You're planning your birthday dinner and text the group for restaurant ideas. One friend writes back that she's excited to celebrate but doesn't care where you go, since she probably won't eat much now that she's on Zepbound. Another suggests somewhere with "lighter options" because she started Wegovy. Someone else jokes that you can all split an appetizer.
You've worked hard to be able to sit down to a full meal and enjoy it. Now you're bracing to be the odd one out at your own birthday. You feel irritated and hurt. A couple of these friends know your history, and you can't understand how they can talk on the thread about their medications and how little they eat. Then you notice a voice you rarely hear anymore. Your eating disorder voice is back for a moment, bringing a twinge of envy and the thought that it's not fair. You remind yourself how dark that part of your life was and how much the illness took from you.
Diet Talk in the Age of GLP-1s
Weight-loss medications have been around for decades. In an earlier post, I wrote about their history, including the amphetamine “rainbow pills” handed out at diet clinics in the 1960s and the fen-phen boom of the 1990s. The pattern has been remarkably familiar: A medication arrives with promises of making weight loss easier, enthusiasm grows, and widespread use eventually reveals risks or limitations that received less attention at first. By then, another medication may be on the horizon, offering renewed hope that the results will be different this time. Today, much of that enthusiasm surrounds GLP-1 medications such as semaglutide and tirzepatide.
While weight-loss advertisements have appeared in magazines, on billboards, and on television for decades, what feels different about this wave is the degree of visibility and accessibility. Now, you can open Instagram to look at a friend's vacation pictures and find yourself watching a video about GLP-1 medications. Telehealth companies and med spas advertise directly to consumers, often offering prescriptions after a brief online intake. Even when you aren't looking for weight-loss information, you may find it filling your social media feeds.
At the same time, more conversations are treating body size as a medical issue. “Obesity” is now referred to as a chronic disease, with the classification still based on BMI, a calculation basd only on height and weight that doesn't measure an individual's health. This shift reinforces the assumption that people in larger bodies need medical treatment to lose weight. With GLP-1 medications in the spotlight, weight loss is often presented as something you're expected to pursue for your health. If you're in recovery from an eating disorder, these messages can be difficult to question, especially when they come from healthcare providers or are presented as responsible health decisions.
Hearing about these medications from people you know can be even more difficult. A friend mentions how little she eats now or a family member says they're relieved to stop thinking about food. They may have no idea how that sounds when you've worked so hard to eat enough and respond to hunger. These conversations can stir up old fears about weight gain or leave you questioning what you've learned from your eating disorder treatment providers, particularly when the people around you seem convinced that losing weight has improved their lives.
The Prescription for an Eating Disorder
People who take these medications often say they think less about food. They may mention forgetting meals or feeling full after a few bites. If you're in eating disorder recovery, this can sound very much like the way you once described your illness. It can be disorienting to hear the experience being discussed with relief and sometimes pride, even by those who were once concerned about your “diet” and weight loss.
Much of eating disorder recovery involves learning to notice even subtle signs of hunger and eat in response. This may take years to achieve after you've learned to ignore or distrust your body. A friend talking about hunger as a problem that medication has solved can bring back doubts about whether responding to hunger is really the right thing to do, or even necessary.
The popular idea of "food noise" adds to the strain. Those of us working in the eating disorder field are very familiar with this phenomenon because being consumed with thoughts about food is a natural response to deprivation, as documented in the Minnesota Starvation Experiment in the 1940s1. We also know that labeling food “bad” and treating it as off-limits contributes to this “food noise.” Calling those thoughts noise to be silenced echoes what the eating disorder always claimed: that wanting food is the problem and quieting the want is the cure.
Eating Disorders Essential Reads
Protecting Your Peace With Food and Your Body
In order to protect your eating disorder recovery, it's necessary to separate someone else's choice from your own. Their decision to take a medication says nothing about what your body needs. Your friend's prescription came out of a conversation about their body. Your recovery came from years of work on your own.
Weight-loss talk can start before you have time to think about how you want to respond. Having one sentence in your back pocket can make those moments easier: “I'm trying to focus less on my weight and pay more attention to my body. Can we talk about something else?” You do not owe the whole table your history. I would practice saying it aloud, since boundaries can be harder to find when you're caught off guard.
While it's impossible to completely shield yourself from GLP-1 weight-loss messaging unless you move to a deserted island, it's possible to limit how much of it you actually consume. On social media, you can mute or unfollow accounts that post injection updates and before-and-after photos. If lunch turns into a conversation about weight loss and you can't, or don't have the energy to, redirect it, give yourself permission to excuse yourself.
At home, you may not get a break from it. If your partner or parent is on a weight-loss medication, you might sit down to dinner and watch them push away a plate that's still half full. They may mention how little they can eat now. Even when they say nothing, you take it in while you're trying to stay with your own hunger and fullness and enjoy the meal, all of which you worked hard to reclaim from your eating disorder. That's why the conversation at home needs to be more direct. Ask them to keep dose talk and body commentary away from shared meals. I imagine most people who care about you want to help and haven't connected their experience to your recovery.
If you're working with an eating disorder therapist or dietitian, bring these encounters to them, including the envy. Feeling a pull toward appetite suppression, wanting to lose weight, or fearing weight gain doesn't mean you're relapsing. It is useful clinical information about where your recovery needs support, and it is nothing to be ashamed of. Your therapist or dietitian can help you sort through what came up and plan for the next shared meal.
Back at the Table
You return to the group chat, and this time your eating disorder doesn't get to write the reply. You pick the restaurant you love and plan to order what you want. You tell the friends who know your history that all this weight-loss talk is hard for you, as you've worked too hard to find peace with food and your body, and ask them to leave it out when you're together. Either way, you get to sit at your own birthday dinner and eat a full meal.
To find a therapist, visit the Psychology Today Therapy Directory.