GLP-1-Based Therapies in Eating Disorder Recovery

Background/Objectives: Glucagon-like peptide-1 (GLP-1)-based therapies, initially developed for glycemic control and now widely used for weight management, affect appetite, satiety, gastrointestinal function, and body weight in ways that may support or complicate eating disorder (ED) recovery. This review examines emerging evidence on GLP-1-based therapy use across ED presentations and considers implications for recovery-oriented care. Methods: We conducted a narrative synthesis of peer-reviewed research, review articles, and relevant clinical guidance addressing GLP-1-based therapy mechanisms, ED psychopathology and treatment, and recovery-related clinical and psychosocial considerations. Results: Evidence is most developed for binge-eating disorder (BED), but remains preliminary and inconsistent. Some observational findings suggest reductions in binge-eating symptoms, whereas a placebo-controlled trial found greater weight loss without a significant between-group difference in binge-eating episodes. Evidence for bulimia nervosa, anorexia nervosa, atypical anorexia nervosa, and other specified feeding or eating disorder presentations is sparse. For restrictive and purging presentations, appetite suppression, early satiety, delayed gastric emptying, and gastrointestinal adverse effects may reinforce restriction, complicate symptom monitoring, or interfere with nutritional rehabilitation. Conclusions: GLP-1-based therapies are not established treatments for ED psychopathology, and changes in weight, metabolic health, or selected symptoms should not be equated with multidimensional ED recovery. When these medications are prescribed for appropriate medical indications or investigated as adjunctive treatments, ED screening, informed consent, multidisciplinary monitoring, and assessment of psychological, nutritional, behavioral, and functional outcomes are warranted.