What GLP-1s did to my binge-restrict cycle

Apologies for the length. I’m trying to describe an experience with glp-1 medication that I have not seen described in detail before…and that takes a beat to do 😄

I take a GLP-1 to help me with binge eating, which I have experienced for 35+ years.  For me, binge eating has always been accompanied by restriction, with the two fueling each other in an endless, debilitating loop.  As context, I lost little weight on the medication.  Just like before the glp-1, I do not count anything and try to eat intuitively.  I am being supported by a medical team who is aware of what I describe below.

I’d like to describe my binge-restrict cycle pre- and post-GLP-1, in case it helps anyone.  

Before the glp-1, I would habitually buy into the thin ideal, believing that if I were just thinner than I would be more acceptable, lovable, acceptable, etc…  Given that I was bullied for decades due to my weight, including during those formative childhood years, the “lower weight = safety, attention, resources” link was (is!) very tangible to me.  So, I restricted through a variety of means, from dieting to over exercise and so on.  

This restriction phase could last a few days, a few weeks, or even a few years.  My cycling weight reflected this — I’ve been 100 pounds heavier than I am now three times in my life, with lots of notable fluctuations in between.  I can use the photos on my phone to chart this — well, really the absence.  2010-2012? I was much fatter and I have 2-3 pictures of myself total in these years; 2013 I restricted down and allowed pictures, then used pictures to body check, then used pictures to motivate, as evidence by the increasing pace of pictures in this year…until 2014-2105 happened and I regained it all as my binge eating kicked in.  Same with my medical charts; I’d only go to the doctor when I was thinner, no matter what ailed me.  

I can now see that these cycles do not indicate moral failure or even a skill-based failure.  My body desperately wants to survive; all of our bodies do.  Based on extensive research I’ve done on the (in)efficacy of purposeful restriction, of weight cycling, and so on, I understand why regain happened — I deprived it (restriction).  But awe for my body was not enough for me to accept my higher weights during the cycle.  My cultish devotion to thinner = better drove me, time and time again, to step back into the restriction phase.  

Something notable always happened in the restriction phase:  the euphoria of weight loss enabled me to persist in overriding those evolutionary signals to “eat everything and gain back that weight!!”  I would body check in order to motivate myself to overcome the pain of not feeling well-fueled, of my hips aching from walking, from the gnawing hunger that woke me at 3am.  This is why my restriction phases could, like the binging, persist for weeks/months/years.  

In the recent decade, before the glp-1, I tried to stop the binge-restrict cycle.  I engaged in years of therapy, of research (I’m a trained social scientist), of teaching myself all sorts of intuitive eating, mindfulness, fat acceptance, evidence-based body positivity practices, and acceptance-and-commitment therapeutic skills, among others. This collection of ideas and skills helped me reduce the weight cycling.  I did restrict still, but after a period of time would “wake-up” to the absolute nonsense of (seriously) harming myself just to reach some cultural ideal.  I did still binge, but after a period of time I would feel my interception skills kick in, my internal drive to eat and move for the goal of feeling ZESTY rather than thin.  My weight fluctuated, but to a lesser degree.  

I decided to go on the glp-1 because of the continued, persistent interest in restricting and binging.  Sure, I was using skills, but had so many failures and it’s EXHAUSTING to need to use those skills most of your waking hours.  I wanted the noise reduced; I wanted a little more space to stop and think about how to respond to a binge urge (e.g., Am I hungry?  Have I been restricting and do I need to ‘water my parched flower’?  What is the best way to CARE for myself now?).  

Through really observing the changes to my mind within the week-long glp-1 release scheduled, I found is a few critical things:

1.  The glp-1 absolutely gives me the mental space to enact all of my healthy skills — mindfulness, mindsets related to rejection of healthism, the thin ideal, oppressive narcissism, the cult of thinness.  I am not always successful. I still binge on occasion.  But I do have a LOT more mental space because I can spend 5 minutes on a skill within a day, rather than hours trying to navigate urge after urge.  I can also find a ‘pause’ to use my skills.  

