Over the past few years, it’s been impossible to escape talk about GLP-1 weight-loss drugs. Semaglutide drugs like Ozempic, Wegovy, and Mounjaro have burst into public awareness, beyond simply as treatments for diabetes and obesity, but as “miracle” appetite suppressants that seem to change people’s relationship with food overnight. That change has brought tangible benefits for many. At the same time, it’s also stirred up a new generation of eating-related problems and exposed ways our culture talks (or doesn’t talk) about eating disorders.

As clinicians and advocates working with people in deep, messy struggles with food and body image, we can’t ignore the bigger picture any more than we can turn a blind eye to what’s happening in research. Here’s what’s going on and where Ketamine Infusion Therapy is beginning to make a difference.

GLP-1 receptor agonists weren’t invented to shift culture. They were developed to help people with type 2 diabetes manage blood sugar and, more recently, to support weight management in people whose bodies don’t respond well to diet and exercise alone. These drugs mimic a hormone in the body that controls feelings of hunger and fullness, and for many, that means an appetite that finally feels manageable rather than overwhelming. Purdue Ag Business Center

On the surface, this sounds positive: fewer intrusive hunger pangs, less constant thinking about food, fewer late-night fridge raids. A story in The Guardian details a woman whose lifelong binge eating and food preoccupation eased dramatically on a GLP-1 medication, reducing the “food noise” that once controlled her life. The Guardian

But that doesn’t tell the whole story.

A growing number of clinicians and eating disorder specialists are seeing other patterns emerge. GLP-1s don’t just suppress appetite — they change how hunger feels. For someone whose eating disorder is tied to self-worth, control, or distorted cues around hunger and fullness, that can be destabilizing. Some patients have experienced relapses into restrictive eating patterns after starting these drugs, precisely because their internal signals shifted in ways that overlap with disordered eating behaviors. Eating Recovery Center

Worse, when these medications are framed in the media and advertising as “easy weight loss,” they feed right into a diet culture that tells people thinner is better. That messaging can hit anyone struggling with body image hard, but it’s especially dangerous for people with a history of anorexia, bulimia, or atypical eating disorders, those who may look “healthy” on the scale but carry deep psychological struggles with food, fear of weight gain, and body distrust. ABC

So we’re seeing a new type of paradox: for some people, GLP-1 medications are life-changing in a positive way; for others, they unintentionally trigger or worsen disordered eating thoughts or behaviors. This makes sense when you look at the science, too. Early clinical research suggests that GLP-1 receptor agonists influence reward-related brain circuits and the way the body interprets cravings and energy balance mechanisms that closely overlap with the neurobiology of disordered eating. PubMed And while that could make these drugs useful tools for conditions like binge eating disorder (BED), the formal evidence is still coming in and is far from definitive. PubMed

It’s not just biology. GLP-1 weight-loss drugs have become cultural symbols as much as medical therapies. They show up in memes, talk-show segments, Instagram ads, and diet accounts that equate self-worth with control over food. People who formerly struggled silently with eating disorders now find themselves right in the middle of public debate; is this treatment empowering or dangerous?

For people already vulnerable to disordered thoughts about food and weight, that mix of cultural pressure and physical appetite suppression can feed anxiety, shame, and a sense of not being in control. When eating disorders flare, the consequences aren’t just mental, they’re medical. Malnutrition, electrolyte imbalance, cardiac stress, and bone loss are very real risks. Treatments that only focus on weight without addressing psychological roots can do more harm than good.

This is where Ketamine Infusion Therapy enters the conversation, not as a quick fix, but as a fundamentally different way of approaching eating disorders.

Ketamine isn’t a diet drug. It doesn’t trick the body into feeling full or reduce hunger signals by hormone manipulation. What it does is something much deeper.

Decades of research now show that ketamine affects glutamate signaling in the brain, specifically, the N-methyl-D-aspartate (NMDA) receptor pathways involved in mood, cognition, and neuroplasticity (the brain’s capacity to restructure itself). That’s part of why ketamine’s rapid-acting antidepressant effects have transformed care for treatment-resistant depression and PTSD, and why clinicians started asking if it might help other entrenched psychiatric illnesses. PubMed

Eating disorders are not just behavioral; they are neurobiological. Patterns of rigid thoughts about food, compulsive thinking about body image, and obsessive fear of weight gain don’t come from a lack of willpower. They come from neural circuits that have gotten stuck in repetitive loops. Ketamine opens the door to re-wiring those circuits. A recent exploratory case series looked specifically at using intravenous ketamine as an adjuvant treatment for restrictive eating disorders like anorexia nervosa. The findings were striking: patients showed considerable advancements in BMI and reductions in obsessive-compulsive symptom patterns, including rumination, cognitive rigidity, and guilt, core features that traditional treatments commonly struggle to tackle. Springer

That’s not a fluke. Other pilot work combining ketogenic nutritional approaches with ketamine infusions also showed lasting improvements in chronic eating disorder thoughts, including fears about weight and self-acceptance, even when weight was already medically normalized. PMC. And warm data from clinical trials like a UCSF study underway now exploring how ketamine changes learning and cognitive flexibility in anorexia point in the same direction: ketamine changes how the brain learns about food, fear, and reward. UCSF Clinical Trials

In real terms, that means patients often describe something that doesn’t appear on a lab report: a shift in their relationship to food, their body, and themselves. They talk about less “stuckness,” fewer intrusive thoughts, and a sense of being able to learn new patterns instead of repeating old ones.

Ketamine isn’t a cure-all. Not everyone responds, and it doesn’t erase an eating disorder overnight. But for people who have tried therapy, SSRIs, CBT, nutritional counseling, and still feel trapped in harmful cycles, Ketamine Infusion Therapy offers something they haven’t had before: a way to change the brain’s rigidity at the source. That’s not theory. That’s emerging evidence and real human experience.

As clinicians, we see people whose lives are reshaped not because they suddenly “want to eat more” or “stop caring about weight,” but because they finally have the cognitive space to relearn self-compassion, build healthier patterns, and let go of self-criticism that has no place in recovery.

The conversation about GLP-1 drugs and eating disorders isn’t black and white. For some people, these medications provide greatly needed relief from compulsive hunger. For others, they trigger deeper problems because they enter a landscape already fraught with cultural weight stigma and fragile internal cues.

Eating disorders are complex. They live at the intersection of biology and environment, brain and belief, body and identity. Treating them requires tools that respect that complexity.

Ketamine Infusion Therapy is one of those tools, not the only one, but a hopeful sign when everything else has failed. It gives patients a neurological reset, an entry point for therapeutic growth, and, most importantly, a real chance at lasting recovery.

If you or a loved one has been squeezed between the mixed messages of weight-loss culture and the hardship of eating disorders, know this: there are new routes to recovery. And for many, ketamine is the start of one.

Contact us here to schedule a consultation.