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Dr. Sheenie Ambardar, MD is an award-winning psychiatrist, psychotherapist, and coach who serves patients throughout California and New York via telehealth. Dr. Ambardar has training and certification in Medical Weight Management from the International Association for Physicians in Aesthetic Medicine (IAPAM) - approved by the American Academy of Family Physicians (AAFP)

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The use of GLP-1 agonists (GLP-1s) in the treatment of binge-eating disorder, emotional eating, overweight, and food chatter offers much hope and promise to those who have struggled with these debilitating lifelong issues.

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Dr. Ambardar is among a handful of clinical psychiatrists at the forefront of utilizing GLP-1 agonists to target both the psychological and physical aspects of binge-eating, emotional eating, overweight, and food chatter.

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‍What are GLP-1 receptor agonists?

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GLP-1 receptor agonists (GLP-1s), also known as incretin mimetics, are a group of medications frequently used for managing Type 2 diabetes. Recent research has shown promising potential for their use in weight management, binge-eating disorder, and emotional eating.

GLP-1 agonists, such as semaglutide (Ozempic, Wegovy), liraglutide (Saxenda), and GLP-1/GIP agonists such as tirzepatide (Mounjaro), work by mimicking the action of the GLP-1 and/or GIP hormones.

The main function of these hormones is to stimulate insulin secretion, slow stomach emptying, and lower blood glucose levels. GLP-1 agonists like Ozempic and Wegovy also have effects on the brain, specifically on brain areas associated with reward and appetite regulation. These medications work to decrease appetite as well as decrease food cravings/food chatter, making them potential candidates for treating eating disorders like binge-eating disorder (BED).

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What are the benefits of using GLP-1s for adults struggling with binge-eating, emotional eating, overweight, and food chatter?

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1. Weight Loss: GLP-1s slow stomach emptying which can help enhance feelings of satiety or fullness, which in turn aids with weight management. Several studies have demonstrated significant weight loss in overweight or obese individuals treated with GLP-1s.
2. Reduced Binge-Eating Behavior: The enhanced feeling of satiety associated with GLP-1s can also improve binge eating behaviors. By helping individuals feel fuller sooner and for longer periods of time, these medications can potentially reduce the frequency and severity of binge eating episodes.
3. Decreased Food Chatter: GLP-1s may help reduce persistent, intrusive thoughts about food often referred to as "food chatter." The exact mechanism for this effect is not entirely clear but may be linked to how these medications influence hunger and satiety signals in the brain. This can result in reduced psychological preoccupation with food and help people better control their eating behaviors.
4. Improved Metabolic Health: GLP-1s can also have positive impacts on overall metabolic health and reduce risk factors for diseases like Type 2 diabetes and heart disease. By aiding weight loss, improving glycemic control, and potentially even directly acting on fat cells and the cardiovascular system, these medications may contribute to improved metabolic profiles.
5. Potential Psychological Benefits: Although more research is needed, there are indications that GLP-1s may have positive psychological benefits. Some individuals report improved mood and decreased anxiety related to food, which could be linked to an overall reduction in food chatter and improved control over eating behaviors.
6. Favorable Side Effect Profile: While all medications carry some risk of side effects, GLP-1s tend to have a favorable side effect profile, especially when compared to other weight-loss medications. The most common side effects are gastrointestinal and typically decrease over time.

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It's important to remember that while GLP-1s can be an effective tool for managing weight and eating behaviors, they are not a standalone solution. Medications such as Ozempic, Wegovy, Mounjaro, and Saxenda should be used in conjunction with lifestyle changes, including healthy eating and regular physical activity. Additionally, these medications may not be suitable for everyone and any potential benefits need to be weighed against potential risks. Always consult your physician for personalized medical advice.

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Who Should Consider GLP-1 Therapy with Ozempic, Wegovy, Mounjaro, Saxenda, & other medications?

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1. Individuals who are Overweight or Obese: People who are overweight or obese and have struggled to lose weight through diet and exercise alone may benefit from GLP-1s. These medications can enhance feelings of fullness and satiety, potentially leading to decreased calorie intake and weight loss.
2. Those with Binge Eating Disorder: GLP-1s can be a beneficial addition to a comprehensive treatment plan for those with binge eating disorder. By increasing feelings of fullness, these medications can help individuals gain control over their eating habits, reducing the frequency and severity of binge eating episodes.
3. People Struggling with Food Chatter: Individuals who frequently experience intrusive thoughts about food or struggle to control their cravings may find GLP-1s beneficial. These medications may reduce preoccupation with food and help individuals better manage their eating behaviors.
4. Patients who struggle with Emotional Eating: Emotional eating refers to the use of food to deal with emotions, rather than to satisfy physical hunger. By increasing feelings of fullness and reducing food cravings, GLP-1s may be beneficial for those struggling with emotional eating and help them to gain control over their eating habits.

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GLP-1s are not suitable for everyone, including those with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. These medications also come with potential side effects, most commonly gastrointestinal symptoms.

Patients considering GLP-1 therapy should always consult with their physician to discuss potential risks and benefits. Any decision to start GLP-1 medications should be based on a comprehensive evaluation of the individual's overall health status, personal medical history, and treatment goals. At The Happiness Psychiatrist®, GLP-1s are prescribed by Dr. Ambardar as part of an integrated treatment plan that includes health and wellness coaching, dietary changes, exercise, and other lifestyle and behavioral modifications.

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What does the Evidence-based Research say? We're glad you asked!

Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity

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Once-Weekly Semaglutide in Adults with Overweight or Obesity

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A pilot randomized controlled trial of liraglutide 3.0 mg for binge eating disorder

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Short term effects of semaglutide on emotional eating and other abnormal eating patterns among subjects living with obesity

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Weight-Loss Drugs Like Ozempic Are Treating Binge Eating, Too

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Dulaglutide Reduces Binge Eating in Patients With T2D and Binge Eating Disorder

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Tirzepatide Once Weekly for the Treatment of Obesity

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Wegovy (semaglutide): a new weight loss drug for chronic weight management

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Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity

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Would glucagon-like peptide-1 receptor agonists have efficacy in binge eating disorder and bulimia nervosa? A review of the current literature

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Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes

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Liraglutide for psychiatric disorders: clinical evidence and challenges

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The Future of Treatment:

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The use of GLP-1 agonists in the treatment of binge-eating disorder, emotional eating, overweight, and food chatter offers much hope and promise to those who have struggled with these debilitating lifelong issues.

Dr. Ambardar is among a handful of clinical psychiatrists at the forefront of utilizing GLP-1 agonists to target both the psychological and physical aspects of binge-eating, emotional eating, overweight, and food chatter.

This is an exciting time for the field and the future of psychiatric medicine will likely see more cross-disciplinary treatments like this, where drugs initially developed for metabolic disorders find utility in treating psychiatric conditions.

As always, any medication decisions should be made with the supervision and collaboration of your physician. If you think GLP-1 therapy might be helpful to you, I encourage you to contact our office today.

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