Why GLP-1s Don't "Fix" Disordered Eating
GLP-1 medications have changed what's medically possible for weight loss, and for a lot of people, that's been genuinely useful. But a smaller body doesn't always come with the relief people expect. The number on the scale moves. The self-judgment often doesn't.
That gap is worth taking seriously, because it points to something the medication was never designed to treat.
Why parents, specifically, carry so much weight
Of everything people bring into a session, parents tend to hold the most charge — because most of us are carrying two things at once that feel like they shouldn't be able to coexist. Your parent hurt you in some way. Through absence, or criticism, or emotional unavailability, or something more serious. And you love them. Or you wanted to. Or you know they weren't only that.
Therapy asks you to hold both. Guilt shows up when you believe that naming the first truth somehow cancels out the second — like saying my father wasn't emotionally present is the same as saying he was a monster, or that you're betraying the whole family by going here at all.
That's not what's happening. But guilt doesn't always wait for an explanation.
Where that belief comes from
Most of us didn't arrive at "I need to look a certain way" on our own.
We were taught it — by advertising, by family, by every cultural cue that ties personal worth to appearance. Somewhere along the way, many people internalize a quieter, harsher belief underneath the surface one: if I don't look a certain way, I'm unlovable. I'm bad. I don't belong.This isn't vanity. It's older and more functional than that. Humans are wired to seek social safety — inclusion, acceptance, belonging — because for most of human history, being cast out of the group was dangerous. Fitting a narrow appearance ideal can feel like a shortcut to that safety: if I look the way I'm "supposed" to look, I'll be accepted, and I'll be safe. It's a survival strategy wearing the costume of a beauty standard.
What GLP-1s can and can't do
GLP-1 medications work on appetite and metabolism. They don't touch the belief that drove someone to want to change their body in the first place. Emerging research backs this up: people most drawn to these medications tend to report higher body shame, more body surveillance, and lower body appreciation to start — and body dissatisfaction can persist after weight loss, or simply take a new form, like a fear of regaining the weight replacing the original insecurity.In other words: the body changes. The narrative that your worth depends on your body often doesn't — unless it's addressed directly.
Where the real work happens
The goal isn't to shame the instinct to control your body — that instinct was trying to keep you safe. The goal is to honor what it was protecting you from, and build a sturdier way of meeting that same need. That means separating self-worth from body shape and size in the first place — locating your value somewhere that doesn't collapse the moment your body changes, ages, or doesn't cooperate.
This is also where narrative approaches tend to be most effective — not because they promise a better body, but because they help rewrite the story running underneath the pursuit of one.
Medication can be part of someone's health picture. It's just not a substitute for the psychological work of believing you're worthy of love and belonging regardless of what you look like. That work is available with or without a prescription — and it's the part that actually lasts.
If you recognize this pattern in yourself — chasing a body that will finally make you feel acceptable, only to find the feeling doesn't arrive — it's worth exploring with support. Reach out to schedule a consultation and start doing the work that actually changes how you see yourself.