2.  The week-long release of the glp-1 can trigger a binge-restrict cycle if I am not careful.  Here’s how that works:  

—Day 1 and days 6 and 7 have the least suppression of food noise/binge urges.  

—Days 2-5 have strong suppression of food noise — and interest in food, that is appetite.  

—This means that I can unintentionally restrict on day 2, I can get ‘high’ from the result of that restriction on day 3 (e.g., ‘oh, I feel slimmer this morning!!!’ is a constant, unwelcome refrain from my mind on day 3), which makes me want to ‘consolidate’ the win of being thinner.  

—So, it is easy to ‘consolidate the win’ of feeling slimmer on days 4 and 5, and I can slip into restriction quite easily on these days. 

—But, when days 6, 7, and 1 roll around, my body says “what are you doing; you need calories; eat all the things.”  I can refeed myself at that point but ALSO I experience binge urges to eat well beyond levels of comfort.  

—So, days 6, 7, and 1 sometimes do include binge eating.  However, unlike the pre-glp-1 days, the binges are much smaller, I can often stop after one binge session (e.g., just one afternoon of binging rather than many days), and I can use skills within the binge to step away — something I did not think was fathomable in the past!! 

This means that it feels like the glp-1 is a bit less effective at helping with binge urges as they arise (and are still arising on the medication).  Nearly all my binges have occurred on day 7 or 1, for example.  However, if I adequately fuel myself on days 2-5 — that is, if I do not let disordered thoughts of ‘feeling/looking thinner’ drive restrictive eating behaviors — then actually my binge urges abate quite a bit, and so, too, does the behavior.  

3. Taking a step back to see what’s happening within the week-long release cycle, I feel like the glp-1 has condensed my binge-restrict cycle into something that used to play out over years to a cycle that plays out over a week.  And, honestly, this is a much more manageable timeframe.  I know exactly what I need to do to reduce that cycle:

—Days 2-5 = focus on more calorically dense food so that my calories remain higher without stomach fullness sensations prematurely telling me I have eaten enough (e.g., more fat, fewer vegetables); basically, if I allow myself to be restricted during these days, the binge urges will be VERY intense the other days - understandably so 

—Days 2-5 = bring all my critical awareness about body image skills to bear:  I reject whole-heartedly thin idealization.  It’s destructive to all - me, you, us, them, whether we are currently thinner, fatter, or somewhere in between. I should engage in more reading and affirmation work on these topics during these days.  This is a work in progress.  Breaking that “thinner = love, safety” link often feels impossible, but I can use skills to manage the damaging thought, before it takes hold in behavior like restriction, body checking, over-excessive to ‘consolidate’

—Days 6, 7, and 1 = bring all my intuitive eating skills to bear:  I will eat to complete fullness and I will eat when I am hungry.  I will not restrict to ‘consolidate’ my ‘loss’ and I will not binge because that, too, divorces me from my bodily needs. (I realize that this might be confusing, but internally I have a VERY strong compass to differentiate between eating-more-to-make-up-for-deficit versus eating due to binge urges. The two eating experiences feel like night and day to me.)

I am far from perfect at managing this weekly cycle.  But…I am so much better than I was pre-glp-1.  I can see the patterns in my body and mind so clearly; I can sense which of my skills are more important or vital; I can be proactive about managing the cycle; and I have the mental space to put my skills/mindsets into practice.  

I lost so much of my life due to binging and restricting.  GLP-1s are allowing me to manage that disorder and step into living.  

Has anyone experienced anything like this?  Does anyone have advice for further enhancing intuitive eating skills, or skills that help with binge-restrict?  I am far from solving this cycle completely — again, I still binge maybe once every three weeks or so — but it’s SO much better than in the past.  Still, though, I want to improve.

This is my favorite reddit board.  Thank you all for your vulnerability and thoughts!