“GLP-1s and the New ‘Perfect’ Body: What Are We Really Normalizing?” Nicole Paolucci LMHC

Let’s talk a little bit about GLP-1s and eating disorders.

GLP-1s are on the rise, coming in all different names and from different manufacturers, and they are becoming incredibly easy to access. What was once primarily a medication for people struggling with diabetes has now become the new diet drug of the century. In some cases, access to these medications can literally be just a click away.

People are experiencing pretty immediate effects and losing weight very quickly. At the same time, we still don’t fully know what all of the potential long term effects of these medications will be.

For chronic dieters and people who have struggled with eating disorders, this can feel like the most amazing thing in the world. Here is something that can decrease your appetite, help you lose weight quickly, and seemingly take away the constant thoughts about food.

But we need to look at the bigger picture.

The “average” woman’s body we are seeing today is not necessarily a natural or average body. Young women are constantly looking at photos and videos on social media of flat stomachs, tiny waistlines and thigh gaps. They’re watching women eat what looks like huge meal, and somehow still have a perfectly flat stomach immediately afterward.

That is not the norm.

Our bodies change after we eat. Carbohydrates hold onto water. Our stomachs expand. We get bloated. We retain fluid. We go out drinking and may wake up looking different the next morning. That is part of having a human body.

Yet women are being shown these images over and over again and getting the message that we should be able to eat, drink and live our lives while still maintaining a completely flat stomach at all times.

There is such a lack of acceptance around normal fat on our bodies and what normal fat distribution is actually supposed to look like.

And who is making money off all of this?

Pharmaceutical companies, clothing lines, fitness centers, brands, celebrities, influencers and the list goes on. Because at the end of the day, there is a lot of money to be made when people continue to feel like their bodies need to be changed.

We are also seeing a rise in GLP-1 use among people who have struggled with eating disorders. One of the things I hear all the time is, “It quiets the food noise.”

But how about sometimes we are supposed to have food noise?

If you are hungry, your body is telling you that you need to eat. If you have been restricting or dieting, of course you may be thinking about food more. Your body is trying to tell you something.

And yes, when you take a medication that decreases appetite, you may experience less hunger and fewer thoughts about food. But for someone with an eating disorder, we have to be really careful about what that means.

Are we actually treating the eating disorder, or are we giving the eating disorder another way to ignore hunger?

The other part of this conversation is: What happens when you come off the GLP-1?

What happens if you can’t afford it anymore? Your insurance stops covering it? You don’t want to take it anymore? Or you have to stop for another reason?

If you already struggle with an eating disorder and your appetite comes back or your body begins to change, you may find yourself right back at square one, desperately trying to figure out another way to lose the weight quickly.

I always tell my clients: Diets work when you’re on them. When you’re off them, they don’t work anymore.

GLP-1s absolutely have a place in medicine, and there are people who medically need and benefit from them. But when it comes to eating disorders, chronic dieting and body image, we need to be having a much bigger conversation about what these medications are doing….not only to our bodies, but to our relationship with food, hunger and what we believe our bodies are supposed to look like.