Can GLP-1s Treat Eating Disorders? One Woman’s Controversial Story Is Challenging Everything

In today’s episode of Bite Back with Abbey Sharp, I’m joined by author and eating disorder research advocate Paige Gordon, who lived with bulimia for 22 years before starting a low-dose GLP-1 medication that she says eliminated her drive to binge and purge. We explore whether biology, appetite signalling, and reward circuitry could play a larger role in some people’s eating disorders, and whether GLP-1 medications could eventually have a therapeutic role beyond weight loss. This is a nuanced conversation about food noise, bingeing, purging, recovery, and what Paige’s experience could mean for future eating disorder research. Here’s a run down of what we discussed in today’s episode: What Does the Urge to Binge and Purge Actually Feel Like? When Recovery Doesn’t Make the Food Noise Go Away What Changed After Starting a GLP-1? Can Different Causes Create the Same “Food Noise”? Did the GLP-1 Treat the Eating Disorder—or Suppress the Symptoms? What Does Recovery on a GLP-1 Actually Look Like? Could GLP-1s Ever Be Studied as a Treatment for Bulimia? Could Paige’s Story Be Misused by the Weight-Loss Industry? Are We Overcorrecting Toward a Biological Explanation? What Does the Research on GLP-1s and Eating Disorders Actually Show? 👩🏼‍💻 RESEARCH LINKS: https://link.springer.com/article/10.1186/s40337-026-01634-6 https://pubmed.ncbi.nlm.nih.gov/39891848/ Check in with today’s amazing guest: Paige Gordon https://paigegordonauthor.com/ https://www.instagram.com/paigegordonauthor/ https://www.tiktok.com/@paigegordonauthor #GLP1 #bulimia #eatingdisorder #foodnoise #bingeeating #eatingdisorderrecovery — DISCLAIMER:The content in this episode is for educational and entertainment purposes only and is never a substitute for medical advice. If you’re struggling with with your mental or physical health, please work one on one with a health care provider. If you have heard yourself in our discussion today, and are looking for support, contact the free NEDIC helpline at 1-866-NEDIC-20 or go to eatingdisorderhope.com. — 📚 GRAB MY BOOK: The Hunger Crushing Combo Method ⤵️ Learn how to reach your healthiest weight without dieting using evidence based nutrition strategies. Amazon: https://www.amazon.com/gp/product/0306836793?tag=hacboogrosit-20 More purchase options: https://www.abbeyskitchen.com/hunger-crushing-combo/ 🎙 LISTEN TO BITE BACK WITH ABBEY SHARP ⤵️ Real conversations about nutrition, wellness, diet culture, parenting, and the biggest food debates. https://lnk.to/Bite-Back?utm_source=hoobe&utm_medium=social ⭐ Enjoying the podcast? Follow Bite Back on Apple Podcasts, Spotify, Amazon Music, or wherever you get your podcasts. If you're enjoying the show, leaving a rating or review really helps support it! ✉️ SUBSCRIBE TO MY NEWSLETTER https://abbeyskitchen.myflodesk.com/kd6ijl0y3e 🥞 FREE Hunger Crushing Combo™ E-Book https://www.abbeyskitchen.com/hunger-crushing-combo/ 💪 FREE Protein 101 Guide https://www.abbeyskitchen.com/protein-intake-recommendations/ 📖 MY FIRST COOKBOOK: The Mindful Glow Cookbook Amazon: https://amzn.to/2nev0lf 👩🏼‍💻 COACHING: 🍽️ Feeding Kids Without Diet Culture Webinar Raise confident eaters without food battles, guilt, or diet culture. https://www.abbeyskitchen.com/coaching/ 📈 Business Coaching Build and grow your online brand with proven social media and business strategies. https://www.abbeyskitchen.com/coaching/ 🤝 Personalized One-on-One Coaching Tailored support for content creation, business growth, podcasting, AI, brand partnerships, and more. https://www.abbeyskitchen.com/coaching/ 📱 FOLLOW ME @AbbeysKitchen Instagram: www.instagram.com/AbbeysKitchen TikTok: www.tiktok.com/AbbeysKitchen Facebook: www.facebook.com/AbbeysKitchen Pinterest: https://ca.pinterest.com/AbbeysKitchen 🌐 VISIT MY WEBSITE Healthy recipes, nutrition resources, parenting advice, and evidence based articles. https://www.abbeyskitchen.com 💬 If you enjoyed this episode, please leave me a comment below with your thoughts and let me know what you'd like to see next! With Science & Sass, Xoxo Abbey 🌸 Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Speaker 00

  Ultra running shoes are all about space, the space to go further, to feel better, to do something you never thought possible. And this space starts with Ultra Fit. Unlike traditional running shoes, Ultra Fit gives toes more room to move naturally. So every step is strong, balanced, and comfortable. Whatever you're lacing up for, stay out there with Ultra. Shop now at ultrarunning.com. That's A-L-T-R-A running.com.

