Ozempic Treat Binge Eating

Can Ozempic Treat Binge Eating? For Some, the Answer Is Yes

Kristen Ireland struggled with bulimia nervosa for years, working with a therapist and taking medications for anxiety and depression.

It wasn’t until her psychiatrist prescribed Victoza, a diabetes medication that works much like Ozempic, Wegovy and Mounjaro, that her binges and purges faded away.

“I feel free now,” said Ireland, 27 years old, who manages sports-merchandise stores in Jackson Hole, Wyo. 

Treating eating disorders is another potential application for a class of drugs that has taken the weight-loss world by storm. The drugs, synthetic versions of the GLP-1 hormone that act on appetite centers in the brain and gut, have helped patients lose 15% of their body weight on average. 

How Ozempic works in the body

Ozempic and similar drugs mimic a naturally occurring gut hormone called glucagon-like peptide 1, or GLP-1, which binds to and activates receptors in various parts of the body that can have beneficial effects for diabetes and obesity.

Pancreas: Helps pancreas produce more insulin when blood sugar is high, lowers secretion of glucagon

Some studies and the experience of doctors in the field suggest they could also help people stop binge eating. Along with helping people feel full sooner and longer, GLP-1 drugs reduce the effect of dopamine released while eating. The drugs work on an area of the brain involved in impulse control and decision-making, leading to better control and less impulsiveness around food, neuroscientists said. 

But the drugs don’t address problems that often underlie binge eating or bulimia. The drugs might reduce the frequency of binges but they can’t relieve related stressors, trauma or mental illness, eating-disorder specialists said. Any benefit might disappear when people stop taking the drugs. 

“It’s a short-term fix,” said Dr. Kelli Rugless, a psychologist and chief clinical officer at Project HEAL, a nonprofit that helps people with eating disorders pay for treatment.

About one-tenth of Americans will develop an eating disorder in their lifetime, according to the National Eating Disorders Association. Binge-eating disorder, when a person regularly binges while feeling a loss of control or distress over eating, is the most common.

Dr. Andrew Kraftson, director of the Weight Navigation Program at the University of Michigan, said he closely monitors his patients taking the drugs who have binge-eating disorder, to see how the medication might be helping. Patients with a history of anorexia, however, require particular attention and vetting, he said, and anyone with active anorexia shouldn’t take them. 

Ireland said she took Victoza from 2018-22 except during monthlong gaps when her insurer stopped paying for the drug until she and her doctor pushed back. “I’d be back to eating quarts of ice cream every night, and then I’d purge in the morning,” Ireland said.  

Her psychiatrist, Dr. Michael Lutter, switched her to low-dose semaglutide, the active ingredient in Ozempic and Wegovy. Ireland said she pays about $300 out-of-pocket for a 2 ½-month supply from a pharmacy in Dallas. The Food and Drug Administration doesn’t review versions of the drugs made at so-called compounding pharmacies. 

Lutter spent years studying how genetic mutations affected binge eating. He found that some people with binge-eating disorder had mutations that affected hunger and fullness cues. He began prescribing the drugs to patients in 2019 when he started his own practice in Plano, Texas.

Dr. Michael Lutter has studied how genetic mutations affect binge eating. PHOTO: NATALIE ROBERSON

“They respond amazingly well,” Lutter said. He starts patients on low doses of the drugs and increases them until the binge eating is brought under control. The goal isn’t weight loss, he said, though patients often lose weight. He said he encourages patients to take the drugs in conjunction with treatment by therapists and dietitians. 

Annie Moody, 17, had been binge eating for years before she was referred to Lutter in 2021. More adolescents are taking medications for weight loss and getting bariatric surgery, measures the American Academy of Pediatrics this year recommended to treat obesity for some children. 

Lutter diagnosed her with binge-eating disorder and tried prescribing a couple of drugs that didn’t work, including an ADHD drug FDA-approved to treat binge eating and an appetite suppressant. In January, he prescribed a low dose of semaglutide, which she gets from a compounding pharmacy in Frisco, Texas. Moody’s family pays about $180 for a three-month supply. 

Food used to take up all her thoughts, she said. When she wasn’t eating, she was obsessing over what she would eat next. When she ate, she lost control, eating until she felt sick. That has all changed on semaglutide, she said: “I can think about other things now.”

Prescribing weight-loss drugs to treat eating disorders without a robust therapy requirement could be dangerous, several eating-disorder specialists said. Effective treatment for binge eating requires helping patients recognize innate hunger and fullness cues, said Dr. Holly Peek, assistant medical director of the Klarman Eating Disorders Center at McLean Hospital in Belmont, Mass. “It’s missing the forest for the trees,” she said.

Dr. Susan McElroy, a psychiatrist and chief research officer at the Lindner Center of HOPE in Ohio, prescribes GLP-1 drugs for patients with binge eating, together with therapy and the oversight of eating-disorder specialists. She also monitors patients’ weight, eating patterns and lab results. “These drugs can work when nothing else has worked,” McElroy said.

Lutter said the semaglutide and similar drugs he prescribes aren’t meant to replace therapy. Patients can go back to their dietitian or therapist if their binge eating resumes, he said. 

Moody and Ireland said they don’t feel they need the support of therapists or dietitians anymore. Both expect to be on the drug indefinitely. 

“It’s a huge part of me,” Ireland said.