Tirzepatide and Eating Disorder

[LettuceEater]

I've dug through this forum obsessively and found almost nothing about eating disorders. I have EDNOS, and I can go 48-72hr without eating pretty easily, then I crash straight into a binge/purge pattern. I'm considering tirz to quiet the food noise and cravings that set off the bingeing, but the idea that not eating could become too.. simple worries me.

I'm older than I was when my ED first showed up, and I don't want to end up anemic, passing out, or embarrassing myself in public. My plan is to keep taking supplements (multivitamin, probiotics, just vanilla OTC stuff) and make protein the priority whenever I DO eat...

But yeah, has anyone here dealt with EDs alongside GLPs?

 

[Beardboost]

On Triz, the urge to go 48-72h without food fades. What works better is building your eating pattern around the injections: start fasting right away for 14-16 hours daily instead of stretching it so long, then leave yourself 8 hours in the day for 3 meals, with protein, fibre and healthy fats at the front of the list. GLP1's take the edge off cravings. Over 10 weeks, staying away from anything with an unhealthy amount of sugar has come easily. I used food to deal with depression and put on 40kg across 3 years, so eating disorders are something I understand well. I set alarms to eat, 12pm - 3pm and 6pm, and even when I'm not hungry I still make sure I get my nutrition. GLP's gave me this strange mindset I thought Id never have.

 

[N Sharp]

I appreciate that you took the time to write this up, and it's good to see you looking into things and staying aware of your own circumstances.

An ED diagnosis never came my way, yet I dealt with a comparable cycle of fasting followed by binging - no problem at all going without food, but once I started eating, some switch got flipped and I felt completely out of control!

Purging was never something I did, but I could tell I was sliding toward a harmful direction, and I really wanted a life where food wasn't an issue - so I saw Tirz as a chance to simply start fresh, and WOW! Food noise/fear/anguish/frustrations - gone!

It opened my eyes in a huge way, since I came to see that a lot of my own problems were things I'd brought on myself (restriction, self-sabotage, etc.)

Thanks to Tirz, I figured out how to eat smaller meals without my brain's emotional torment or hunger's physical punishment - which was precisely what I'd set out to do, and I'm so happy & grateful!

Given all of that, the key thing to ask yourself now is: what do you want your own experience to look like? What are you aiming for with a GLP? If you hit that aim & came off a GLP, is that world the one you'd want? These are a few of the questions I put to myself before I began my own journey, so I thought I'd pass them along for your research as well.

 

[Grogu]

For this drug class, a BED or other ED diagnosis usually counts as an exclusion criterion in clinical studies, which leaves the research thin on using them in people with eating disorders. The anectdotal picture points the other way though, with glp-1s linked to less binge eating among those who are obese or overweight.

Even without a formal ED diagnosis, going that long without food and then cycling through binge/purge is an eating disorder in plain terms. Your worry that losing the food noise will remove the craving trigger and push you into starving yourself is precisely why practitioners have held back on prescribing glp-1s to people with eating disorders.

In the last couple of years I have run into plenty of posts where people with EDs got some relief from tirzepatide. So alongside all the supplements you list to keep from fainting in public, it might be worth adding some therapy to the mix, if you are not already in treatment.

Pharmacological Treatment of Binge Eating Disorder and Frequent Comorbid Diseases - PubMed



Of the specific eating disorders, BED is diagnosed most often. It frequently travels with ADHD, depression, bipolar disorder, anxiety disorders, alcohol and nicotine use disorder, and obesity. A narrative review along these lines set out to...

pubmed.ncbi.nlm.nih.gov

 

[5byfive]

This is one of those posts where I need to say up front that I work as an ED therapist, but I am not your therapist.

When it comes to Binge Eating Disorder, GLPs look like they could be useful. That said, BED tends to operate more along the lines of a substance abuse problem than like what we usually classify as an eating disorder.

With other EDs, the picture is far murkier. Honestly, some of what these medications do would appear likely to help, while other effects would appear likely to worsen things. Right now, until research exists, there is simply no way to tell whether the overall result will be a net benifit or a net harm.

If someone is in your situation, trying it might be worthwhile, but only with oversight from a licensed and experienced professional. This is really not a case where you want to lab rat yourself without support.

 

[randompersonrandom]

This is a weigh-in, not advice. Because of my own history and what runs in my family (I have BED, I'm prone to body dysmorphia, and anorexia and bulimia both show up pretty strongly among my relatives), there was something I had to stay aware of: every decision had to be driven by numbers rather than by my own judgment. I'm glad that's the route I took.

Right now I'm 5'5" and 128 pounds. By any objective measure that's normal, leaning toward slim, yet on most days I see myself as terribly fat. So here's my compromise: I'm targeting dead-center of the lower half of normal BMI, but not a pound under. That puts my endpoint at 121 pounds.

Once I'm there, I doubt it will seem like enough. Even so, no matter what I think, I won't drop below that line. My thinking can't be trusted on this, I have no reason to believe it would EVER be enough, and if I let my own not-quite-well eyes be my guide, I'll end up hurting myself.