• 0:30Abbey Sharp?

  How do you know that the medication treated your eating disorder rather than simply treating one symptom by suppressing your appetite so effectively that you couldn't binge and purge?

• 0:44Abbey Sharp?

  Welcome to another episode of Bite Back with Abbey Sharp, where I dismantle diet culture rules, call it the charlatan spinning the pseudoscience, and help you achieve food freedom for good. For decades, people who binge ate were told some version of, "You just need more willpower. Like, just stop being such an undisciplined glutton, and you'll lose weight." Thankfully, we now know it's much more complicated than that. We know that restriction, trauma, dieting, emotion, regulation, genetics, neurobiology, and our food environment can all play a role in binge eating. But as conversations around GLP-1s and food noise have gone mainstream,

• 1:27Abbey Sharp?

  I think there's another uncomfortable question we now need to ask. In moving away from the willpower explanation, have we sometimes become too confident about what is driving the behavior? Because we talk a lot about food obsession and binging as consequences of restriction, dieting, trauma, and unmet emotional needs. And for many people, they absolutely can be. But what about the person who stops dieting, adequately nourishes themselves, challenges their food rules, understands their triggers, goes to therapy, and does all the psychological recovery work, and the volume on food is still screaming? What if, for some people,

• 2:12Abbey Sharp?

  there's an additional biological component to that drive that we haven't adequately understood or treated? Today's guest, Paige Gordon, sits on the board at NIDA after living with bulimia for 22 years. After starting a low-dose GLP-1 medication, she says something extraordinary happened. The drive to binge and purge disappeared. Now, to be extremely clear here, that does not mean that GLP-1s are a proven treatment for bulimia. They are not. The research is nowhere close to that. But her story raises a question that I don't think we should be afraid to ask. Have we sometimes been treating a biologically amplified drive

• 2:57Abbey Sharp?

  as though it were primarily a thought pattern that someone just needed to unlearn? And on the flip side, are we now at risk of swinging too far in the other direction and turning a deeply complex psychiatric illness into a hormone or reward circuitry problem that we can simply medicate our way out of? Because that is the uncomfortable gray space I want to live in today. All right, and before we start, I just want to take a moment to thank you all so much for joining me today. If you're new here, welcome to the Bite Back family. Please do take a moment to leave me a little five-star review and a little love note, and subscribe on Apple, Spotify, YouTube,

• 3:40Abbey Sharp?

  or wherever you are listening and watching so that you never miss out on an episode. All right, kids, let's do this. Paige, thank you so much for joining me today. I'm really excited about this conversation.

• 3:51Speaker 02

  I'm glad to be here. Thanks for having me.

• 3:53Abbey Sharp?

  Okay, so take me back before the GLP-1. What did the urge to binge or purge actually feel like in your body and brain?

• 4:04Speaker 02

  So before I started purging, which started when I was around 18, I would binge. And I started binging when I was 11. And so I was a binger for a good seven years before I started purging. And it had really nothing to do with feeling hungry. That would be the first thing I would say. It was an impulsive, almost like something that was on my mind all the time in terms of a certain type of food. I tended to go for the highly ultra-processed food or highly satiable food that were high in sugar and fat. You know, I certainly wasn't binging on broccoli.

• 4:45Speaker 02

  And it just kind of became this obsession in my mind where if I didn't give in to those behaviors, then it was difficult for me even to function. And it had very little to do with being hungry. I could eat three meals a day, and I still found myself at the donut shop eating two dozen donuts, for example. And so in that way, it was almost maybe a little bit like OCD. I mean, we call this food noise now, but that's not a new concept in the eating disorder field, for sure. They just used a different name. And I had that, yeah.

• 5:18Abbey Sharp?

