GLP-1’s: You Have My Attention
In a few years, unless something changes dramatically, anyone who wants to be on a GLP-1 will probably be. And if you live with food noise, those relentless thoughts about how, what, or when to eat, what’s “healthy,” or whether you’ve earned your food- then chances are, you’ll consider taking one too.
As an expert in food and the bodies who has worked in the field of eating for 18 years, I can no longer walk into a room without someone asking me what I think about it all.
Am I pro or against?
Is this helping or hurting?
What message is this sending to the world about thin privilege and thin superiority?
So- let’s take in the truths. The truth is that our world is obsessed with being thin.
Thinness has become a physical symbol of wealth, superiority, privilege, and discipline.
Fatness is too often viewed—consciously or not—as a symbol of weakness or lack of self-control. I don’t endorse these beliefs. I’m naming them because they’re real, and they shape how we see ourselves and each other.
We make hiring decisions based on body size. We form dating preferences. We make parenting choices. And the clutter and noise in our heads is often connected to how we feel in our bodies.
I’ve written about the factors that contribute to this: cultural discrimination, racial privilege, religious beliefs, genetics, biology, neuroplasticity, and the fact that the food most easily available to us is addictive and chemically engineered. These historical and scientific forces underlie why we attach value to size and shape, even when we know we shouldn’t.
After nearly two decades in this work, I don’t think thin preoccupation is going anywhere (though I wish it would).
What I do believe—powerfully—is that the way forward is to use every tool available to help people feel more content in their bodies and less demoralized by the ones they don’t have.
So, do I believe that GLP-1s may be a tool to help with food noise—and possibly even with anorexia and bulimia? The answer is that it merits a real investigation.
Though counterintuitive, one of the defining symptoms of eating disorders is relentless, obsessive food noise.
And food noise, even on its own, is enough of a symptom to merit treatment. I’m beginning to think that treating food noise through GLP-1 use may actually be a way to quiet the symptoms enough to allow healing to begin.
How these medications may help is by disrupting what I call the Flawed Food Loop.
At the heart of foodnoise is restriction. People restrict themselves to feel better. They think they’re being “good” if they eat less. They skip meals to justify a larger dinner. They “drink their calories.”
They follow rigid, often secret rituals around food. That restriction is typically followed by overconsumption, or bingeing, to compensate for the deficit.
The binge leads to deep shame and guilt, which then drives more restriction.
What I call the Flawed Food Loop repeats again and again, becoming more entrenched as the noise and symptoms grow louder. What we practice grows stronger, and our neural pathways deepen.
So what if GLP-1s are a tool to quiet the noise and loosen the grip of restriction?
What if food becomes less powerful, less seductive, more normalized?
That’s what I’m seeing- again and again- even in patients who are underweight or at low weight. They are feeling freedom from the noise. And in some cases, they have the healthiest relationship with food and their bodies that they’ve ever had.
So who am I to ignore this? GLP-1s—you have my attention. The question now is: where do we go from here?
Can we use these medications not just for weight loss, but for healing? For quieting the noise, softening the shame, and helping people live more freely in their bodies?
I want to know what you think. Let’s talk about it. Leave it in the comments.
Get to KnowDr. Danielle Shelov
Dr. Shelov's therapeutic approach emphasizes understanding individuals within the context of their families, childhood experiences, relationships, and larger systems as crucial to psychological treatment.
You Might Also Like
