GLP-1s and Eating Disorder Therapy

Will My Eating Disorder Therapist Work With Me If I’m Taking a GLP-1?

I get this question all the time as an eating disorder therapist. Sometimes it comes in a consult call. Sometimes it comes in a nervous, whispered way, like it’s a confession:

“Will you still work with me if I’m on a GLP-1? Or thinking about it?”

Short answer: Yes.

Longer answer: girl, let’s talk about it. 🤍

Why people are scared to ask

If you have a history of disordered eating or an eating disorder, you may have already braced for the reaction. Maybe you’re expecting a lecture. Maybe you think a therapist will say “I can’t work with you unless you stop.” Maybe you’re afraid of being judged for wanting a medication and wanting recovery, like those two things can’t exist in the same room.

So people hide it. They skip mentioning the prescription, or they bring it up three months into therapy, wrapped in an apology.

I never want you to feel like you have to do that with me.

My job isn’t to make your choices for you

I’m not here to judge you. I’m here to guide you in the direction of your own life.

My job isn’t to require you to make the same choices I would make. It’s to help you understand how the choices you’re making are affecting your relationship with food, your body, and your mental health, so you can make the best informed decision for you. I’m not the medication police, and I’m not here to cheer or boo. I’m here to be curious with you.

Why GLP-1s can get complicated with a history of disordered eating

I’m not here to debate whether GLP-1s are “good” or “bad.” Plenty of people take them for medical reasons, and that decision belongs to you and your prescriber.

But when there’s a history of disordered eating or an eating disorder, things can get tangled fast. A few things I pay close attention to:

• Appetite suppression: Does quieter hunger feel like relief, or does it start feeling like permission to eat less and less?
• Restriction and food rules: Are old rules creeping back in, just with a new explanation?
• Fear of weight gain: Is the medication feeding a fear that was already there?
• Weight loss as the whole goal: Is your worth starting to feel tied to the number again?

None of those are automatically “wrong.” They’re just worth noticing, out loud, with someone who won’t flinch.

What it actually looks like in session

If you’re on a GLP-1 (or thinking about it) and we work together, here’s what you can expect:

1. We pay attention to behaviors and thought patterns. What are you eating? What are you not eating? What’s the voice in your head saying about it?
2. We get curious about what’s driving the decision. Is it a medical need? Pressure? Old shame? A mix? All valid to explore.
3. We talk about risks. Honestly, without scare tactics.
4. We loop in your care team when appropriate. I’m a big believer in collaborating with your medical provider and the rest of your treatment team.
5. Yes, I might challenge you. Gently, but I will. That’s part of therapy too.

This is what I mean by harm reduction: meeting you where you are instead of demanding perfection before you’re “allowed” to get support. You don’t have to be “sick enough” or “recovered enough” to deserve care.

Keeping you safe is part of the job

There are so many GLP-1 products being pushed out from all kinds of places right now, and not all of them are created equal. If you’re using one, I want to help make sure it’s coming from a safe and trusted place, ideally through a licensed prescriber who knows your full history, including your eating disorder history. That’s a big reason I encourage a team approach.

Here in the Waco area, these are local providers I’ve worked with and trust:

The Baseline
203 Colonnade Parkway, Woodway, TX 76712
(254) 218-3749
thebaselinewoodway.com

CenTex IV
13701 Woodway Dr., Suite 615, Woodway, TX 76712
(254) 651-6150
centexiv.com

Custom Health Waco
4700 Bosque Blvd., Suite K, Waco, TX 76710
(254) 218-3711
customhealthwaco.com

Not sure where to start? Ask me. You’re always free to choose your own provider, and I’d encourage you to tell whoever is prescribing about your eating disorder history. I just want you to be in good hands.

You don’t have to hide it from me

Therapy should be the place where you can say the complicated stuff. If you’re taking a GLP-1 and it feels good, say that. If it feels scary, say that. If it’s stirring up old eating disorder thoughts you thought you’d left behind, definitely say that.

I’m not going to judge you, lecture you, or refuse to work with you.

If you’re in Waco or anywhere in Texas, I offer in-person and virtual sessions. Wondering if we’d be a good fit? Book a free 15-minute consult and ask me anything, including this question. You can also join my Between Sessions newsletter for gentle, real-life notes on food, body image, and everything in between.

Frequently Asked Questions

Will you work with me if I’m taking a GLP-1?

Yes. I don’t require you to stop or start any medication to work with me. Medical decisions are between you and your prescriber. My role is to help you understand how your choices are affecting your relationship with food, your body, and your mental health.

Do I have to stop taking my GLP-1 to start eating disorder therapy?

No. I’m not going to make that call for you. We’ll talk openly about how it’s impacting your thoughts and behaviors around food, and I’ll encourage communication with your medical provider when appropriate. Learn more about eating disorder therapy HERE.

Can a GLP-1 make disordered eating worse?

It can be complicated when there’s a history of disordered eating or an eating disorder, especially when appetite suppression, restriction, food rules, or fear of weight gain get tangled together. It doesn’t look the same for everyone. That’s why it helps to talk about it with both your prescriber and your therapist.

Should I tell my doctor about my eating disorder history?

Yes, I’d encourage it. The more your care team knows, the better they can support you. With your permission, I’m happy to collaborate with your medical provider.

How can I tell if my GLP-1 is coming from a safe source?

Start with a licensed prescriber who knows your full health history, and ask them or your pharmacist about where your medication should be filled. Be cautious about anything that feels too easy, too cheap, or too unregulated. If you’re in the Waco area, I can share local providers I trust, including The Baseline, CenTex IV, and Custom Health Waco. If you’re unsure about a source, bring it up in session and with your prescriber, and we can talk through it together.

Can you recommend local providers for GLP-1 prescriptions in Waco?

I can share Waco-area providers I trust, including The Baseline, CenTex IV, and Custom Health Waco. Which provider is right for you is your call, and I always encourage sharing your eating disorder history with whoever is prescribing. With your permission, I’m happy to coordinate with them.

Do you work with people considering bariatric surgery who are also thinking about GLP-1s?

Yes. I’m a Board Certified Bariatric Counselor, and supporting people before and after bariatric surgery is a big part of my practice. Being an eating disorder therapist doesn’t disqualify me from that work. It’s part of why I do it the way I do.

Do you offer virtual eating disorder therapy in Texas?

Yes. I see clients in person in Waco and virtually across Texas.

Do you take insurance?

I accept several major insurance plans, including Aetna, BCBS, UHC, and Cigna, among others. Reach out and we can look at your coverage together. More information HERE

Hannah Short, LCSW, BCBC, CMNCS, CCM
Rooted & Nourished Psychotherapy, Waco, TX

This post is general education, not medical advice or therapy. Decisions about medication are between you and your prescriber. If you’re in crisis, call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.