  Yeah. Yeah, and just for folks who, you know, hear this term now, "food noise," over and over again. Like, we're not talking about like, "Oh, what's for dinner?" Or, "I could use a snack." We're talking about relentless mental chatter about food that can crowd out cognitive space for creativity and relationships and work and self-care and a million other things, like you just said. Like, you can't focus on anything else until you kind of give in to that, what that food noise is asking for. So in your experience, was there a point where you, you know, like you genuinely were not restricting anymore? You were adequately nourishing yourself, like you said, you're doing the recovery work,

• 6:02Abbey Sharp?

  and the food obsession was still there?

• 6:04Speaker 02

  Always, yeah. So for me, so I had, I'm 44 years old. So I had binge eating disorder in the 90s. That wasn't in the DSM yet. So I don't think anyone would have known what to do with me if I had asked for help. And when I first went into treatment, which was in 2000, the treatment was definitely based on a restrictive modality, which is, you know, good evidence. I don't think I'm the normal in terms of what's typical. So I'm not criticizing treatment in that way. I just was an outlier, I suppose. And so, yeah, when I first started treatment, I was in a larger body. I was not restricting. You know, the first time I learned about sizes was actually in quantities of food,

• 6:49Speaker 02

  was in treatment. Like, before treatment, I had no idea that a half a banana was one serving size of fruit. I would eat a banana like a normal person. And ever since treatment in 2000, now I'm like, "Oh, half a banana." That's a certain, you know, this information I didn't need. But I learned it in eating disorder treatment, which is funny. So, yeah, I didn't ever restrict. And that was always the basis of what the, I kept being told if I just ate three meals, two snacks a day, that this urge, this craving to binge would go away. And that wasn't my reality. And so I think probably that was the myth. No one ever asked me in treatment if I binged before I started purging, ever. And I don't know if that happened because I went into treatment early in the 2000s. I'm not sure if it would be different now.

• 7:33Speaker 02

  But it was always assumed that, you know, my bulimia was the way it was because of I was restricting, and it just wasn't true.

• 7:42Abbey Sharp?

  Right, yeah. And I think one thing that the GLP-1 era has really forced us to confront here is that, you know, we may be lumping very different experiences together under this umbrella of food noise. Because, you know, as you're kind of alluding to, we've long known that restriction itself can make the brain extremely preoccupied with food. But now we're learning more about genetics and biology and how that can influence hunger and satiety and reward sensitivity and susceptibility to weight gain. So I'm so glad we're now having that conversation. But let's talk about the GLP-1 now. So what changed for you symptomatically, psychologically, when you started the GLP-1?

• 8:26Speaker 02

  Sure. So I take a very low dose, first of all. I take sub-therapeutic of what's FDA-approved for weight loss, more than half, less than the starting dose, for example. But I would say around week three, just that urge to binge completely went away. It was completely off my mind. And because I didn't have this overriding biological signal that was like driving me towards this behavior, I was, for the first time in my adult life, able to make better choices for myself. Because I always knew what I needed to do. I knew, I, you know, I make a joke, Abbey, that like I have probably more hours than dieticians than some dieticians do at this point because I was in and out of the treatment. Which I think is pretty common

• 9:11Speaker 02

  for people with eating disorders. They're pretty well-educated on nutrition. So I knew what I needed to do. I just couldn't get myself to do it. And so once I kind of, the GLP helped turn the volume down. And so I felt like I had more agency to make those better choices. I was really motivated not to have my eating disorder anymore. So as soon as that dial went down just a little bit, I was very easily able to be like, "Okay, three meals, two snacks. Three meals, two snacks." And I did that right away. And even if I didn't necessarily want to, but similar to what you do when you're first going to treatment, right? I just did it myself, and I was able to stick with that. You know, in my case, I actually gained a little weight because I was, you know, and I was fine with that.

• 9:55Speaker 02

  I just didn't want the urges to binge. And for the first time, it Actually worked and I was like, oh my God, I think we might be missing something for a subset of patients, certainly not most. And I don't know how many, but I felt like it was a scientific question worth investigating.

• 10:13Abbey Sharp?

  Oh, yeah. And I think this is where your story is so interesting and complicated in some ways, because it raises this possibility that the exact same surface complaint, which is, you know, I can't stop thinking about food, could arise from very different mixtures of deprivation, reward sensitivity, appetite signaling, learned behavior,

• 10:34Speaker 02

  Right.

• 10:34Abbey Sharp?

  compulsivity, psychological distress, like so many different factors here. And theoretically, the appropriate intervention could be completely different depending on what's driving it. So, you know, for one person, those intrusive thoughts might be their brain appropriately screaming like, feed me, you know,

• 10:52Speaker 02

  Right.

