the starving brainFood Noise and GLP-1s
The treatment of eating disorders is rapidly evolving.
After nearly twenty years of doing this work, I did not expect a major shift to fundamentally disrupt the treatment models I had relied on for my entire career.
Initially, I was deeply skeptical of GLP-1 medications. One of my earliest blog posts was titled NOzempic. I feared we were witnessing yet another dangerous health craze—one that would reinforce physical bias, promote unattainable ideals, and intensify an already relentless cultural obsession with thinness.
I worried that the treatment of eating disorders—already complex and emotionally grueling—had just become even more complicated.
And then I began watching my patients.
Some chose to start GLP-1s despite my reservations. Even when I disagreed with the decision, I understood that for some, this was something they needed to explore.
We agreed to proceed only with full transparency—particularly around weight—and with a clear commitment to monitoring not just physical changes, but emotional ones.
A central part of treatment became paying close attention to what these medications felt like from the inside.
The Results
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What I observed was impossible to ignore.
The anguish quieted dramatically. The internal battle around food softened. Anxiety and depression decreased. Mental space opened up—space that allowed patients to reconnect with other aspects of their lives in ways that had previously felt inaccessible. We established clear weight floors, and when the weight dropped too low, medications were adjusted or paused. Care remained intentional, monitored, and collaborative.
To be clear:
the jury is still out.
In many ways, this is the Wild West of eating disorder treatment and GLP-1 use. There is much we still do not know, and humility is essential.
But I am willing to explore these medications as one tool—not a cure, not a shortcut, not a mandate—for a wide range of eating issues.
Relief is the goal. A full, meaningful life is the goal. Feeling comfortable in your own skin is foundational to well-being.
the bottom lineThis work is not about validating thin privilege.
It is about working within the society we actually live in—not the one we wish existed.
And perhaps, if we can truly turn down the volume on thin obsession and body preoccupation, we can finally begin to change the narrative itself.
For too long, food noise and body obsession have run the show.
Maybe this is one way—carefully, thoughtfully, ethically—to help dial that noise down.
