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The effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on binge eating in patients with obesity: a systematic review and meta-analysis
The use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) as treatment options for weight management and type 2 diabetes has sparked interest in their potential effects on binge eating behaviors. Recent research suggests these medications may help alleviate binge eating and body dissatisfaction, although there are worries they could lead to increased eating restraint.
To explore this issue, a systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, focusing on studies comparing any GLP-1RA with placebo or active comparators. The analysis covered RCTs published between January 2005 and April 2026 and sourced from databases including MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Controlled Trials. Notably, trials with participants who had severe physical comorbidities, such as cancer, were excluded. Researchers computed standardized mean differences using random-effects models while assessing heterogeneity.
In total, 25 RCTs involving 8069 participants met the inclusion criteria, with approximately two-thirds of participants female and the majority White. The findings indicated that participants receiving GLP-1RAs experienced moderate reductions in binge eating severity (n = 2106; k = 9; g = −0.23 [95% CI −0.36 to −0.10]), loss of control over eating (n = 362; k = 5; MD = −18.38 [–23.34 to −13.43]), and eating disinhibition (n = 911; k = 13; g = −0.54 [−0.90 to −0.18]). Furthermore, there was a noted decrease in emotional eating (n = 429; k = 4; g = −0.30 [−0.51 to −0.09]) and an increase in cognitive or dietary restraint (n = 911; k = 13; g = 0.31 [0.17–0.44]). The effects were more pronounced in participants diagnosed with binge eating disorder.
Despite these positive findings, all studies were assessed as having high risk or concerns related to bias, with significant heterogeneity identified across trials. While GLP-1RAs have demonstrated efficacy in reducing binge eating and emotional eating and enhancing dietary restraint, the implications of increased restraint remain uncertain. The authors conclude that further research with larger sample sizes targeting individuals with diagnosed binge eating disorder, along with extended follow-up periods, is necessary to guide clinical applications effectively. [NPID: Binge eating, body dissatisfaction, eating restraint, GLP-1]
Year: 2026