• 10:52Abbey Sharp?

  because they are depriving themselves. So suppressing that signal further via a GLP-1 could be extremely dangerous.

• 10:59Speaker 02

  Absolutely.

• 10:59Abbey Sharp?

  But then for another person, like perhaps in your situation, reducing that intensity, that that that food salience of the intensity of that food salience and the reward driven urges might be super therapeutic. And unfortunately, you know, as we know, right now, we don't have a validated clinical tool that can confidently tease those experiences apart.

• 11:23Speaker 02

  Yeah.

• 11:24Abbey Sharp?

  And like just looking at someone or weighing them is not evidence of what is going on in their head. It's just, it's just not. And so I love your story because I think it complicates the status quo, because I imagine a lot of eating disorder clinicians would ask, you know, how do you know that the medication treated your eating disorder rather than simply treating one symptom by suppressing your appetite so effectively that you couldn't binge and purge? I'm curious, what do you think of that suggestion? Like, did you initially interpret your experience as proof that your illness had been biological all along?

• 12:04Speaker 02

  So I think there was a couple of questions there. The first one, in terms of like, clinical responses or clinicians' responses to me, I think it's a valid question. And I think that that can happen in some instances and where you're just completely eradicating your hunger cues. And so then you're just sort of on autopilot.

• 12:24Abbey Sharp?

  Yeah.

• 12:24Speaker 02

  Even in that instance, though, I wonder if there's not an opportunity for that to be a helpful intervention in some instances, as long as someone is being properly monitored to stop the behavior and to get them on the new habit, right? So I mean, that's an if question. I don't think we should be like trialing some people randomly. But I wonder even in that instance, if there aren't like some specific instances that could be helpful. Certainly for me, I had been sick for 22 years. So by the end of my disease, most of my meals were binges and then purging. And so I think it did kind of stop that behavior, because at that point, it had gone from binge eating to, you know, making a bad situation a lot worse with my stomach being stretched

• 13:07Speaker 02

  out and all the, all the things. It really was able to stop that and make new habits for myself. But you know, like the gastric emptying portion of taking a GLP, that goes away in about a month or so. It's a short term effect that is known. So the rest of that is all psychological. So for me, I, I, I saw it as evidence that there was something biological going on with me. However, I would argue that all eating disorders are biological. And what I mean by that is this conversation we're having right now is a neurological event. So I don't, I don't think it's like, oh, it's based in biology or genetics, or oh, it's based in environment and social cues. They're all

• 13:50Speaker 02

  together. I mean, whether or not you're having preoccupation with food, or if you have body dysmorphia or whatever, that is still something going on in your brain. So it's all biological. And I don't think those two things are like at odds with each other. But for me, certainly, this is kind of crazy, Abbey, but like you would think that I would know that I was mentally ill because I had an eating disorder for 22 years. And I did. But I was like, you know, I, I knew what I was doing. In some ways, I wish I would have had, you know, that I didn't realize what I was doing. It would have been easier because it just made me hate myself more because I couldn't stop the behaviors. But taking the GLP medication was such a profound effect in terms of even just

• 14:34Speaker 02

  affecting the way my mood was. It was the first time I was able to confidently admit that I had a mental illness, because I had a comparison point to how I felt in my brain and my body before versus after. And I was like, wow, I'm like, it did for me what they were hoping 60 milligrams of Prozac would do, right?

• 14:54Abbey Sharp?

  Right.

• 14:55Speaker 02

  That didn't work at all. I tried that. It did absolutely nothing for me. And so I was like, wow, like I, there is something so profoundly dysregulated in my brain that this medication is somehow indirectly helping. It's probably not fixing the exact thing, but it's helping just enough. And I'm really motivated. So I was able to make change. Like, it was just amazing. It was amazing.

• 15:15Abbey Sharp?

  Wow.

• 15:19Speaker 00

  Ultra running shoes are all about space, the space to go further, to feel better, to do something you never thought possible. And this space starts with Ultra Fit. Unlike traditional running shoes, Ultra Fit gives toes more room to move naturally. So every step is strong, balanced, and comfortable. Whatever you're lacing up for, stay out there with Ultra. Shop now at ultrarunning.com. That's A-L-T-R-A running.com.

