Weight loss drugs could help with binge eating disorder

This article discusses eating disorders, so please read the content with care.

Published today in eClinicalMedicine, the systematic review and meta-analysis carried out by UCL researchers found that weight loss drugs, known as GLP-1 receptor agonists, can reduce episodes of binge eating.

Lead author Dr Ilaria Costantini (UCL Psychiatry) explains, “Binge eating disorder, where people regularly eat an excessive amount of food while feeling they have lost control, is common and highly impairing, affecting over 17 million people worldwide.”

This eating disorder is characterised by loss-of-control and emotional eating – these episodes can be very distressing.

“Treatment options for binge eating disorder are limited and there are currently no approved medications, so there remains a need for better ways to help people living with this condition,” adds Ilaria. “We found evidence that weight loss drugs may help to manage some key symptoms of binge eating disorder.”

In the largest study to date on the subject, the researchers collated evidence from 25 randomised controlled trials that took place in 12 countries on four continents, including data from 8,069 participants.

The studies were testing the effects of drugs targeting the appetite-regulating hormone GLP-1 such as semaglutide (often marketed under brand names Ozempic or Wegovy), tirzepatide (also known as Mounjaro) or liraglutide.

These drugs target the central nervous system and insulin secretion to suppress appetite, and may also affect brain processes involved in reward and impulse control.

Study participants also reported increased cognitive or dietary restraint, related to how much people intentionally limit their eating, but the researchers say more studies are needed to understand this link.

First author of the study, PhD candidate Izzy Emptage (UCL Psychiatry), says, “From the evidence available, we cannot say whether the increase in dietary restraint reflects a positive and helpful form of self-regulation or if it is a more dysfunctional pattern of eating. We hope that future research can clarify whether or not taking weight loss drugs might contribute to more pathological forms of eating restriction such as meal skipping.”

While these drugs are typically used to support weight loss in people living with obesity, the findings suggest they could also play an important role in treatment plans for people with binge eating disorder, alongside psychological therapies and social support.

Ilaria adds, “One strength of our study is the involvement of a lived experience panel, who shared important insights into their views and concerns about the use of these medications for binge eating, as well as the challenges many people face in accessing treatment for binge eating disorder.

“Importantly, they emphasised that sustainable recovery is likely to depend not only on medication but also on psychological therapies and social support, as well as policy or community-level approaches to tackle societal norms and weight bias.”

The team hopes these findings will highlight the potential of weight loss drugs to help reduce binge eating symptoms and support further research into how these medications could be used in clinical practice and treatment plans.

Study limitations

The researchers note limitations of their study, as most of the trials included in the review had a high risk of bias and were funded by pharmaceutical companies, and they rarely included participants with a clinical diagnosis of binge eating disorder, which the researchers say limits the certainty of the findings.

They say that robust, independently-funded randomised controlled trials with long follow-up times that include people diagnosed with binge eating disorders are still needed to clarify the potential clinical role of these drugs to help treat binge eating disorder, and to determine whether the observed short-term benefits translate into meaningful and sustained improvements.

See the full paper here >

Dr Ilaria Costantini's Medical Research Foundation Launchpad Grant Award was supported by Rosetrees.

If you have been affected by any of the issues raised in this article, support is available. Contact the Beat Eating Disorders helpline on 0808 801 0677 (England) for emotional support and information.

More details about Beat's helplines and support services - including phone numbers for Scotland, Wales and Northern Ireland - are available on the Beat website: Helplines - Beat

You can also contact the Samaritans free of charge on 116 123, 24 hours a day, 365 days a year. If you feel you are in immediate danger to yourself, call 999.