Why do some people respond better to GLP-1 drugs than others? This study suggests the answer may lie not just in biology, but in behavior.
GLP-1 receptor agonists such as Ozempic can play an important role in managing diabetes by helping control blood sugar and supporting weight loss, which can reduce the risk of complications. Still, their effects vary from person to person.
A study of 92 individuals with diabetes in Japan, followed over their first year on these medications, suggests that the underlying reasons for overeating may influence how well the drugs work. People who tend to eat in response to the sight or smell of appealing food showed the strongest long-term benefits, while those who eat primarily due to emotions were less likely to see the same results.
“Pre-treatment assessment of eating behavior patterns may help predict who will benefit most from GLP-1 receptor agonist therapy,” said Prof Daisuke Yabe of Kyoto University, senior author of the article in Frontiers in Clinical Diabetes and Healthcare. “GLP-1 receptor agonists are effective for individuals who experience weight gain or elevated blood glucose levels due to overeating triggered by external stimuli. However, their effectiveness is less expected in cases where emotional eating is the primary cause.”
Understanding Eating Behaviors and Treatment Response
These medications reduce blood glucose in several ways, including increasing insulin release, and they also influence appetite, which can lead to weight loss. However, not all patients experience this effect. To better understand why, researchers examined how different eating habits might shape treatment outcomes.
The study included 92 people with type 2 diabetes in Gifu Prefecture, Japan, who were starting GLP-1 receptor agonist therapy. Researchers monitored them over 12 months, collecting data at the start, after three months, and after one year. They recorded body weight, body composition, dietary habits, and blood markers such as glucose and cholesterol. Participants also answered questions about their eating behaviors.
The team focused on three patterns linked to weight gain. Emotional eating refers to eating driven by negative feelings rather than hunger. External eating describes eating triggered by sensory cues such as the appearance or smell of food. Restrained eating involves deliberately limiting food intake to control weight. While moderate restraint can support weight loss, excessive restriction may lead to unhealthy eating patterns.
Different Patterns, Different Outcomes
Overall, participants showed significant reductions in body weight, cholesterol, and body fat percentage over the year, while muscle mass remained stable. Blood glucose levels also improved, although these changes did not reach statistical significance.
Eating patterns were linked to differences in outcomes. After three months, participants reported more restrained eating and less emotional and external eating. By 12 months, however, restrained and emotional eating had returned to their original levels.
“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,” said Dr Takehiro Kato of Gifu University, second author of the article. “Individuals with prominent emotional eating tendencies may require additional behavioral or psychological support.”
Long-Term Trends and Study Limitations
Initial levels of emotional or restrained eating did not predict long-term treatment success. In contrast, reductions in external eating persisted throughout the year. Participants who reported higher external eating at the start experienced the greatest improvements in both weight and blood glucose control.
Because the study was observational and relied on self-reported data, it cannot establish cause and effect. The researchers also noted that participants may have been especially motivated to manage their diabetes, which could have contributed to the observed weight loss.
“While our study suggests a potential association between external eating behavior and treatment response to GLP-1 receptor agonists, these findings remain preliminary,” said Yabe. “Further evidence is necessary before they can be implemented in clinical practice. Should future large-scale or randomized controlled trials validate this relationship, incorporating simple behavioral assessments could become a valuable component in optimizing treatment strategies.”
Reference: “Association between eating behavior patterns and the therapeutic efficacy of GLP-1 receptor agonists in individuals with type 2 diabetes: a multicenter prospective observational study” by Yuya Koide, Takehiro Kato, Makoto Hayashi, Hisashi Daido, Takako Maruyama, Takuma Ishihara, Kayoko Nishimura, Shin Tsunekawa and Daisuke Yabe, 4 July 2025, Frontiers in Clinical Diabetes and Healthcare.
DOI: 10.3389/fcdhc.2025.1638681
Never miss a breakthrough: Join the SciTechDaily newsletter.
Follow us on Google and Google News.
2 Comments
How junk food I want lose weight how do this is hard stopping eating
I had excellent results on Ozempic. I felt the food noise disappear in the first 15 minutes. I thought it was a weird joke. I changed my diet to high protein and very low carbs from the first day. I lost 100 lbs in 12 months. Medicare dictated the choice of drug.
In 2025 Medicare changed me to Mounjaro. I lost another 60 lbs on it and was down to 106 pounds. That was too low a BMI and the meds were taken away from me. The food noise returned LOUDLY within the next 24 hours. I had to regain 50 pounds to get the meds again…trying now to find a ” maintenance dose” to keep food noise gone but not to get too thin.