• 15:51Speaker 03

  The action's on the court. And as the official beer sponsor of the NBA, Michelob Ultra is getting fans closer to the game with a chance to win courtside seats, merch, and more. Visit michelobultra.com/courtside to enter. Michelob Ultra Courtside, 26 to 27. No purchase necessary. Open to US residents 21+ begins on October 1st, 2026 and ends on June 30th, 2027. Multiple entry periods. See official rules at michelobultra.com/courtside for free entry, entry deadlines, prizes, and details.

• 16:18Speaker 04

  Blowing ad budget on metrics that look great till the CFO sees them? That's bullspend. And marketers are calling it out in Dashboard Confessions.

• 16:28Speaker 05

  I remember telling my boss, it'll be good for the brand when leads were slow. Yeah, it, it wasn't.

• 16:36Speaker 04

  Cut the bullspend. LinkedIn lets you target by company, job title, and more. Advertise on LinkedIn. Spend $250 on your first campaign and get a $250 credit. Go to linkedin.com/campaign. Terms and conditions apply.

• 16:51Abbey Sharp?

  And so tell me more about that, that kind of like holistic effects, holistic success of a GLP-1. What happened to body image and food rules or need to compensate and purging and weight obsession? Like, what about all of those elements that we know are associated with eating disorders?

• 17:08Speaker 02

  Right. So I've had some people tell me they didn't think I had bulimia because I didn't have obsession with body image. And that's one of their requirements for having bulimia and the DSM. Some people tell me that they think I had food addiction, which I'm like, eh, I was throwing, like throwing up like three or four times a day. Are you sure I didn't have bulimia? You know, so it's one of those things. I think that's probably the one of the problems with DSM. It's just like all based off of symptoms, you know, and, you know, anyway. So it's a tricky question. Fat phobia and weight bias certainly contributed to me getting bulimia. There's no question. I started gaining weight because of my binge eating disorder. And what I sincerely, sincerely

• 17:52Speaker 02

  thought of to myself is like, I'm going to end up being one of those people that is so disabled, they're not going to be able to physically walk, and they're going to have to get craned out of a house. I was like, that's, I'm like, that's what's going to happen to me. I can't control myself. So if that's the way I'm going to be, I might as well not be that and be thinner. I wasn't necessarily going like, oh, I need to be a size six. I need to be a size eight. I just didn't want to be 1,000 pounds. So that contributed to my original decision to start purging, unfortunately. So I had weight obsession in that way. Like, I didn't, I was, I was afraid of being obese and that there's no question about that. And, you know, that's something I've had to really think through of like, why did I feel that way? Like, what, what messages were told to

• 18:36Speaker 02

  me as a young child that made that seem like worse than having bulimia? That's quite sad.

• 18:42Abbey Sharp?

  Yeah.

• 18:42Speaker 02

  Um, but I, I never had, I wasn't, I never weighed myself multiple times a day. I wasn't obsessed on anything like that. So that didn't change because I didn't have that. I've never counted calories. Thank God. Cause that's something you can't unlearn. So I'm lucky in that way. So I, you know, that didn't change. What did change, I would say, is there is a long time where I would avoid certain food, not because I was afraid of weight gain, because I knew it, just putting it in my mouth would be an instant binge, similar to like an alcoholic, not wanting the first drink. So it wasn't related to me being afraid it was going to make me fat, but I just knew it would turn into a binge. And so, once I took the GLP, it really opened up what I was able to eat and enjoy, sincerely enjoy, because now I

• 19:27Speaker 02

  can eat absolutely anything and I don't have to worry about it turning into a binge. So it really opened, I eat way more food than I ever did before. It's kind of amazing.

• 19:35Abbey Sharp?

  Amazing. That's amazing. Yeah. It's so interesting because like, again, we don't have validated tools for this yet, but I feel like when it comes to that earlier question of like, could a GLP-1 actually treat an ED as opposed to suppressing a symptom? I think, you know, perhaps one litmus test or question to ask yourself could be something like, you know, if this medication had completely eliminated all binging and purging and given you your life back, but you hadn't lost a single pound, would you consider it equally successful? Because I think if that, the answer is yes, then I think that is a really incredibly important distinction because now we're not talking only about a weight loss treatment that happens to reduce binging. We're talking about whether there could be

• 20:20Abbey Sharp?

  theoretically some kind of, you know, some psychiatric or behavioral therapeutic effect independent of weight loss. And that's really powerful here. That, that is what I want to see, you know, investigated.

