Doctors may need to consider their patients’ eating behaviours before prescribing blockbuster weight loss drugs, new research suggests.
A Japanese study has found that people who eat in response to emotions may not see the same benefits from widely used medications such as Ozempic, Wegovy, and Mounjaro as those who overeat when food looks or smells appealing. These drugs, known as glucagon-like peptide-1 (GLP-1) receptor agonists, mimic a hormone that reduces appetite and are increasingly prescribed for both diabetes and weight loss.
The year-long study, published in Frontiers in Clinical Diabetes and Healthcare, tracked 92 patients with diabetes who were taking GLP-1 drugs. Researchers from Gifu University and Kyoto University collected data on participants’ diets, blood markers, body composition, and weight changes. They also assessed patients’ relationships with food, focusing on three main eating patterns: eating in response to negative emotions, eating when food appeared appetising, and restricting diet for weight loss purposes.
Diverging Results Based on Eating Style
Most participants lost significant weight and showed improvements in cholesterol levels during the first year of treatment. However, outcomes varied depending on eating habits.
Those who tended to overeat because food looked appealing experienced the most consistent weight loss and improved blood sugar control over 12 months. In contrast, participants who relied on food to manage emotions were less likely to sustain benefits.
At the three-month mark, many patients showed greater control over their eating and were less likely to eat for emotional reasons or because of the appearance of food. But by the 12-month point, emotional and restrictive eating habits had re-emerged, suggesting that psychological factors may undermine long-term progress.
“Individuals with prominent emotional eating tendencies may require additional behavioural or psychological support,” said Dr Takehiro Kato, clinical lecturer at Gifu University and one of the study’s authors. “One possible explanation is that emotional eating is more strongly influenced by psychological factors which may not be directly addressed by GLP-1 receptor agonist therapy.”
Calls for More Research
While the findings highlight a potential link between eating behaviour and treatment outcomes, the researchers stressed that larger studies are needed before changes to clinical practice can be made.
“While our study suggests a potential association between external eating behaviour and treatment response to GLP-1 receptor agonists, these findings remain preliminary,” said Dr Daisuke Yabe, professor at Kyoto University and co-author of the study. “Further evidence is necessary before they can be implemented in clinical practice.”
The results underline the growing recognition that medication alone may not be sufficient for lasting weight loss, especially for patients who struggle with emotional eating. Experts say combining drug treatment with dietary guidance and psychological support may be the most effective path forward.
