Drugs commonly used for weight loss, known as GLP-1 receptor agonists, have been found to reduce the key symptoms of binge eating disorder, in a new review of evidence led by University College London (UCL) researchers.
The systematic review and meta-analysis, published in eClinicalMedicine, found that weight loss drugs can reduce binge eating episodes, loss-of-control eating and emotional eating, and highlights its potential role to treat binge eating disorder as well as obesity.
Lead author Dr Ilaria Costantini (UCL Psychiatry) said: "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.
"But treatment options are limited and there are currently no approved medications, so there remains a need for better ways to help people living with this condition. We found evidence that weight loss drugs may help to manage some key symptoms of binge eating disorder."
In the largest study to date on the subject, the researchers pulled together evidence from 25 randomised controlled trials that took place in 12 countries on four continents, including data from 8,069 participants.
The studies were testing the effects of drugs targeting the appetite-regulating hormone GLP-1 such as semaglutide (often marketed under brand names Ozempic or Wegovy), tirzepatide (also known as Mounjaro) or liraglutide.
These drugs can suppress appetite by targeting the central nervous system and insulin secretion, and they can delay stomach emptying, while also potentially influencing brain processes of reward and impulse control.
The researchers found that the drugs yielded benefits beyond weight loss, including reducing binge eating, loss of control eating and emotional eating.
Participants also reported increased cognitive or dietary restraint (which relates to how much people intentionally limit their eating), but the researchers say more research is needed to understand this link.
The study's first author, PhD candidate Izzy Emptage (UCL Psychiatry), said: "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. We hope that future research can clarify whether or not taking weight loss drugs might contribute to more pathological forms of eating restriction such as meal skipping."
The researchers say their findings demonstrate that weight loss drugs could be an important part of treatment plans for people with binge eating disorder, alongside psychological therapies and social support.
Izzy Emptage added: "Many people with binge eating disorder cannot access weight loss drugs through their public healthcare providers, so many have to seek treatment privately at considerable personal cost.
"We hope that by highlighting the potential of weight loss drugs to help with binge eating symptoms, our findings will lead to further funding of larger high-quality studies in this area, to better understand how this medication could be used in practice and improve treatment options."
Dr Costantini said: "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. Importantly, they emphasised that sustainable recovery is likely to depend not only on medication but also on psychological therapies and social support, as well as policy or community-level approaches to tackle societal norms and weight bias."
The researchers note limitations of their study, as most of the trials included in the review had a high risk of bias and were funded by pharmaceutical companies, and they rarely included participants with a clinical diagnosis of binge eating disorder, which the researchers say limits the certainty of the findings.
They say that robust, independently-funded randomised controlled trials with long follow-up times that include people diagnosed with binge eating disorders are still needed to clarify the potential clinical role of these drugs to help treat binge eating disorder, and to determine whether the observed short-term benefits translate into meaningful and sustained improvements.
The study involved researchers in the UCL Faculties of Brain Sciences, Population Health Sciences and Medical Sciences alongside colleagues in the Universities of Exeter, Oxford, North Carolina and Karolinska Institute, and was supported by Wellcome, the Medical Research Foundation and the National Institute for Health Research (NIHR).