• 20:33Speaker 02

  I'll take it, I'll take it a step further. Um, so I, I, you know, I think I just had a DEXA scan in my, uh, my body max indexes. It's, it's within the normal range, but it's on the lower end. Um, if, if someone, because this is so confusing to people, this concept, if I went to eating disorder clinic and they told me that the only way they would give me this medication is if I was no longer weight suppressed, because I am weight suppressed, meaning I, when I first into, went into treatment, I was like 180 pounds. I'm now around 125. I would think you were stupid for telling me that because I think it would add a whole other host of side effects that aren't positive, but I would do it. I would do it in two seconds. I would be, I would be in a larger body, no problem if it meant

• 21:16Speaker 02

  that I didn't have to have this urge and this craving all the time. And that's what I always had a problem with in treatment. I was like, I don't have a problem being in a larger body, but it's not going to solve my problem. I'm just going to be in a larger body and I'm still going to have this obsession with food. So like, why are you guys making me do this? So yeah, I, I would do that in two seconds if, if it's what I needed to do.

• 21:37Abbey Sharp?

  That's amazing. I think that's very telling, right?

• 21:40Speaker 02

  Mm-hmm.

• 21:40Abbey Sharp?

  Um, now you now sit on the board at, um, NIDA and I assume you're sitting beside a lot of eating disorder clinicians who understandably are reluctant to entertain this idea of giving GLP-1 medications to people with eating disorders. And I think there are real, you know, concerns here about restrictive eating and nutritional inadequacy and weight loss reinforcement and fat phobia and the normalization of ultra thinness that has come with these jail, this GLP-1 boom that we're seeing.

• 22:10Speaker 02

  Yeah.

• 22:11Abbey Sharp?

  Now, what are the questions that you think the eating disorder community like is afraid to ask that may stand in the way of us fully understanding, you know, binge biology and improving treatment?

• 22:27Speaker 02

  Well, it's hard, it's, it's hard to take a look in the mirror and be realistic of where we are in treatment. I, I would say that's the first thing. Anytime I make a post, like if a paper comes out, like there's been two papers recently that, one came out recently about like, why a treatment hasn't improved in 20 years. And it like listed out all the reasons. And then another one came out in December, a meta-analysis that said like, uh, you know, in terms of binge eating, the outcomes have actually gotten worse in treatment. So anytime I do a post on that, like the clinicians start coming for me, you know, because I think it's really hard to, to have a realistic look in the mirror and say like, what we're doing isn't working that well. It's almost treatment

• 23:08Speaker 02

  resistance is the norm. Um, and so if that's the case, then it means we're missing something. It's not the patient's fault. It means we fundamentally don't understand something. And I think that anything that could potentially reduce suffering deserves rigorous, rigorous clinical investigation. I'm not suggesting that people go try this at home. You know, what I'm suggesting is that this deserves investment, um, from the scientific community to see if there's something there. And wouldn't it be great if we could find a way to figure out ahead of time if someone is going to, um, respond well to this medication instead of causing harm? Cause right now I have no idea if it's, if it's causing more harm

• 23:52Speaker 02

  than good. I, you know, I, I've had 85 women contact me, say they love it, but that doesn't mean anything. That's a biased response. And then I have other people say clinicians are like, I'm talking to people with anorexia and it's causing some, I'm like, well, that doesn't mean anything either, because most people that go into treatment have anorexia. You're not seeing people with binge eating disorder. Um, so we don't have a good, good sense of it. And I would like to know, I'd like to know.

• 24:15Abbey Sharp?

  And for you, are, are you, are you worried that your story could be weaponized by the weight loss industry? I'm like, I can just imagine some telehealth company seeing a story like yours and turning like, this medication changed my relationship with binging and purging into GLP-1 is now treating food addiction and eating disorders. When that's not what the evidence says yet, right?

• 24:36Speaker 02

  They want, I'm not worried about it at all because Pharma wants to stay far, far away from this topic right now. Um, you know, historically Pharma has abandoned eating disorders. That's why we only have two approved FDA medications, which were both repurposed drugs. Um, you know, they don't, they don't want to invest in us. Some reasons are we're difficult, uh, all mental health are difficult to run clinical trials on and the group is too small. They don't see it as having any money. So for the most part, they want to stay away from us. So I'm not particularly worried about that, to be honest. I do worry, and it was a big worry of mine when I wrote my book, that someone would read my book and pick it up as a prescriptive, um, thing. And I was really, really worried about that.

