Making Room for the Rainbow: A Conversation About GLP-1 Medications and Eating Disorders
As conversations about GLP-1 medications like Ozempic® (semaglutide), Wegovy®, Zepbound®, and Mounjaro® (tirzepatide) continue to grow, so do the questions.
Can these medications help someone with an eating disorder?
Could they make recovery more complicated?
After reading a thoughtful Elle article exploring these very questions, I found myself reflecting on what I have seen in my own clinical work. Like so much of healing, the answer is rarely simple.
The truth is, both can be true.
This is not a black-and-white conversation. In my work, I often talk about moving beyond black and white and leaning into the rainbow - a place where multiple truths can exist at the same time, where curiosity replaces certainty, and where healing often begins.
When we rush to label something as either "good" or "bad," we often miss the person sitting in front of us. For some individuals, GLP-1–based medications have reduced binge eating, quieted constant thoughts about food, and helped them experience relief for the first time in years. That experience should not be minimized. For others, appetite suppression can reinforce restrictive eating disorder thoughts, make it more difficult to meet nutritional needs, or complicate the recovery process. That experience is real, too.
When I think about these medications, I ask questions that go beyond weight or appetite:
What is this person's relationship with food?
What role has dieting played throughout their life?
Is the medication helping them move toward health, or further into disconnection from their body's needs?
Are we treating the behavior, or are we also addressing the emotions underneath it?
Does this person have the support of providers who understand both the medical and psychological aspects of eating disorders?
These questions are important because eating disorders are about so much more than food. Food is often the language an eating disorder speaks, but it is rarely the whole story. Recovery is about rebuilding trust with your body. It is about healing shame, perfectionism, anxiety, trauma, and the belief that your worth is determined by your size or what you eat. A medication may reduce appetite or quiet "food noise," but unfortunately it cannot heal the emotional wounds that often fuel an eating disorder.
That does not mean these medications do not have a place. For some people, they absolutely may. It simply means they work best when they are part of a larger treatment plan, one that includes thoughtful medical care, nutrition support when appropriate, and therapy that addresses the underlying patterns keeping an eating disorder in place.
One of the takeaways from the Elle article - and one I wholeheartedly agree with - is that we need more nuance in this conversation. We can acknowledge that GLP-1–based medications, including semaglutide and tirzepatide (and now retatrutide), may be incredibly helpful for some people while also recognizing that they may not be the right fit for everyone. Those two ideas are not in conflict.
If you have a current or past history of an eating disorder and are considering one of these medications, give yourself permission to slow down, ask questions, and create a treatment team that understands both the medical and emotional pieces of the puzzle. There is no prize for making a quick decision.
Healing has never been about finding the perfect answer - it is about finding the approach that honors your whole self. More often than not, healing is found in the rainbow - in the space where we can hold complexity, ask thoughtful questions, and make room for more than one truth.