Can Weight-Loss Injections Such as Mounjuro and Ozempic Reduce Binge Eating?
GLP-1 receptor agonists (such as semaglutide, liraglutide and tirzepatide) are now familiar in weight loss and the treatment of type 2 diabetes. A new systematic review and meta-analysis published under the leadership of University College London (UCL) points to another effect of these drugs: reducing binge-eating symptoms.
When data from 25 randomized controlled trials and 8069 participants were pooled, people using GLP-1RAs reported less uncontrolled eating, less eating disinhibition and less emotional eating than controls. However, the quality of the evidence behind this finding matters as much as the results themselves.
Binge-eating disorder (BED): An eating disorder defined in DSM-5, characterized by episodes of consuming excessive amounts of food in a short period with a sense of loss of control. It affects more than 17 million people worldwide, and approximately two-thirds of these people are also overweight or obese.
Loss-of-control eating: A behavioral pattern in which a person feels unable to stop the amount they eat, even without a BED diagnosis.
Eating disinhibition: A tendency to overeat in response to emotional or environmental triggers, independently of hunger signals.
Emotional eating: Responding to emotional states such as stress, anxiety or sadness by eating.
Cognitive/dietary restraint: A tendency to consciously limit food intake—it may be healthy self-regulation, or, when excessive, a pattern that increases the risk of an eating disorder.
The researchers searched MEDLINE, EMBASE, PsycINFO and Cochrane CENTRAL databases from January 2005 (the first GLP-1RA approval) - April 2026. Randomized controlled trials comparing treatment with placebo, an active drug or standard care and reporting eating behavior using validated scales were included. Participants with serious physical comorbidities (such as cancer) were excluded—we will return to this point at the end of the article.
30.732 records screened → 25 RCTs included in the systematic review, 24 included in the meta-analysis.
8069 participants, 12 countries, 4 continents (84% in high-income Western countries).
Median age 47,3; of the participants, 67,5% were women; median baseline BMI 35,8 kg/m².
Treatment duration ranged from 6-104 weeks.
| Drug | Target | Number of Studies | Administration |
|---|---|---|---|
| Liraglutide | GLP-1R | 12 (%48) | Daily injection |
| Semaglutide | GLP-1R | 6 (%24) | Weekly injection or oral |
| Retatrutide | GLP-1R, GIP, GCG | 2 (%8) | Weekly injection |
| Dulaglutide | GLP-1R | 2 (%8) | Weekly injection |
| Exenatide | GLP-1R | 2 (%8) | Injection twice daily |
| Tirzepatide | GLP-1R, GIP | 2 (%8) | Weekly injection |
| Survodutide | GLP-1R, GCGR | 1 (%4) | Weekly/daily injection |
| Cagrilintide | Amylin analogue | 1 (%4) | Weekly injection |
Note: Most of the evidence comes from liraglutide, the oldest GLP-1RA and the one that has been on the market longest. Data on newer drugs with more powerful appetite-suppressing effects, such as tirzepatide and retatrutide, are very limited.
In a separate analysis, loss-of-control eating was assessed on a 0-100-point scale and was, in the GLP-1RA group, on average 18,4 points lower (95% CI: 13,4-23,3 points) than in controls (n=362, k=5)—a reduction of clinically noticeable magnitude.
This last row is particularly noteworthy: in the 3 studies involving a BED diagnosis or directly targeting binge eating, the effect size (g=-0,60) appears numerically larger than that in the other 14 studies (g=-0,27). However, the difference is not statistically significant (interaction p=0,10) and is based on data from only 129 people—there is not yet enough power to conclude that the drugs are “more effective in BED patients.”
- Of the 25 studies, 12 were rated “high risk” and the remainder “some concerns” (Cochrane RoB-2)— no study received a “low risk” rating.
- The most common problems were deviations from the planned intervention and missing outcome data (the known adverse effects of GLP-1RAs create a risk of compromising blinding).
- Heterogeneity was high in the overall pooled result and disinhibition analyses, and moderate to low in the loss-of-control and binge-eating analyses.
