July 15, 2025 • 28 mins
Could Ozempic do more than help with weight loss? Dr Trevor Steward is uncovering the science behind what’s happening in the brain when people take drugs like Ozempic. His research queries how these medications influence appetite, food-related thoughts, and their potential to turn down the dial on binge eating disorder.
Read more in Dr Steward's article for Pursuit.
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Cassie Hayward (00:00):
This podcast was made on the lands of the Wurundjeri people,
the Woi Wurrung and the Bunurong. We'd like to pay
respects to their elders, past and present, and emerging.
Nick Haslam (00:14):
From the Melbourne School of Psychological Sciences at the University
of Melbourne, this is PsychTalks.
Welcome back to a new season of PsychTalks. I'm Nick
Haslam and I'm joined as always by my co-host, Cassie Hayward.
Cassie Hayward (00:28):
Hi Nick, great to be back in 2025.
And for anyone new, we're here to explore the latest
research in psychology and neuroscience with our brilliant experts at
the University of Melbourne School of Psychological Sciences. We break
down the science behind how our mind works and what
these insights might mean for you at home.
Nick Haslam (00:47):
That's right. And this season of psych talks is set
to be a cracker. We'll be getting our teeth into
some really fascinating research, like how
self-compassion could ease the pathway through menopause. And why misinformation
has spread so rapidly online, just to name a few.
Cassie Hayward (01:01):
I can't wait. Now, today we're talking about Ozempic and
other GLP-1 receptor agonists, drugs that have become hugely popular
for weight loss. But there's a lot more to the
story than just numbers on a scale, especially when it
comes to their interactions with disorders like binge eating. Our
colleague and guest, Dr Trevor Steward, is investigating what these
medications do to the brain, not just our bodies.
Nick Haslam (01:28):
Welcome to PsychTalks, Trevor.
Trevor Steward (01:30):
Thanks for having me.
Cassie Hayward (01:31):
It's a fascinating area, Trevor, but could you start by
telling us a little bit about your background and your
research interests and how you've ended up studying Ozempic?
Trevor Steward (01:39):
Yeah, sure, Cassie. So, my background is in psychology. I
did my undergraduate degree in the United States and then
now
Afterwards moved to Spain to specialise in neuroscience and during
my PhD I was embedded in an eating disorders unit
in a public hospital and it was there that I
really saw firsthand the burden of eating disorders and how
much they can impact people's both physical and psychological well-being
(02:02):
as well as their caregivers.
And what really struck me was that there weren't any brain-
based interventions available for these disorders. You know, anorexia nervosa
is a perfect example. I recently went to a conference
and there was a professor there who got into psychiatry
and eating disorders, and he said in 1970, there wasn't
a single approved medication for anorexia nervosa.
(02:25):
And there still isn't a single approved medication for anorexia nervosa.
So that just really makes it evident that we need
to understand these disorders more in depth. Then I moved
to the University of Melbourne in 2019 and that's where
I sort of expanded my research program. But then just
in the past two years, much like everyone in in society,
we've really been awed by the emergence of these new
medications called GLP-1 receptor agonists.
(02:48):
Uh, for example, Ozempic, and these medications are absolute game
changer in the in the realm of treating obesity. And
then with more people using these, we started to get
more anecdotal evidence around other psychological effects that they're having
that are related to eating behaviours and eating disorders. And
so that's where I want to step in and try
to understand what's going on on a neurobiological level.
Nick Haslam (03:11):
So you talked about Ozempic - can you give us a
quick definition of what kind of drug it is, what
other drugs are in that class, and what they've mostly
been used for before they became revolutionary in this area
of weight?
Trevor Steward (03:23):
Yeah, for sure. So when we talk about drugs like Ozempic,
we're actually talking about a broader class of medication known
as GLP-1
receptor agonists. Now, GLP-1 stands for glucagon-like peptide-1. Don't worry,
you don't have to remember that. Which is a naturally
occurring hormone in the body involved in the regulation of
blood sugars. Now, after we eat, GLP-1 helps us to
(03:45):
stimulate the secretion of insulin, which lowers our blood glucose,
while then also, um, you know, helping to regulate our appetite.
Now, what we can do with these medications is basically
mimic the effects of this naturally occurring hormone, which will
then slow, for example, our gastric emptying, our digestion, that
makes us feel fuller for longer. And it also um
(04:06):
does other things in terms of metabolic health and uh
regulating insulin levels. Now, Ozempic is the most famous of
these types of medications, but its generic name is actually semaglutide.
