The effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on binge eating in patients with obesity: a systematic review and meta-analysis
Abstract
Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used for weight management and type 2 diabetes, may reduce binge eating behaviours and body dissatisfaction, but there are concerns that they might increase eating restraint. We evaluated the effectiveness of GLP-1RAs for binge eating severity and related eating behaviours.
Methods: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing any GLP-1RA with placebo or active comparators reporting validated measures of binge eating, disinhibited eating, and loss of control eating. We searched MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Controlled Trials for RCTs published from Jan 2005 to April 2026. Trials including participants with severe physical comorbidities (e.g., cancer) were excluded. Standardised mean differences (Hedges' g) based on change-from-baseline scores or post-intervention raw mean differences (MD) with 95% CIs were estimated using random-effects models, with heterogeneity quantified using I2 and τ2; publication bias was not formally assessed due to the limited number of studies. Intervention effects on body image concerns were not meta-analysed due to limited data. PROSPERO: CRD42024570728.
Findings: Twenty five RCTs (n = 8069; ∼two-thirds female; majority White) met inclusion criteria. Compared with control conditions, participants allocated to GLP-1RAs reported moderate reductions in binge eating (n = 2106; k = 9; g =…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 8,069 participants or records.
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