- In some studies, data were not provided numerically in the original article but were estimated by digitally “reading” graphs.
- All studies were short to medium term (6-104 weeks); there are no data on whether the effect persists after treatment is stopped.
- Funders: Wellcome Trust and Medical Research Foundation —reported to have had no role in the study design, analysis or publication decision.
- There are no pharmaceutical company employees among the authors.
Biological/metabolic pathway (strong evidence): A direct anorectic effect in the central nervous system, increased insulin secretion and delayed gastric emptying—all of these can indirectly reduce uncontrolled eating.
Emotional/reward pathway (evidence still preclinical/speculative): GLP-1RAs can cross the blood-brain barrier, and animal/imaging studies suggest they may also affect reward circuits associated with food cravings and impulsivity. However, this meta-analysis did not directly test this pathway—it could not distinguish which mechanism was responsible (weight loss, direct appetite suppression or changes in reward circuits).
- “GLP-1 drugs treat binge-eating disorder”
- “These drugs are now an approved, proven solution for BED too”
- “Increased restraint shows that these drugs completely restore eating control”
- No GLP-1RA is approved for a BED indication; the effect is adjunctive and small to moderate in magnitude
- Only 3/25 studies directly targeted BED; most evidence is exploratory
- None of the 25 studies received a “low risk” rating
- Whether increased restraint is good or bad is unclear; cancer patients were excluded
The researchers held two patient-involvement meetings with 11 people with lived experience. Some participant comments:
“This is just a tool, not a solution. It helps in the short term, but psychological support is essential too.”
“More than one thing brought us here; it will take more than one thing to get us out.”
- As explicitly stated in the methodology section, “participants with serious physical comorbidities (such as cancer)” were excluded. Whether this effect of GLP-1RAs on binge eating applies to people receiving cancer treatment or living after cancer is unknown.
- Obesity is recognized by IARC as a risk factor for 13 different cancer types; on our website, we previously discussed GLP-1RAs in the context of weight loss and cancer risk —but this new study focuses on the effect on eating behavior independently of weight loss.
- In Turkey, semaglutide (Ozempic/Wegovy), tirzepatide (Mounjaro) and liraglutide (Saxenda) are licensed for type 2 diabetes and obesity indications; there is no separate indication or SGK reimbursement for binge-eating disorder.
- Emotional eating, appetite changes and body-image problems are common during cancer treatment—but this does not justify trying a GLP-1RA without consulting your oncology team.
There are very few approved drug options for BED; because GLP-1RAs are already widely prescribed, any additional benefit could quickly affect clinical practice. This is the most comprehensive systematic review to date.
In the meta-analysis of 25 RCTs / 8069 participants, binge-eating severity (g=-0,23), eating disinhibition (g=-0,54), loss-of-control eating (-18,4 points/100) and emotional eating (g=-0,30) decreased in the GLP-1RA group versus controls; cognitive restraint increased (g=+0,31). The overall pooled effect was g=-0,50.
Only 3 studies directly targeted BED; none of the 25 studies received a “low risk” rating; participants were mostly white, middle-aged and Western; follow-up was short to medium term; cancer patients were excluded; most included studies were industry-funded.
GLP-1RAs may be an adjunctive option in patients with obesity and BED/binge-eating symptoms—but they do not replace psychotherapy, dietitian support and social support. In cancer patients, decisions must be made together with the oncology team.
What is the relapse rate when treatment is stopped? Do more potent agents (tirzepatide, retatrutide) have a larger effect? Is the effect independent of weight loss or dependent on it? What would safety and efficacy be like in cancer patients?
References:
- Emptage I, Kozmér S, Cobham-Wilson A, Sousa B, Sugden K, Wheeler L, Llewellyn C, Makarondis J, Bulik C, Solmi F, Costantini I. The effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on binge eating in patients with obesity: a systematic review and meta-analysis. eClinicalMedicine. 2026;104007. doi:10.1016/j.eclinm.2026.104007
- Lauby-Secretan B, et al. Body Fatness and Cancer—Viewpoint of the IARC Working Group. N Engl J Med. 2016;375:794-798.
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