Um, there's some several other ones out on the market
now that you might have heard of, for example, Mounjaro
or Zepbound, and all of these compounds are quite similar
in the sense that they mimic this GLP-1 hormone. Now, historically,
(04:31):
these medications were used to treat type 2 diabetes and
what they found was that these individuals who are using
these GLP-1 medications to regulate their diabetes were also losing weight.
And then someone came up with a genius idea of saying, oh,
what would happen if we really upped the dose of
these medications in people with obesity? Would they also lose weight?
(04:53):
And that's when we started to see the emergence of
these compounds. And there have been some very large clinical
trials for people with obesity that have found that it
can help people to lose weight, um, at levels that
you can't really ever see with other types of interventions. Um,
apart from that, it's also there's now emerging clinical trials
that have found that it's effective for conditions like sleep
apnoea or for fatty liver disease, and so we're only
(05:17):
um at the tip of the iceberg in terms of
what is indicated uses could be.
Cassie Hayward (05:22):
As you say, there's been this huge buzz about what
these drugs can do from a weight loss perspective.
But that's not entirely your focus, is it? You're looking
at what they might also be doing to the brain.
Can you tell us a little bit about what you're
doing there?
Trevor Steward (05:36):
Yeah, exactly. And so, um, our, uh, study is going
to be examining the effects of tirzepatide, which is also
known as Mounjaro or Zepbound, in adults with binge eating disorder.
Binge eating disorder is a very serious eating disorder. It's
the most prevalent eating disorder. Um, there's more people living
with eating disorder than bulimia nervosa or anorexia nervosa combined.
(05:57):
And binge eating disorder is characterised by the presence of
binge eating episodes, which are characterised by people eating large
amounts of food for a short amount of time, often
accompanied by feelings of loss of control, guilt, shame, and
they really get locked into this really
Um, difficult, entrenched cycle that impacts your quality of life
and impacts their health and makes it very difficult for
(06:19):
them to maintain a positive wellbeing. Whereas bulimia nervosa does
have bingeing episodes, but it's also characterised by the presence
of compensatory behaviours. So that could be, for example, someone
self-inducing vomiting or, you know, exercising to excess to try
to compensate for the previous binge eating episode.
And what we're interested in this study is to try
(06:40):
to understand how tirzepatide
impacts the brain processes linked to some of these core
eating disorder symptoms such as compulsions to eat, impulsivity around food,
or what you as often um heard of in social media,
food noise, which is these intrusive thoughts around food where people,
for example, can't get this idea out of their head
of how they're planning to binge eat.
(07:02):
Or a certain type of food that they would like
to eat. Now, there's a lot of anecdotal evidence around
drugs like Ozempic or tirzepatide, being able to lower the
volume of these intrusive thoughts around food. However, on a
neurobiological level, we just don't understand how this is occurring
and why this is happening. There are GLP-1 receptor, um,
GLP-1 receptors located throughout the brain.
(07:25):
But it's not really clear why uh a drug that's
targeting the gut would have such a huge impact on
these brain processes. And so we're really interested in trying
to interrogate that further.
Nick Haslam (07:36):
It is a bit surprising, as you said, I mean,
if the drug is primarily slowing the gastric processing or whatever, Uh, emptying,
is that what you, what you said? Uh, how does that,
how does that, um, have any effect whatsoever on attention
you pay to certain thoughts or any of the other
processes involved in binge eating disorder?
Trevor Steward (07:53):
No, that's a great question, Nick. And so we're stipulating
this is mainly based off of animal research because we
really don't have that much evidence in humans yet around
us that by um lowering or slowing down the gastric
emptying process, you are impacting food reward pathways. And so
For example, dopamine is probably the most well known neurotransmitter
(08:14):
out there. It's very much linked to motivation to find rewards.
And so if you are able to slow down the
emptying of someone's stomach and say, OK, now you don't
need to find that reward. That reward isn't as salient
for you anymore. Or if, if you even did find
that reward, you wouldn't get as much pleasure from it
as you would have previously. That's going to lead to
(08:34):
neurobiological changes that extend beyond the gut. It's going to
mean that these cues
around food are no longer as salient as they used
to be, or even the predictions that you make within
your mind about whether this, um, food will give you pleasure,
will start to be diminished. And so that really offers
a lot of hope for people with binge eating disorder
because it's breaking that cycle of like, oh, if I
(08:57):
want to find relief from the stressors of everyday life,
or I find myself entrenched in this pattern where as
soon as I come home, I start eating one thing,
which then leads to me eating everything in the kitchen.
