The dual role of GLP-1 receptor agonists in weight management and eating disorders: Potential benefits and risks

Mar 10, 2026Journal of psychiatric research

GLP-1 receptor drugs may help or harm weight control and eating disorders

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Abstract

GLP-1 receptor agonists may reduce binge-eating episodes but also raise concerns due to psychiatric adverse effects.

Evidence supporting the appetite-suppressing effects of GLP-1 receptor agonists is limited and inconsistent, often derived from small trials.
Some patients have reported reductions in binge-eating episodes when using GLP-1 receptor agonists.
Psychiatric adverse effects, including anxiety and depression, have been noted in individuals taking these medications.
Extreme appetite suppression and pathological dietary restrictions have been associated with GLP-1 receptor agonist therapy.
GLP-1 receptor agonists may affect brain reward pathways, complicating their influence on eating behaviors.
Caution is necessary when prescribing GLP-1 receptor agonists to individuals with a history of eating disorders.

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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as effective therapies for type 2 diabetes mellitus (T2DM) and obesity, as they improve glycaemic control, promote weight loss and modulate metabolic processes. However, their potent appetite-suppressing effects pose a complex challenge in patients with or at risk of eating disorders (EDs). This narrative review examines the dual role of GLP-1RAs in weight management and in the development or exacerbation of EDs, such as binge eating disorder (BED) and bulimia nervosa (BN). GLP-1RAs have been reported to reduce binge-eating episodes in some trials, but evidence is limited and often inconsistent due to small sample sizes. Conversely, psychiatric adverse effects - including anxiety, depression and disordered eating behaviours - have been observed, raising concerns about the use of these medications in individuals susceptible to EDs. There are case reports of extreme appetite suppression, pathological dietary restriction and psychiatric complications with GLP-1RA therapy, sometimes necessitating discontinuation. Moreover, GLP-1RAs influence brain reward pathways, which may further complicate their impact on eating behaviours. Although these drugs hold promise for mitigating certain ED symptoms, this review highlights the need for caution when prescribing GLP-1RAs to patients with disordered eating and calls for further research to delineate their benefits and risks in this population.

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The dual role of GLP-1 receptor agonists in weight management and eating disorders: Potential benefits and risks

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