A recent study suggests that popular weight loss medications like Ozempic and Wegovy may not be as successful for individuals who struggle with emotional eating.

These medications are designed to curb appetite, making them more suitable for people who overeat in response to external food cues—such as appealing sights or smells—rather than those who eat to cope with emotions like stress, sadness, or anxiety.

Healthcare professionals are now being encouraged to evaluate a person’s eating behaviors and emotional relationship with food before prescribing weight loss drugs or recommending bariatric surgery.

The study, published September 16 in Frontiers in Clinical Diabetes and Healthcare, found that GLP-1 receptor agonists (the class of drugs including Ozempic and Wegovy) were more effective for those whose overeating is driven by external stimuli rather than emotional triggers.

Dr. Daisuke Yabe, a senior author of the study and professor of medicine at Kyoto University, explained:
“GLP-1 receptor agonists work well for individuals who gain weight or have elevated blood sugar due to eating prompted by external food cues. But when emotional eating is the main issue, these medications are less likely to be effective.”

Experts not involved in the research agree that emotional and psychological issues must be addressed before initiating any weight loss interventions, including medication or surgery.

“It’s not just about controlling food intake—we have to uncover and manage underlying causes,” said Dr. Mir Ali, a bariatric surgeon and medical director at MemorialCare Surgical Weight Loss Center in California.

Dr. Zhaoping Li, a professor of clinical medicine at UCLA, added, “Each patient is unique. Understanding why someone overeats is critical to determining the right treatment.”

Registered dietitian Kristin Kirkpatrick, president of KAK Consulting and a specialist at the Cleveland Clinic Department of Wellness & Preventive Medicine, said the findings provide an important perspective.

“Though the study was small, it highlights how emotional eating patterns can impact success with weight loss drugs,” she noted. “As a clinician, it reminds me that education and support around intuitive and mindful eating are vital—especially for patients planning to stop these medications eventually.”

Study Details: GLP-1 Medications and Eating Patterns

The researchers tracked 92 Japanese participants with type 2 diabetes who were starting treatment with GLP-1 medications. Data were collected at the start, at three months, and again after 12 months.

Researchers examined body weight, fat composition, dietary habits, and relevant blood markers such as cholesterol and glucose levels.

They focused on three eating styles:

1. Emotional Eating – eating in response to feelings such as sadness or anxiety

2. External Eating – triggered by the sight or smell of food

3. Restrained Eating – conscious restriction to manage weight

While the overall group experienced reductions in body weight, body fat, and cholesterol, the most significant and lasting improvements were observed in those with external eating behaviors. In contrast, individuals who identified with emotional or restrained eating patterns often returned to their previous habits after a year.

Dr. Li emphasized that eating behaviors are complex and often tied to emotional and psychological states, including boredom, stress, and anxiety.
“Eating isn’t always about hunger,” she said. “We have to help people understand what triggers their eating habits.”

Dr. Ali added that diagnosing emotional eating can be challenging and recommended psychological evaluation for patients before starting medication or surgery.
“GLP-1 drugs reduce hunger, but if emotional triggers are driving the behavior, suppressing appetite may not solve the problem,” he explained.

Addressing Emotional Eating

Kirkpatrick said that when it comes to emotional eating, the focus needs to shift from food control to emotional awareness.

“Food can temporarily relieve negative emotions, providing a calming effect—but typically, the choices made are low in nutrients and highly processed. The relief is brief, followed by a crash and often another craving, continuing the cycle,” she said.

She added that for those dealing with external eating, the issue is more about the cues—like visual or olfactory triggers—that drive food cravings, sometimes leading people to seek out fast food even when it’s not readily available at home.

Restrained eaters, on the other hand, may benefit from changing their mindset about food.
“Mindful eating includes the idea that no food is completely off-limits. It’s more sustainable to allow occasional indulgences without guilt rather than creating a cycle of restriction and bingeing,” Kirkpatrick said.
“I encourage my clients to view food in terms of nourishment for body, mind, and soul—rather than labeling it as ‘good’ or ‘bad.’”

Obesity and Related Health Risks

According to the Centers for Disease Control and Prevention (CDC), about 40% of adults in the United States are classified as obese. This rate is fairly consistent across genders, with the highest prevalence seen in adults aged 40 to 59.

Obesity is typically defined by a body mass index (BMI) of 30 or higher, or a waist circumference over 40 inches in men and 35 inches in women. It increases the risk for several health conditions, including:

• Heart disease

• Type 2 diabetes

• High blood pressure

• Gallbladder disease

• Fatty liver disease

• Sleep apnea

Medications such as semaglutide (found in Ozempic and Wegovy) and tirzepatide (found in Mounjaro and Zepbound) have become common tools in managing obesity and diabetes. But lifestyle changes—like improving diet, increasing physical activity, and getting enough sleep—remain fundamental to long-term success.

Kirkpatrick acknowledged that these medications can provide real benefits, especially when they reduce constant food thoughts or “food noise.”

“Many patients say it’s life-changing—suddenly, they’re not thinking about food all the time. But they also worry about what will happen once they stop taking the drug and have to face the same emotional triggers again,” she said.

Ultimately, while medications can help, they work best when combined with a personalized plan that includes psychological support and a sustainable approach to eating.