That's essentially pumping the brakes on that because it's saying, oh,
this medication is telling me that, maybe that's not gonna
work for me this time.
Nick Haslam (09:14):
If it's changing pathways, or if it's in some way,
you know, breaking patterns in the way you say.
Does that imply that potentially after a course of treatment
with the drug, the problem might be fixed as it were,
or does it imply that instead you have to continue
to use indefinitely?
Trevor Steward (09:32):
Yeah, and so there's a lot of unknowns around that,
and that's something that we are particularly cautious around for
this study because studies in
individuals with obesity have found that when individuals stop taking
these medications that most often it's accompanied by weight regain,
not necessarily to the same level that they had before,
they began using the drug, but they do go back
(09:54):
to or the weight is gained again.
And also anecdotal evidence has shown that individuals who stopped
taking the drug also report the re-emergence of, you know,
intrusive thoughts around food or compulsions to eat and cravings.
And what I'm really concerned about in this population is
we're talking about people here with this severe psychiatric disorder
and often they will report that starting to take these medications,
(10:18):
opens up a lot of mental space for them. They
feel as if they're, you know, much freer than they
had been before or
ever in their lives around the relationship with food. But
what would happen if they were to suddenly stop taking
this medication? Would these intrusive thoughts come back with a vengeance?
Would they, for example, feel as if they had failed?
And so we have to have a lot of care
when we're dealing with this population and this medication. So
(10:41):
that's why for this study we're using a multidisciplinary team
involving psychiatrists, endocrinologists, and importantly, clinical psychologists that will be
delivering CBT in conjunction with the tirzepatide.
Nick Haslam (10:53):
So, obviously, it's early days and you haven't got all
your findings yet, but is it your sense that you
can't simply give someone a prescription and expect it to
be beneficial overall for binge eating disorder, you'd need to
have adjunct treatments as well?
Trevor Steward (11:07):
I would advocate for that position. I don't think the
evidence is there to say that tirzepatide alone or any
other GLP1 receptor agonist alone is enough to treat, uh,
an eating disorder or binge eating disorder specifically. And it's
also important to remember that psychiatric disorders
rarely exist in isolation. They're often accompanied by comorbid, um,
(11:28):
for example, anxiety disorders or depressive disorders. And so, yes,
this medication may prove to be effective at treating some
of the core symptoms of binge eating disorder or reducing
the frequency of bingeing episodes, but that doesn't mean that
it's gonna necessarily help the patient to deal with, for example,
the underlying trauma that caused them to use binge eating
(11:50):
episodes as a form of coping.
Or for example, if it will then lead to, OK,
less mental space is being dedicated to seeking out food
or that type of reward, but then now they're gonna
be spending more time thinking about, you know, for example,
entrenched negative thought patterns or anxious thought patterns. And so
that's why I think from a duty of care perspective,
(12:11):
we need to accompany it with CBT, which we know
is effective for some individuals with binge eating disorder.
Nick Haslam (12:17):
So by CBT, Trevor, you mean cognitive behaviour therapy.
Trevor Steward (12:20):
That's right.
Cassie Hayward (12:20):
So just on that, you mentioned the food noise issue,
and you see that a lot on social media, just anecdotally,
people talking about these drugs, just dialling down that noise.
And you mentioned that with obesity and binge eating disorder.
Are you saying that there's not clinical evidence that that
that's actually happening, or we just don't know the pathways
by which that food noise dials up and down?
Trevor Steward (12:43):
Yeah, that's a great question. So the, the situation is
that the evidence is lacking. Um, most of these randomised
control trials weren't specifically looking at intrusive thoughts around food.
Their main primary outcome measure was weight loss, changes in BMI,
and some of them maybe they had a questionnaire around
food cravings pre-post, 6 months later after taking it, but
(13:05):
they're not really
getting into the granular details of how food cravings are
being modified, and when it's happening to these participants, or
even their food choices. And so for our city, what
we'll be using is something called ecological momentary assessment or EMA,
which essentially uses prompts on participants' mobile phones to ask
them throughout the day how they're feeling from a mood
(13:28):
and affect point of view.
