen preoccupation, fear of weight regain, and mood instability in vulnerable people.
Do GLP-1 medications lead to lasting weight loss?
For most people, no. Research shows rapid weight regain within 18 to 24 months after stopping, often faster than with diet based programmes.
Do GPL-1 medications fix emotional eating?
No. They reduce appetite, not the underlying drivers such as trauma, attachment injury, shame, or emotional regulation difficulties.
Can weight loss improve mental health?
Sometimes, but not reliably. Rapid weight loss can trigger anxiety, identity disruption, emotional numbness, depression, and in some cases suicidal ideation.
Is obesity a disease?
This framing is contested. Body size alone is a poor indicator of health and often obscures trauma, social context, and access to care.
What is wrong with BMI?
BMI does not account for age, sex, ethnicity, muscle mass, trauma exposure, or socio-economic factors and performs poorly as an individual health measure.
Are GLP-1 drugs just another form of dieting?
Mechanistically different, but culturally similar. The core assumption remains that weight loss equals health, with similar risks of weight cycling and psychological harm.
Why are clinicians concerned about telehealth prescribing of GPL-1 medications?
Concerns include aggressive marketing, limited screening, poor continuity of care, and insufficient monitoring for eating disorder and mental health risk.
What if my body is naturally larger?
Some bodies are simply bigger. Not all larger bodies are unhealthy, and medicalising size alone can cause harm.
What is the alternative to GPL-1 medications?
A Health at Every Size approach that focuses on trauma informed care, attachment repair, nervous system regulation, supportive nutrition, joyful movement, and overall wellbeing rather than weight.
What should I ask my doctor if weight is the focus?
What would you recommend if I were in a thin body presenting with the same concern?
Clinician Disclaimer
This article is for educational purposes only and does not constitute medical advice. Decisions about medication should be made in consultation with a qualified health professional who is HAES informed about eating disorders, trauma, and mental health. GPL-1 medications may be appropriate for some individuals and harmful for others. Care should always be individualised.
References
Cannon, B. (2016). A secret about dieting with Traci Mann, PhD. Eye on Psi Chi, 20(3).
European Medicines Agency. (2024). Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 8–11 April 2024: GLP?1 receptor agonists (safety review and pharmacovigilance data). European Medicines Agency.
House of Commons Women and Equalities Committee. (2021). Changing the perfect picture: An inquiry into body image (Sixth Report of Session 2019–2021). UK Parliament.
The Conversation. (2025, January 8). Stopping weight loss jabs leads to much faster rebound than thought. The Conversation.
Therapeutic Goods Administration. (2025, December 1). Product warnings updated for GLP-1 receptor agonist class [Safety alert]. Australian Government Department of Health and Aged Care.
West, S., Scragg, J., Aveyard, P., Oke, J. L., Willis, L., Haffner, S. J. P., Knight, H., Wang, D., Morrow, S., Heath, L., Jebb, S. A., & Koutoukidis, D. A. (2026). Weight regain after cessation of medication for weight management: A systematic review and meta?analysis. BMJ, 392, e085304.
