Eating Disorders
August 19, 2025
TLDR: GLP-1 Medications and Body Sovereignty
This article explores the complex landscape of GLP-1 medications (Ozempic, Wegovy) through a trauma-informed, nuanced lens that prioritizes body sovereignty and individual autonomy. Key points include:
Body sovereignty—the freedom to make choices about your own body—must anchor all clinical conversations about weight and medication
With 12% of American adults having used GLP-1s, avoiding "body talk" and weight-related comments is essential etiquette
Individual experiences vary dramatically—some find liberation from food noise, while others discover deeper psychological issues
These medications intersect with eating disorders, food addiction, mental health, and systemic healthcare inequities
Insurance covers $1,000/month injections but not nutrition counseling, reflecting broken healthcare priorities
Wise Mind Nutrition emphasizes the importance of:
Supporting clients through all phases: pre-medication, active use, and discontinuation
Addressing nutritional needs regardless of the appetite regulation method
Recognizing that rigid thinking serves no one in complex healthcare decisions
Challenging our own biases while holding space for all choices
Understanding that pharmaceutical solutions don't address the root environmental causes
The article concludes that healthcare professionals must lead with radical curiosity over rigid dogma, providing nuanced support that honors each person's journey while advocating for systemic change.
[Read full article for comprehensive insights on navigating GLP-1 conversations in clinical practice]
With 12% of American adults having taken GLP-1 inhibitors and prescriptions continuing to skyrocket, we're facing a healthcare conversation that demands both clinical expertise and genuine compassion. I was recently quoted in a Washington Post article by Steven Petrow about the etiquette surrounding these medications, and I want to expand on why this matters for everyone navigating the complex world of nutrition and mental health.
The Core Principle: Body Sovereignty in Practice
At the heart of my clinical approach lies a principle that anchors everything I do:
"Body sovereignty describes the freedom and autonomy to make choices about your own body and health."
This isn't just therapeutic jargon or feel-good language. For those of us who've navigated our own recovery journeys—who've had autonomy stripped away by addiction, trauma, or institutionalization—body sovereignty is sacred. It forms the foundation of trauma-informed care and guides how we approach every client interaction.
In the Washington Post piece, I recommended avoiding "body talk" because commenting on someone's body or weight loss method is rarely neutral. These conversations carry judgment, can trigger shame, and violate the therapeutic container many of us work hard to create.
The Reality of GLP-1s in Clinical Practice
After over a decade at the intersection of nutrition, mental health, and recovery, I've learned that rigid thinking serves no one—not our clients, not our field, and certainly not the complex humans seeking our help. I've walked with clients through every phase of their GLP-1 journey:
Pre-Medication Phase
Unpacking the "why" behind the decision
Addressing underlying behavioral patterns
Preparing for psychological shifts that accompany rapid physical changes
Active Use Phase
Managing the intense appetite suppression
Ensuring adequate nutrition when food becomes uninteresting
Processing identity changes as the body transforms
Discontinuation Phase
Navigating the often-overlooked challenges where biological and psychological factors collide
Supporting clients through potential weight regain
Addressing the return of food noise and appetite
Each person's experience is radically different. Some find liberation from food noise that has plagued them for decades. Others discover their eating issues run deeper than appetite alone. Many land somewhere in between. There's no universal truth here—just individual stories that deserve respect and clinical nuance.
Critical Intersections: Where GLP-1s Meet My Clinical Focus
The GLP-1 phenomenon touches everything I care about in nutritional psychiatry and addiction medicine:
Eating Disorder Recovery
I've witnessed these medications both help and harm recovery. They can quiet the obsessive food thoughts OR reinforce restriction patterns. Context is everything. A client with binge eating disorder might find relief, while someone with a history of anorexia might spiral deeper into restriction.
Ultra-Processed Food Addiction
When appetite suppression masks addiction patterns, we risk missing the root cause. These drugs don't cure the neurobiological hijacking that occurs with ultra-processed food addiction—they just mute the signal. The underlying reward system dysfunction remains.
Mental Health Complexity
Rapid body changes trigger identity crises. Social eating becomes fraught with anxiety. The inflammation-mood connection gets disrupted in ways we're still studying. Clients report everything from improved depression to increased anxiety, often simultaneously.
Systems of Oppression
Let's address the elephant in the room—these medications reflect our broken healthcare system. Insurance covers a $1,000/month injection but won't pay for nutrition counseling. Big Pharma profits while root causes go unaddressed. We're medicating a food environment problem at the individual level.
Leading with Curiosity, Not Judgment
The article's core message—don't ask if someone's on these medications—extends beyond social etiquette. In our practices, we need to:
Hold space for all choices without an agenda
Address nutritional needs regardless of how appetite is regulated
Process the psychological complexity of medical interventions
Challenge our own biases (we all have them, whether we admit it or not)
Recognize that autonomy in health decisions is revolutionary
The Bigger Picture: Beyond Individual Choices
This conversation isn't just about GLP-1s. It's about how we show up when the ground shifts beneath our feet in healthcare. These medications force us to confront uncomfortable questions:
What happens when pharmaceutical solutions overshadow nutritional approaches?
How do we honor body sovereignty while acknowledging commercial forces at play?
Can we hold dialectical thinking in a polarized world?
Where does personal responsibility end and systemic change begin?
My years in recovery taught me that rigidity can save your life—until it becomes your prison. The same holds for our professional stances. We need frameworks strong enough to guide us but flexible enough to evolve with emerging evidence and client needs.
Moving Forward Together: A Call for Nuanced Support
We can't opt out of these conversations. But we can choose how we engage. Let's lead with:
Radical curiosity over rigid dogma
Systemic analysis over individual blame
Nuanced support over binary thinking
Body sovereignty over professional ego
Evidence-based flexibility over ideological purity
Behind every GLP-1 question is a human being navigating impossible choices in an impossible food environment. They're facing societal pressure, metabolic complexity, trauma histories, and a healthcare system that often fails them at every turn.
My job—our job—is to be the professionals who finally see them whole.
Key Takeaways for Practitioners
Respect body sovereignty—clients' autonomy in health decisions is important
Embrace nuance—what works for one client may harm another
Address systemic issues—individual solutions won't fix environmental problems
Stay curious—our understanding of these medications evolves daily
Support all phases—pre-medication, active use, and discontinuation require different approaches
Conclusion: The Conversation Continues
The GLP-1 conversation reflects larger tensions in how we approach health, autonomy, and healing in a complex world. As mental health scientists and clinicians, we must hold space for multiple truths while advocating for systemic change.
Whether someone chooses medication, nutritional intervention, or both, our role remains consistent: to provide nuanced, compassionate support that honors each person's sovereignty over their own body.
Because at the end of the day, true healing happens when people feel seen, respected, and empowered to make choices that align with their values—not ours.