• 25:18Speaker 02

  I'm super clear in the foreword and I, I'm very clear throughout the book that this isn't prescriptive. What it is, is a call to action with researchers and clinicians to ask better questions. And that's pretty much it. Although there, there are doctors who prescribe this off-label and, you know, off-label medication is not illegal. You're allowed to do that, but definitely don't try it at home.

• 25:38Abbey Sharp?

  No, you know, of course. Yeah. I mean, I guess there's also the kind of risk that someone with a restrictive eating disorder could hear your experience and then use it to justify to themselves or to their healthcare provider, like I should be prescribed a GLP-1. Um, and you know, so that's where it's, again, we need better standards of care for folks with eating disorders and more research so that, you know, clinicians do have, uh, you know, have an understanding of when they can be used and when they should be used and, um, when they may do more harm than good. And I think, you know, I think it's, it's also the responsible thing to point out that the opposite risk exists of this

• 26:18Abbey Sharp?

  conversation too, because GLP-1s now have, have become so dominant in conversations that we may reduce all problematic eating behaviors as just some kind of biological reward circuitry problem, where you kind of said earlier, like it's not, it's not one or the other, which this, the, these, you know, eating disorders are the result of a complex interplay of perhaps that circuitry problem, but also diet culture, trauma, learned behavior, food environment.

• 26:47Speaker 02

  Right.

• 26:48Abbey Sharp?

  And so I think it's important that we don't replace psychological, you know, reductionism with biological reductionism.

• 26:55Speaker 02

  For sure.

• 26:56Abbey Sharp?

  And we, you know, the bio, psycho, social, uh, we shouldn't be picking whichever one agrees with our own kind of personal ideology. We, a good healthcare provider, yeah, we need to be investigating all three.

• 27:10Speaker 02

  I agree.

• 27:10Abbey Sharp?

  Um, and so I guess what, I would love to hear from you. What exactly do you want researchers to investigate? What is the most important questions we need to be asking next?

• 27:21Speaker 02

  A great question. So I'm pushing really hard for feasibility studies right now to see if these medications are appropriate to be used in specifically a weight suppressed bulimia nervosa patients and patients with binge eating disorder. That's sort of like the first step before you would go to a randomized, uh, control trial. So I think that's really important. We're having trouble getting investment. I mean, I personally ponied up money to say that I will throw money towards this problem. So that's the first thing, because we can argue about this all day long, but you know, we don't have any, if we don't have any money to study it, like, what are we doing? The second thing is, is I think really more investment in understanding about rare variants.

• 28:04Speaker 02

  So the Broad Institute at Harvard is doing a large genetic study right now, and it's free to submit your swabs. They're trying to look into that. I have a rare variant on my GLP pathway that we think is associated with disordered eating. And you know, in my very simplistic best case scenario, wouldn't be, wouldn't it be wonderful if we could identify some of these GLP variants that would be a predictor of response to these medications that we would know ahead of time? Pharma is not going to support that type of study. That would have to be independent because they would rather get FDA approval for a broad group that works okay, instead of it working extraordinarily well for a very small group. So it's really going to have to be independent funders

• 28:50Speaker 02

  that come up and, and bring the money to the table to get it done. But I think that's the most interesting questions that I have about precision medicine, really. Because I think that paper that I alluded to from Dr. Livingston that came out about treatment outcomes not improving in the past 20 years, one of her main points was that we were treating to averages, and we're not having precision medicine. And that's one of the reasons we're where we are.

• 29:13Abbey Sharp?

  Yeah. And when it comes to eating disorders specifically, you know, there is no one size fits all. I know that we have, you know, we have specific criteria to hit in the DSM, but every individual's experience is so highly variable, what their triggers are, what their origin story is, what specific, whether they're, you know, we're now talking about genes and variants and the intersection of those variants with, you know, their food environment and diet culture and what they're exposed to, and all of those messages. And so I think, yes, individual, an individualized approach is going to be so critical. And so I'm very, very appreciative of, you know, the work that you're doing, the advocacy that you're, you're putting forward,

• 29:56Abbey Sharp?

  and also for coming on and sharing your journey. This was such a fascinating conversation.

• 30:00Speaker 02

  Yeah, this is fun.

• 30:02Abbey Sharp?

  And can you tell everyone if, where they can find more information about what you're doing? And in any way they can support you?

• 30:09Speaker 02

  Great, thank you. So my website is paigegordonauthor.com. You can preorder my memoir that's coming out. So 100% of the royalties to this book are going, donating back to NIDA, specifically to, to a fund that's supporting research on this topic. So it's really just important to me in that way.