Some of their core binge eating behaviours and also how
they're feeling around food cravings because I'm really interested in
trying to understand the dynamics, the temporal dynamics of what
happens first is it the food cravings that happen and then
that go down and then the bingeing episodes that disappear
or is it the other way around, or are the
folks that respond best, the ones that lose the cravings
(13:48):
right away and we don't really have that richness in
the data yet at all. But I'm also concerned around
the way that food noise is being used in social
media because
there's a lot of evidence demonstrating that people that with
an eating disorder
Suffer from problems with interoception. When I say interoception, it
means that someone's ability to perceive internal bodily states, and
(14:09):
that could be, for example, feelings of fullness, uh, you know,
feelings of hunger, or even simple things like, you know, um,
being able to count one's heart, heart rate or, you know,
sensitivity to touch. And we don't understand whether or not
these medications are gonna impact those interoceptive pathways as well.
We have evidence
showing that there's a risk of people with obesity taking
(14:31):
these medications, often skipping meals or eating very little because
they don't feel hunger. And these GLP-1 medications are maybe
working too well if weight loss is your primary objective,
which we, I really want to reiterate, isn't the primary
objective in this population. Our our interest is understanding how
it impacts the brain and how it impacts binge eating behaviours,
(14:54):
not necessarily weight.
And when we're talking about a population that's so used
to this, you know, restrictive and then binge eating cycle
that's been probably defining a lot of their adult life,
we have to be extremely cautious around whether or not
this medication is hijacking those interoceptive pathways and not allowing
them to eat in a healthy way.
Cassie Hayward (15:15):
And the food noise, as you say, there's a lot
of anecdotal stuff on, on TikTok, recognising that's not the
most scientific kind of way of gathering data, but I
was looking at some TikToks in preparation for this. And
the way people talk about food noise being turned off
with these medications is just fascinating and
I was listening to one woman from Australia, and she
(15:35):
said she started taking Ozempic, and she said, Is this
how normal people live every day? She said, she had
no idea how much of her brain power was being
taken up with, you know, and it wasn't binge eating,
it was, it was mild obesity, but she was saying,
I was constantly thinking about, well, should I eat this?
And if I eat this, what do I have to
do and what exercise will I do to counteract it?
And she said, once she started taking this, that just
(15:56):
simply went away, which is fascinating from a kind of
brain function point of view.
But as you say, with your binge eating disorder, um, clients, uh, population,
if that then goes away and
The trauma that might be underlying the binge eating disorder
then takes over. How do you balance that kind of,
(16:16):
maybe the food noise goes away, but is it worse
then to have the trauma take up more space?
Trevor Steward (16:22):
Yeah, that's a really good question. And what you described
there from the TikTok evidence, uh, is actually very commonly
reported in, in just based on, you know, my interactions
with endocrinologists and GPs and what their uh patients are
telling them.
And I think when you imagine someone with binge eating disorder,
imagine that dialled up to 11, you know, they're basically
constantly thinking about, OK, well, when I finish this activity,
(16:44):
I'm gonna go home and I want to binge or
this is gonna be my way of managing the situation
and
they want relief from that. I remember just seeing firsthand
when I was working in the disorders unit, how much,
how debilitating these intrusive thoughts were. It wasn't just around
the food itself, it was the actual act of binge
eating and just being able to carry out those motions
of eating to find that relief. And so if we
(17:06):
can open up that mental space for them by giving
them this this medication, our hope is that it will
then allow them to engage in a more effective way
with therapy.
Because often a big part of CBT is, for example,
identifying triggers, restructuring negative thought patterns, but if you've gone
through multiple courses of CBT and you're finding like, oh,
(17:26):
this still isn't helping me stop this compulsive behaviour.
Maybe it's time to find something else that can sort of,
you know, tip the scales a little bit and allow
that intrusiveness to go down and then to be able
to face the other issues going on around it. I
think the same goes as well in terms of other
things like meal planning, or for example, one thing that
I'm particularly concerned about around is
(17:47):
with this population is, most people with binge eating disorder
do have obesity. They're going to be somewhere between 70
and 80%. And so I'm concerned that these individuals, most
likely based on the evidence we have, will begin to
lose weight over the course of the study because it's
going on for 24 weeks. And they're going to start
to receive messages from society, from their peers, from colleagues
(18:09):
around their body shape. And this is going to start
to internalise, you know,
fat biases, you know, internalise the stigma that they may
have around their body, and how will they deal with
that when on the one hand they're feeling fantastic because
they have all this mental space that's been opened up
with the food noise, you know, going away and being
able to have a better and healthier relationship with food.
(18:29):
But then also being reminded of, oh, people did used
to perceive me in this way and now they're making
these comments around my body. And so that's why going
back to your previous question, I think it's so important
to accompany this with CBT or with some sort of
psychological counselling because they're going to be facing a whole
slew of new problems as they begin taking this medication.
