Medications such as semaglutide, tirzepatide and liraglutide may affect more than appetite and body weight. A new review found that people taking GLP-1-based medications also reported fewer episodes of binge eating, loss-of-control eating and emotional eating.
The findings do not establish that the drugs are an effective treatment for binge eating disorder, however. Most of the more than 8,000 participants had obesity rather than a clinical diagnosis of the disorder, and binge eating was often not the primary reason they entered the trials.
Researchers from University College London and several collaborating institutions analyzed 25 randomized controlled trials conducted in 12 countries. The systematic review and meta-analysis was published in eClinicalMedicine.
Many of the included trials were funded by pharmaceutical companies and were judged to have a high risk of bias. Several authors also reported relationships relevant to the broader GLP-1 research field. One researcher has received institutional funding for unrelated trials funded by Novo Nordisk, another works on a trial funded by the Novo Nordisk Foundation and another reported consulting and royalty income unrelated to the study.
Those factors do not invalidate the findings, but they add to the need for independently funded trials designed specifically around binge eating disorder.
GLP-1 receptor agonists mimic or enhance signals involved in appetite, blood sugar regulation and digestion. They can reduce hunger, slow the movement of food from the stomach and influence brain pathways involved in reward and impulse control.
Those effects have made the drugs widely used for type 2 diabetes and weight management. Researchers are now examining whether they may also change eating behaviors associated with binge eating disorder.
Binge eating disorder involves recurring episodes of eating unusually large amounts of food while feeling unable to stop or control the eating. It can cause significant distress and may occur with or without obesity.
“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,” lead author Dr. Ilaria Costantini of UCL Psychiatry said.
Treatment commonly includes psychological therapies, nutritional support and, in some countries, medication. The researchers said access to appropriate care remains limited, creating interest in additional treatment options.
Across the trials included in the review, GLP-1-based medications were associated with reductions in binge eating, loss-of-control eating and emotional eating. Participants also reported greater cognitive or dietary restraint, meaning they were more intentionally restricting or regulating how much they ate.
That result was not necessarily reassuring.
“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,” first author Izzy Emptage, a doctoral candidate at UCL Psychiatry, said.
The researchers said future studies should examine whether GLP-1 medications encourage constructive eating regulation or potentially contribute to behaviors such as skipping meals or overly restrictive eating.
That distinction is especially important in eating disorder care. A person can experience fewer binge episodes while still developing an unhealthy relationship with food, body weight or restriction. Changes on an eating behavior questionnaire also do not necessarily demonstrate long-term recovery or improved quality of life.
The trials varied in how they measured binge eating and related behaviors. Few recruited people specifically because they had binge eating disorder, and most did not follow participants long enough to determine whether improvements lasted after treatment ended.
The review therefore offers an early signal rather than a clinical verdict. It suggests GLP-1 medications may influence some of the biological and behavioral processes involved in binge eating, but it does not show that medication alone can address the psychological, social and environmental factors that shape the disorder.
A lived-experience panel involved in the research raised similar concerns. Participants emphasized that medication would be unlikely to provide sustainable recovery without psychological care, social support and efforts to address weight stigma.
“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,” Costantini said.
She added that panel members emphasized the importance of combining medication, when appropriate, with broader treatment and support.
The researchers called for larger, independently funded randomized trials that specifically enroll people diagnosed with binge eating disorder. Those studies would need longer follow-up periods and should measure not only the number of binge episodes but also psychological well-being, restrictive behaviors, treatment durability and quality of life.
Until that research is available, the findings should not be read as evidence that GLP-1 medications are a stand-alone treatment for binge eating disorder. They instead provide a reason to investigate whether the drugs could eventually become one part of a broader, carefully monitored treatment plan.
The research was supported by grants from Wellcome, the Medical Research Foundation and the National Institute for Health and Care Research. Funding also supported participation by people with lived experience.
One author reported institutional funding for unrelated research trials funded by Novo Nordisk. Another author currently works on a trial funded by the Novo Nordisk Foundation. A third author reported royalties from Pearson Education and consulting work for Orbimed.