• 30:34Speaker 02

  And I always like to point out the NIDA website because they have a wonderful screener tool there. If you think you're having any issues with food, you can go on there and they will give you resources for next steps, so you can talk to a professional. So yeah, my website's the best way. And then I'm also on Instagram. I'm really vocal on there, same name, Paige Gordon Author. And the last thing, you've touched on it, but I just want to make sure I'm really clear that as much promise as these medications may have for binge eating type disorders, it's the absolute opposite for restrictive type eating disorders.

• 31:06Abbey Sharp?

  Of course.

• 31:06Speaker 02

  And I say restrictive type because people that have binge eating disorder can have restrictive binge eating disorder. So anyone that's coming from a place of restriction, it's, you gotta stay really far away from these medications. And anyone even with, you know, that could be promising, if you're thinking about using it in a weight loss context, it's also bad news bears.

• 31:28Abbey Sharp?

  Yeah, it's a red flag.

• 31:29Speaker 02

  Yeah. So I just always want to tell that to people, make sure I'm clear.

• 31:32Abbey Sharp?

  Yeah, I appreciate just kind of nailing that home because absolutely, we don't want this, and I, and that is what I was kind of alluding to. We don't want this conversation to turn into, oh, well, you know, this is kind of, you know, my way to get a GLP-1, which is obviously not what we want to be endorsing. So again, thank you for, for that kind of hammering home that disclaimer. And thank you again for what you do.

• 31:56Speaker 02

  Thank you. Thank you so much. It was a lot of fun.

• 31:58Abbey Sharp?

  Okay, this was such a unique and interesting conversation. And you know, as someone whose only encounter with food noise was through extreme diet restriction in, you know, my teen years when I had an eating disorder, I am always so eager to learn from those with varying food journeys. And I'm very, very much invested in the future of GLP-1 research and the advocacy work that Paige and others are doing to help us make these medications safer and more effective for those who use them. And while we have loads of research on their use for obesity and metabolic disorders,

• 32:39Abbey Sharp?

  we are still a very long way from seeing official label expansion for various EDs. And the lack of research really is evidence of that. So a recent 2026 review found only nine empirical studies looking specifically at GLP-1 medications in people with eating disorders or disordered eating. And most of that work has focused on binge eating. So not bulimia or anorexia, orthorexia, ARFID, or other combinations of eating disorder presentations. But what we do have for BED or binge eating is definitely quite interesting. So a recent meta-analysis of five small studies involving 182 people

• 33:21Abbey Sharp?

  did find that these drugs may help to reduce some symptoms in some people with BED. But in addition to being still very small and heterogeneous, they generally are studying weight loss as a primary outcome with eating disorder symptoms as kind of almost side effects. And that leaves us with some pretty massive unanswered questions. So we still don't know whether GLP-1s are actually modifying eating disorder psychopathology or simply making binging harder by lowering appetite and food reward. We don't know who might benefit versus who might become more restrictive.

• 34:03Abbey Sharp?

  We don't know what happens to body image distress or compensatory behaviors or nutritional adequacy over years of these medications use. And we have remarkably little evidence in bulimia specifically. The newest reviews are essentially saying the same thing. Promising signal, major safety and misuse concerns, and not enough evidence yet to guide routine eating disorder treatment. So I don't think that Paige's story gives us an answer yet, but I do think it gives us a really good research question and some hope that future treatments won't put all people with binge type symptoms into an existing explanatory box.

• 34:47Abbey Sharp?

  We clearly need more studies designed to figure out who is binging, why they're binging, what exactly the medication changes, and whether that change actually looks like recovery. And I will absolutely be keeping my finger on the pulse as more unfolds. But on that note, that's a wrap for today. If you have not already, please make sure to follow or subscribe wherever you get your podcasts. Do leave me a nice little five star review and a comment. And until next time, signing off with Science and SaaS, I'm Habee Sharp. Thanks for listening.

• 35:24Speaker 06

  When fall comes back around, there's a sense of a reset. And new pieces from Lululemon's Fall Drop are an inspiration to push your goals and elevate your routines. As your calendar fills, easy to layer styles meet the demands of your day. And as you challenge yourself to try even more, versatile sets transition with you. The Lululemon Fall Lineup brings new levels of comfort and confidence, whether you're starting something fresh or starting something over. Check out the latest arrivals in store and on lululemon.com now.