Cassie Hayward (18:49):
And, as we talked about, may have to keep taking it.
Trevor Steward (18:53):
Yes, exactly, and that's something that we're, it's probably the
thorniest ethical issue that we're dealing with in the study
is we're gonna, you know, be in direct contact with
all of our participants, GPs and explain to them, OK,
they're participating in the study, receiving tirzepatide over the course
of 6 months, and then as the study begins to
wind down.
(19:13):
Being in contact with their GPs and saying, OK, do
you want to continue to take this? And if so,
this is the dosing that they've been using. Um, is
there a possibility of a maintenance dose? Where, what would
be the best option for their patient? Um, and then
that also opens up a whole can of worms around
the economics of this
Cassie Hayward (19:31):
Because it's not cheap, right?
Trevor Steward (19:33):
Exactly, um, and it hasn't Been, you know, um, I'm sorry,
what you call it in Australia?
It hasn't been exactly, it hasn't been approved yet by
the PBS for obesity, um, let alone for binge eating disorder,
and so there's a lot of, you know, issues around
access that we need to be cognizant of.
Nick Haslam (19:50):
What do you hope will come of your own research? What, what, uh,
will be the fruits of, uh, your labours?
Trevor Steward (19:57):
Yeah, I think one of the first things that I
want to study, um, or understand from my study is
what's occurring on a neurobiological level with these medications. Um,
why is it having these effects on, you know, intrusive
thoughts around food, food craving, or even taste perception, that's
something that we didn't have a chance to get into
very much now, but there are, there's a lot of
anecdotal evidence of individuals taking these medications
(20:20):
who suddenly find that they're not drawn to complex carbs
or highly processed foods and they're going straight to the
vegetable aisle and they don't when they've never done that
in their entire lives and we don't really understand why
that's happening.
Cassie Hayward (20:32):
And not drinking.
Trevor Steward (20:33):
And not drinking. That's another example of, not drinking, not smoking,
other compulsive behaviours. And so I'd be really interested in understanding, OK,
why is it that this
medication that mimics a hormone in the gut is causing
all these other effects on the brain, and specifically what
circuits and pathways are being impacted by that. And so
that's something more in the short term. And then after that,
(20:55):
I would like to get a more nuanced picture of
what I was describing before and being able to really
track on a very detailed level, the course of treatment
and understanding, OK, at what time point do the intrusive
thoughts stop, at what dose were these individuals taking these medications?
That will then give us some
indications around, OK, whether these treatments are fit for purpose,
(21:15):
for example, for people that don't have obesity, but that
have binge eating disorder. We really can't gauge that now
because in our study, we'll only be recruiting participants with
both obesity and binge eating disorder. But I hope that
that level of detail will allow us to do that.
And then the third and the biggest goals are eventually
to be able to run a large scale randomised control
(21:36):
trial where you know, you have half the participants receiving
the treatment, the other half not receiving the the treatment
and being able to really gauge whether or not this
is effective for binge eating disorder. Now that's a really, uh,
you know, big ask and so now I can pass
a hat around and take donations and try to get
some money for that.
Cassie Hayward (21:54):
Trevor, it's such fascinating research in terms of the clinical
uses of these drugs. One thing we're certainly seeing is
that people who wouldn't at all qualify as obese are
using these drugs just to get kind of super skinny.
We're seeing that kind of return to super skinny people
on red carpets. I know this isn't your area of research,
(22:15):
but do you think these medications
have some unintended consequences of just bringing us back to a,
you know, we talked about the importance of society, expectations
and fat stigma and those sorts of issues. I think when,
when we see celebrities going back to, you know, late 90s,
early 00s levels of skinniness, is there a danger that
that just feeds that cycle of skinny being the, the,
(22:39):
the way to go?
Trevor Steward (22:40):
Absolutely. And that's something that I'm quite concerned of, especially
with this population that I
I spend a lot of time interacting with and setting
because they are receiving these really harmful messages on a
constant basis, especially with social media, and it's quite disheartening
when you, you know, look up Ozempic on TikTok or
Instagram or any of these things. The images you see
(23:02):
are all based around body image and, uh, really putting
that thin ideal on a pedestal and it's difficult to
then
have conversations around these medications that focus on the well-being
of patients, their health, their mental health, because we know
that they're going to probably start receiving comments from their,
(23:22):
you know, friends and family around these medications specifically about
their body image. And so I think it's something that
we need to try to shift the dialogue to more
of the potential benefits of this in terms of health.
