GLP-1 Medications – Body Autonomy and Informed Consent
GLP-1 Medications – Body Autonomy and Informed Consent
GLP-1 medications are a prominent part of our cultural landscape right now. Often, people assume that as an anti-diet, weight-inclusive practice, we are “anti-GLP-1”. This is not the case. In fact, we aim to avoid black-and-white thinking around anything pertaining to an individual’s health. We believe deeply in body autonomy and personal choice. While we have a great deal of knowledge, we are not the experts of your body! You are!
Our goal is to help you make informed decisions about your health. This includes decisions about whether GLP-1 medications might be part of your care.
How GLP-1’s Can Help – Weight Loss Aside
Aside from weight loss, many people find these medications help with disordered eating patterns, creating space for a more peaceful relationship with food. Individuals struggling with binge eating or compulsive overeating report reduced “food noise” and can make decisions about food more confidently. Even a few clients with more restrictive eating patterns have found that turning the volume down on their negative thoughts enables them to eat more regularly. However, at higher doses, the appetite and drive for food is completely shut off, negating the ability to work on the relationship with food.
There is also preliminary research suggesting microdoses (i.e. .025-.05mg) of GLP-1 medications may help improve symptoms of mast cell activation syndrome (MCAS) and other inflammatory conditions. MCAS is a significant barrier to adequate nutrition and eating disorder recovery for a number of our clients. We are here for anything that helps!
What is the Lowest Effective Dose?
When GLP-1 medications first hit the market as a weight loss drug, they were prescribed at very high doses. This led to significant side effects including nausea, vomiting and fatigue. Many describe it as having a “constant hangover”. Now, more commonly, there is a gradual titration to a therapeutic dose. This means individuals can determine the lowest effective dose. Less medication is a good thing (particularly when it’s an out-of-pocket expense). It could also reduce some muscle loss and risk of nutrient deficiencies.
Who Needs Support, Anyway?
One of our dietitians recently overheard someone say “I pay $200 a month for Zepbound but I’d pay that for a dietitian anyway, so what’s the difference?”. Another person saw a sign at a marathon that read “why are you doing this when there’s Ozempic?”. If weight loss is your only goal, you might as well go it alone. However, if you want to support your physical and mental health while using these medications, getting support is important. A dietitian can ensure your intake is nutritionally adequate to help maintain lean body mass and reduce risk of nutrient deficiencies. You can also collaborate with them to improve your relationship with food, helping you build a more positive and long-lasting connection that respects your body’s physical hunger signals.
What About Screening?
We do have concerns about the widespread application of these medications and limited screening process to obtain them. For instance, there isn’t a required screening for eating disorders. And, there should be. Plenty of individuals with eating disorders have easily accessed them. There is a psychological screening required for weight loss surgery. The same should apply to GLP-1 medications.
What About Informed Consent?
When it comes to GLP-1 medications, there needs to be informed consent. And each individual gets to choose. Regardless of the body they live in. Again, body autonomy is key – for ALL bodies. Many fat individuals are pressured into taking these medications and considered “treatment noncompliant” if they don’t. The risks of muscle loss, nutrient deficiencies, gastrointestinal issues, potentially developing an eating disorder and other psychological effects should be clearly outlined. Informed consent should include honest conversations about both benefits and risks, especially when long-term research on higher doses is still evolving.
Cultural Impact and Our Future Generations
We are also concerned about the broader cultural impact of the extensive use of these medications. Rapid body changes among celebrities and public figures are shaping powerful messages about bodies, weight, and worth—messages that reach adults, but also children and teens who are especially vulnerable to developing disordered relationships with food and body image.
We’ll Leave You With This
Our goal is not to judge or prescribe a single path forward. Instead, we hope to foster informed, nuanced conversations—centered on curiosity, compassion, and respect for each person’s unique body and lived experience. Your body and your health are your choice. We’re here for you, however you show up… and whatever choices you make. If you’d like support, reach out here, we’d be honored to help you on your journey!
