Nobody’s talking about the dangers of binge eaters abusing weight-loss drugs

People don’t realise the weight piles back on and exacerbates eating disorders, warns a counsellor and eating disorder specialist

When I first heard about the weight-loss injection Wegovy from colleagues in 2022, my immediate concern was not, as some may expect, about anorexic patients. It was binge eaters that worried me. A symptom of bulimia nervosa and binge eating disorder, it’s at least five times more common than anorexia nervosa.
Bulimia involves eating large quantities of food, often in a robotic or dissociative state, followed by periods of purging or restriction. Binge eating disorder involves episodes of binge eating without periods of purging or restriction. Binge eating is a way for people to “detach” from their challenges, traumas and big emotions to “self soothe” and ultimately leads to weight gain. 
Those who binge eat as part of their eating disorder are woefully let down by health services and many therefore turn to drugs like Wegovy and Ozempic (which is actually a diabetes medication but is often prescribed off-label for weight loss).
They work by reducing appetite and putting people off food, and for those who struggle with binge eating, this can seem like an appealing option.
I have encountered many patients who have tried these medications – more often than not, hoping for a quick fix. But the reality is, there is no quick fix when recovering from disordered eating, or an eating disorder.
Rather than gaining a sense of relief from weight loss while using these jabs, those who binge eat are still left with the traumas and struggles they have been consciously or subconsciously trying to avoid.
If a patient can no longer binge eat as a means of coping, they will very likely move on to a different harmful coping mechanism. This could be anything from an increased alcohol consumption to overspending, gambling, excessive screen time, doom scrolling, over-exercising or workaholism, just to name a few.
There is also the realisation that they will inevitably have to come off of the medication, meaning their binge eating will very likely return. Ongoing peer-reviewed research into using semaglutide for weight loss continues to show that by six to 12 months after coming off of the medication, participants have gained the weight back again.
Many companies show the before and “immediate” after shots of their patients, what they don’t show is how the patient fared six to 18 months after stopping treatment, when they regained the weight. When the weight returns, it can quickly exacerbate feelings of shame, blame and even hopelessness.
Moreover some of my patients have experienced terrible side effects. The drugs can create problems for your pancreas and kidneys and lead to low blood sugar, vision changes and even severe allergic reactions. They can make you incredibly nauseous and quickly encourage any patterns of restriction or purging that the patient may already have by dramatically dampening their appetite.
The fact is that no medication or diet club will promote recovery for people with eating disorders because they don’t support them to process the root causes of their binge eating. Instead, we need a multidisciplinary approach, with psychology specialists like myself, eating disorder dietitians, lifestyle medicine doctors, and even neurodivergence specialists. Our NHS remains chronically underfunded and understaffed; these services generally don’t exist. Without accessible support, it is easy to understand why so many turn to semaglutide.
Semaglutide medications are not a magic bullet for binge eating but I see them being advertised as such. For example, one patient sent me photos from an airport ahead of a holiday, offering Wegovy at “a feather-light price” and saying it can help you “look great in your holiday photos”. It was absolutely startling to see how these medications are becoming the norm.
Additionally, Wegovy and other weight loss drugs have become so dangerously accessible that they risk attracting people with a healthy weight who are hoping to achieve the “ideal body” – which doesn’t exist – into succumbing to cycles of disordered eating.
This is especially a problem for young women who think they need to be slimmer to be more desirable. They are seeing very warped images of people online who don’t look like that in real life – influencers like Kim Kardashian or Kylie Jenner are examples – and so semaglutide drugs become even more appealing.
The NHS says Wegovy should only be prescribed for obese people who have developed health problems due to their weight. I think it really needs to be a tool for patients who are extremely unwell due to their weight and have multiple comorbidities. Then these drugs should only be offered as part of a much wider plan that involves nutritional education and help for the eating disorder. Semaglutide is a tool, not a solution. I don’t demonise weight loss jabs; I just think they’re currently being misused, and we need to see further research into how these drugs can be used in a wider framework safely and successfully.
As told to Emily Craig
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