If you're taking a GLP-1 medication and still losing control around food, you aren't doing it wrong and the medication hasn't failed. Appetite and compulsion are two different things. These medications were designed to reach the first one.
This comes up more than almost anything else I'm asked about, and it's rarely answered well. Search it and you'll mostly find articles about why you might still feel hungry on Mounjaro, written by clinics and telehealth companies. Hunger is not the question you're asking.
What's the difference between appetite and a binge?
Appetite is a physical drive. It builds, it's uncomfortable, and eating resolves it. GLP-1 medications work on exactly this — they slow gastric emptying and act on the signalling that tells your brain you've had enough.
A binge is a different animal. Plenty of people describe eating well past the point of any physical want, sometimes past the point of discomfort, with no hunger involved at any stage. If you've ever thought I'm not even hungry and I can't stop, you already know these are two separate systems.
So a medication that reduces appetite can leave the compulsion largely untouched. That isn't a malfunction. It's the medication doing precisely what it was designed to do, in a situation it wasn't designed for.
Why does the food noise go quiet while the bingeing carries on?
Most people on a GLP-1 describe the mental chatter about food dropping away — the constant background negotiation about what and when and whether. That relief is real and for many people it's the first time in decades.
What the medication doesn't reach:
- The habit. Twenty years of a particular ritual at a particular time of night doesn't dissolve because appetite did. The cue is still there and so is the pathway.
- What food was doing for you. If eating has been how you come down at the end of a day, how you get a moment to yourself, or how you stop, then removing the appetite doesn't remove the need. It just removes the easiest way of meeting it.
- The transition points. Arriving home. Finishing work. After dinner. Before bed. Those moments still need something, and food has usually been it.
- Everything you've come to believe about yourself. Decades of thinking this proves something about your character doesn't get quieter when your appetite does. For some people it gets louder.
Am I the only one this is happening to?
No, and it's worth saying plainly because the shame around it is considerable.
This is one of the most common questions asked in GLP-1 and binge eating communities. People describe the food noise being nearly gone and still being, as one person put it, a "once I start, I don't stop" kind of eater. The overwhelming response is other people saying the same thing.
What's striking is how many of those conversations end with someone saying they're going to look for a therapist — and how rarely anyone in the thread has anything useful to say about the psychological side. The advice on offer is almost always about dose.
What does the research say?
A systematic review and meta-analysis published in eClinicalMedicine in 2026 pooled twenty-five randomised controlled trials and found that GLP-1 receptor agonists were associated with moderate reductions in binge eating, loss-of-control eating and emotional eating.
It also found something less discussed: dietary restraint went up. People on the medication were restricting more, not less.
That matters for anyone with a history of binge eating, because restriction is usually what drives the cycle in the first place. It's worth keeping an eye on rather than discovering the hard way.
Worth adding, in fairness to the research: every study in that review carried a high risk of bias or some concerns, and the authors called for better trials in people with diagnosed binge eating disorder. It's a signal, not a settled fact.
What tends to help
Not white-knuckling, and not increasing your dose in the hope the compulsion goes with the appetite — that's a conversation for your prescriber and not something I can advise on.
What generally does help:
- Working out what the binge is actually for. It's doing something. It's usually working. Until you know what job it's holding down, removing it just leaves a gap.
- Looking at the ritual rather than the food. The time of night, the room, the programme in the background, what happened in the hour before.
- Checking whether restriction has crept in. Eating too little during the day is one of the most reliable ways to lose an evening, and it's easy to do accidentally when appetite is suppressed.
- Using the quiet. Food is less loud than it's been in years. That makes this a considerably easier time to look at what's underneath it than it will be later.
When it's worth getting support
If food has gone quieter and something still isn't right, that's usually the part worth looking at. Particularly if you're bingeing without hunger, if you're frightened about what happens when the medication stops, or if the relief has been followed by feelings you weren't expecting.
I'm a qualified eating disorder therapist and I work with women taking, considering, reducing or coming off GLP-1 medication. I'm not anti-medication and I'm not anti-weight-loss. I don't advise on prescriptions or doses — that's your prescriber's job. I work on the parts the medication was never designed to reach.
Read more about therapy alongside GLP-1 medication, or book a free 30-minute call to talk it through. Nothing is decided on the call.
Claire Feldman is an eating disorder therapist and the founder of Eatology, working online across the UK and Ireland. She is registered with the BACP (membership number 00727765) with specialist training in ADHD and binge eating, CBT, bariatric counselling and obesity practice. This article is general information and not medical advice. Decisions about medication are for you and your prescriber.
Frequently asked questions
Does Mounjaro stop binge eating?
For some people it reduces it considerably, and research has found moderate reductions in binge eating on GLP-1 medications. For others the bingeing continues, because appetite and compulsion are different things. Neither response means you're doing it wrong.
Why do I still binge when I'm not even hungry?
Because bingeing often has very little to do with hunger. It's frequently about habit, ritual, emotional regulation or the need to stop at the end of a day. Reducing appetite doesn't touch any of those.
Is it normal to still binge on a GLP-1?
Yes, and it's more common than most people realise. It's one of the most frequently asked questions in GLP-1 communities, and it's rarely discussed by prescribing services.
Should I increase my dose if I'm still bingeing?
That's a question for your prescriber and not something a therapist can advise on. What I would say is that if the bingeing isn't driven by appetite, a higher dose may not reach it.
Can therapy help while I'm still on the medication?
Yes, and it's often an easier time to do the work. Food is quieter than usual, which makes it more possible to look at what's underneath it. Therapy sits alongside your medical care rather than instead of it.
