I Took a GLP-1 and It Didn’t Cure My Relationship With Food. Now What?
- drtera
- Jun 2
- 5 min read
GLP-1 medications like semaglutide and tirzepatide have become increasingly common. One in 5 American women ages 50-64 have taken a GLP-1 for weight loss, according to a recent report from RAND. It can feel like everyone is on these prescriptions, compounding the pressure to be thinner, as we see our friends literally shrinking. Our diet and body obsessed culture has long fed us (pun intended) the idea that fat is the worst thing we can be-especially as women. Many women start these medications hoping not only for weight changes, but for peace from intrusive thoughts, less shame, reduced negative body image, and relief from years of feeling “out of control.”
And yet, a common experience emerges:
"My appetite quieted, but my relationship with food didn’t heal."
If that’s you, you’re not alone and there is help for the next steps.
What GLP-1 Medications Can (and Can’t) Do
GLP-1 receptor agonists work on the gut–brain axis to increase satiety, slow gastric emptying, and reduce hunger signals. In or some people, this leads to fewer binge episodes or less preoccupation with food, at least initially. I (Dr Tera) am a neuroscience nerd and have spent over a decade studying the insula (aka the part of the brain nicknamed "the body's monitor") and would love to share this science based approach to healing the whole person; mind, body, and spirit with you.
Research suggests that GLP-1s may reduce binge eating frequency in some individuals by influencing reward pathways involved in food intake. However, these medications do not directly address the emotional, cognitive, or relational aspects of eating. Psychological patterns such as shame, rigidity, fear of weight gain, or a long history of dieting often remain unchanged.
In other words, a medication can influence biology, but it does not automatically shift beliefs, identity, or coping strategies around food. Plus, I see many people in my practice who are using GLP-1s off label, microdosing, and chasing an ideal number on the scale. I have multiple clients with known eating disorders who found loopholes to be prescribed these medications and it has only served to further damage their mind-body connections.
Disordered Eating, Eating Disorders, and Overlap With GLP-1 Use
This distinction matters because disordered eating exists on a spectrum and it is far more common than many realize.
Binge Eating Disorder (BED) is the most prevalent eating disorder in the United States, affecting an estimated 2.8 million adults, with many more experiencing subclinical binge eating or loss-of-control eating. BED often coexists with chronic dieting, weight cycling, anxiety, negativ body image, anxiety and depression.
While GLP-1 medications may temporarily reduce binge behavior for some, they do not resolve:
emotional triggers for eating
internalized weight stigma
rigid food rules
fear-based control around intake
For individuals with current or past eating disorders, appetite suppression without psychological support can sometimes reinforce restrictive thinking or mask ongoing food or body based distress. This is why screening, monitoring, and individualized care are essential, especially when weight-focused interventions intersect with mental health. That's exactly why Dr. Tera feels so strongly about supporting people with these concerns, a committment that has only grown each of her 20 years in practice.
Health at Every Size® and Healing the Relationship With Food
A Health at Every Size® (HAES®) framework shifts the focus away from weight as a primary marker of health and instead emphasizes:
attunement to hunger and fullness
respect for body diversity
sustainable behaviors that support physical and mental well-being
reduction of weight stigma and shame
From this lens, the goal is not to control the body into submission, but to repair trust — with food, with your body, and with yourself.
Many people discover that even if a GLP-1 changes how much they eat, it does not change how they feel about eating. That work happens through therapeutic support, reflection, and skill-building not white knuckling or willpower.
Midlife, Perimenopause, and the Desire to “Remain the Same”
For many of my Gen X and Millennial friends, particularly those navigating perimenopause, body changes can feel both unfamiliar and deeply personal.
Hormonal shifts during perimenopause affect:
body composition
appetite regulation
mood and stress response
energy, recovery, and sleep
sex drive
sense of attractiveness & body image
Research shows that eating disorder symptoms can persist or re-emerge during midlife, often fueled by grief over body changes and pressure to “stay the same” in a body that is biologically evolving. I wrote another blog specifically about this if you want to check it out.
The tension between who you were and who your body is becoming can intensify food control, distress, and dissatisfaction — especially in a culture that equates thinness with worth and youth with value.
Healing in this phase requires compassion, flexibility, and care that acknowledges both biology and lived experience. I know you don’t deserve to feel like you are forced to fade into the shadows, this is a time to be supported and redefine what you want this next chapter to be about.
If the Medication Didn’t Fix It, There Is Still Hope
If a GLP-1 didn’t give you peace with food, that doesn’t mean you failed. It means your needs are more nuanced than a prescription alone can meet.
Effective, individualized treatment can include:
therapy for disordered eating or eating disorders
support for binge eating patterns and emotional regulation
HAES-informed, weight-neutral care
attention to midlife and perimenopausal transitions
space to unpack shame, identity, and long-standing food beliefs
a place to process unrealized dreams
This is where meaningful change happens not through restriction of food, emotion, thoughts, and needs, but through understanding with a therapist that will help you learn to regulate your nervous system, treat your anxiety and depression, and navigate the identity shifts inherent in this phase of life.
You Might Be Wondering...
Can a GLP-1 medication cure binge eating disorder?
Why am I still struggling with food after taking Ozempic or Wegovy?
Can therapy help if a GLP-1 isn't enough?
What is the connection between perimenopause and emotional eating?
What is a Health at Every Size® approach to food and body image?
How do I know if I have disordered eating?
Answers to these and many more questions would be a part of the theraputic discussion to understand your goals, where you are coming from, and define a path forward in your healing journey! Dr. Tera is an expert in this area and would love to be able to walk it with you.
Let’s Connect
If you’re finding yourself disappointed, confused, or emotionally stuck after starting a GLP-1, I invite you to schedule a complimentary discovery call with Dr. Tera. She provides telehealth services in 43 states.
This is a chance to:
talk openly about your experience with food and your body
explore whether disordered eating or binge eating patterns may be present
discuss supportive, individualized next steps grounded in evidence and compassion
You don’t need to choose between medical care and mental health. You deserve both, working together, in a way that honors your whole self.
You are not broken. Your body is not the problem. And healing is absolutely possible.
Selected Peer-Reviewed References
American Psychiatric Association. DSM-5-TR: Binge Eating Disorder.
Grilo CM et al. Neurobiological and behavioral mechanisms in binge eating disorder. Biological Psychiatry.
Wildes JE, Marcus MD. Eating disorders in midlife women. Current Psychiatry Reports.
Bacon L, Aphramor L. Weight science: evaluating the evidence for a paradigm shift. Nutrition Journal.
Rubino F et al. GLP-1 receptor agonists and appetite regulation. The Lancet.
RAND report link.
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