You’ve probably noticed the explosion of GLP-1 medications like Ozempic, Wegovy, and Mounjaro in the news, on social media, perhaps even in conversations with friends and family. As an eating disorders service, we’re often asked: What’s our position on these medications?
Last month, we wrote about how the rise of GLP-1 medications can feel for those in eating disorder recovery and the grief, confusion, and sense that diet culture has found a new disguise. If you haven’t read that piece, it may be a helpful starting point.
This month, we want to look at something different. Research consistently shows people regain the weight they lost within 1-2 years of stopping these medications, so what actually creates lasting change? We are particularly passionate about thepsychological work that improves both physical and mental health, whether someone is using these medications or not.
A Clear Starting Point
This blog is not encouraging weight loss.
At Altum Health, we know that the pursuit of weight loss has caused immense harm, particularly for those with eating disorders or disordered eating. The rise of medications marketed as a quick fix can feel confusing, overwhelming and distressing.
Yet, we also know that for people with certain health conditions, these medications can be genuinely helpful when used appropriately.
As we explored last month, these are serious medical treatments designed for people with specific health conditions, not aesthetic accessories for anyone wanting to be smaller. When they become tools for pursuing thinness rather than addressing genuine health needs, we are in dangerous territory. Human bodies are supposed to come in different sizes, weights and shapes. The pursuit of thinness for its own sake is not a medical goal; it’s a cultural one.
What we want to focus on here is the psychological work that determines whether any intervention leads to lasting change. Because that work? It’s remarkably like what we do every day in eating disorder recovery.
What Weight Loss Medications Actually Do
GLP-1 medications quiet what’s often called “food noise” – that constant mental chatter about what to eat, when to eat, and what you ‘should and shouldn’t’ have eaten. For people who experience this, taking weight loss medication can feel like having a radio permanently tuned to static finally switched off. They also work your brain’s reward pathways, which are the same dopamine-driven circuits that respond to highly palatable foods. Our food industry has created ultra-processed foods which are engineered to hijack these pathways, creating intense responses that can drive eating regardless of hunger. GLP-1 medications reduce the pull of these foods, allowing more intentional choices.
Taking GLP-1 medications causes something we call “symptom interruption”. It creates a pause in the complexity of eating, time to breathe and make informed choices.
But here’s the crucial point: symptom interruption is not the same as change.
The Work That Actually Matters
Whether someone is recovering from an eating disorder, working on disordered eating patterns, or using medication for health reasons, the psychological work that leads to lasting change is fundamentally the same:
Changing Your Relationship with Food
This means moving away from seeing food as the enemy, the comfort, the reward, or the punishment. It means learning to trust your body and eat according to what your body needs. This means regular meals, adequate nutrition, and flexibility rather than rigid rules. It means understanding that food is just food: neither good nor bad, neither salvation nor sabotage.
For those using GLP-1 medications, this is the work to do while the food noise is quiet. Learn what balanced eating looks like. Practise eating regular meals, responding to hunger signals, and learning to cook and enjoy the process of taking care of your body. By building these skills whilst on the medication, coming off becomes possible because we’re not solely reliant on having no appetite.
Changing Your Relationship with Your Body
Body positivity has been important, but for many, it can feel out of reach. Some days we feel at ease in our bodies; others, not so much. Instead, we help our clients move toward body neutrality, not forced positivity, but peaceful coexistence. This means recognising that your body is not a project to be fixed, and that your worth has nothing to do with your size. It means learning to respond to your body’s signals with curiosity and compassion rather than control.
Developing Alternative Coping Strategies
If food has been your primary way to manage stress, loneliness, boredom, celebration, or difficult emotions, expecting yourself to ‘jut stop’ is unrealistic. You need other options. We call this building your ‘Alternative Cookie Jar’, a collection of non-food ways to comfort, soothe, and care for yourself.
This is essential whether you’re in eating disorder recovery or using weight-management medication. Because if food has been your main coping strategy and that strategy is suddenly less available, you need somewhere else to turn.
Understanding Your Patterns
What drives your eating? Is it emotional regulation? Social connection? Habit? Reward-seeking? The patterns that shape your relationship with food don’t disappear when symptoms are interrupted. They wait. And if they’re not addressed, they reassert themselves the moment the interruption ends, which is when weight regain happens, leaving people feeling like they’ve failed.
Why This Matters for Our Community
We’re seeing something concerning in the GLP-1 landscape. Many people are being prescribed these medications with minimal psychological support. They experience symptom relief, they assume they’re “fixed,” and when they stop, the struggles return.
Not because they’re weak or have no self-control. Because they changed their symptoms without changing their relationship with food.
Research from Oxford shows that weight regain after stopping GLP-1 medications happens four times faster than after diet-only programs; people can return to near pre-treatment weight within 1.5 to 2 years.
Think about what we know from treating eating disorders. In severe cases, refeeding can be lifesaving. It addresses the immediate physical crisis. But refeeding alone doesn’t constitute recovery. Without the psychological work, the person’s relationship with food, their body, and themselves remains unchanged. The physical symptoms have been addressed, but the underlying patterns that drove the disorder are still there, waiting.
The same principle applies here. GLP-1 medications can interrupt symptoms, they can quiet the food noise, reduce the pull toward certain foods, and create space. But symptom interruption is not transformation. Without the psychological work, when the medication stops, the old patterns reassert themselves.
Both ED recovery and effective GLP-1 use require:
- Establishing regular, adequate eating patterns
- Developing a peaceful relationship with your body
- Building non-food coping strategies
- Understanding and addressing emotional triggers
- Moving away from all-or-nothing thinking about food
- Learning to trust your body’s signals
The medication might quiet the noise. But you still have to learn to live in the quiet – to build a relationship with food and your body that doesn’t depend on that external support.
What We Want You to Know
If you’re curious about GLP-1 medications, that’s understandable given how much attention they’re receiving. If you’re using them for health reasons and working with appropriate medical support, the psychological work outlined here is what will determine your long-term success.
But if you’re in eating disorder recovery or working on your relationship with food through other means, the work is the same. Learning to eat regularly, developing self-compassion, building alternative coping strategies, understanding your patterns, and making peace with your body.
That’s the work that changes things. Not the presence or absence of a medication.
The medication might give you quiet. What you build in that quiet is what actually matters.
We covered this in more detail last month, but it bears repeating for anyone with an eating disorder, a history of disordered eating, or a high drive for thinness: these medications require extreme caution or may not be appropriate at all. Please feel free to reach out to discuss how we can support you through this complex landscape and to prioritise your health.