But then also be aware that these can, you know,
throw more fuel on the fire in terms of fat
biases and stigma that these patients are living with.
Nick Haslam (23:46):
So Trevor, for someone who's listening and thinking about taking
a Ozempic or a similar medication, either for eating disorder
or just for weight loss, what would you recommend they
consider first?
Trevor Steward (23:56):
Yeah, so I think the first thing is you need
to speak about this with your doctor. Um, I would
really discourage people from trying to obtain these medications through
online pharmacies and compounding pharmacies, which, you know, is, uh,
readily available option nowadays, unfortunately, it's quite
dangerous sometimes because you don't necessarily know what you're going
(24:17):
to get, if it's gonna really be GLP-1 receptor agonists
that you think you're ordering. And then when you're having
that conversation with your GP or medical professional, um, be
very transparent about any sort of eating disorder symptoms that
you might be experiencing. Even if you say, oh, I
don't have any eating disorder, you might have other preoccupations
(24:37):
around your body image, or maybe you have a history
of engaging in something like purging behaviours and
Your doctor might not necessarily ask that question unless you
prompt it. And so I would really recommend going to
that appointment prepared, knowing that they might be willing to
give you the medication without necessarily asking all the questions
of you that are necessary to make sure it's the
(24:57):
safest decision. And also being aware of the fact that
that if you do start taking this, it's a possibility
that you might need to start taking it for a
long time. What impacts would that have for you in
terms of economic impacts or family planning, things like that.
Nick Haslam (25:12):
Uh, it's just such fascinating work, Trevor. What's one final
takeaway or piece of advice you'd like to leave our
listeners with?
Trevor Steward (25:19):
Yeah, well, I, if I could leave, um, our listeners
with one thing, I'd just say, uh, be mindful with
the words that you use around body image and weight.
You never really truly know what someone else is dealing
with and even, um, you know, casual remarks can cause harm.
And y'know, if you are someone that's living with an
eating disorder, I, um,
(25:39):
I can understand that it's so frustrating having to go
through different courses of treatment, having to navigate the healthcare system,
and just feeling as if nothing's working. And so I
really really want to encourage someone if they are living
with eating disorder or they're caring for someone with an
eating disorder, not to lose hope around that. Um, for example,
Eating Disorders Victoria has some wonderful peer support groups that
(26:00):
you can look up online if you are living with
these types of eating disorders and not sure what to do.
And then on another point, I think it's really worth reiterating,
and this is something that I try to emphasise to
patients that I'm speaking to is that, be critical of
what you are engaging with on social media. It's hard
because it's almost like a knee jerk reaction. I find
myself doing this where the second you take out your phone,
(26:21):
you're consuming content and you don't necessarily know why just
sort of passively getting into your psyche.
But I just really wanted to emphasise, you don't need
a stranger on the internet telling you how to live
your life in terms of body image ideals or what
medications to take. So I think that's something that I
really want to encourage people like, OK, well, question what
advice you're getting is really thinking whether or not they
(26:44):
have your best interests in mind.
And then last point, which I realised this isn't one,
this is like more like 4 or 5 is um.
It's important to remember that these medications and the use
of these medications and mental health care, it's a political issue,
let's not beat around the bush. Right now, there's very
strong evidence linking obesity and binge eating to socioeconomic status
(27:05):
and you know, for example, food deprivation or living in food,
food deserts. And what's really troubling is that this these
medications are so expensive that down the line we might
be in a situation where only people from privileged backgrounds
are going to be really able to access them. And
so we need to
make sure that we're engaging politically within the space to,
you know, are we endorsing calls to actually believe in,
(27:27):
you know, a humane health system that, you know, allows
people to access these.
Cassie Hayward (27:31):
Oh, it's fascinating. Thank you for joining us, Trevor. I
think it's just, there's so many things in there that
we could have spent another hour talking about, but, um, yeah,
fascinating research and good luck with your future research.
Trevor Steward (27:41):
Right, thanks, Cassie. Thanks, Nick.
Cassie Hayward (27:45):
You've been listening to Psych Talks with me, Cassie Hayward,
and Nick Haslam. A big thank you to our guest today,
Dr Trevor Steward.
Nick Haslam (27:54):
This episode was produced by Carly Godden with production assistance
from Mairead Murray and Gemma Papprill. Our sound engineer was
Jack Palmer. Thanks
Cassie Hayward (28:01):
for tuning into PsychTalks, and we'll see you again in
two weeks. Bye for now.
This podcast was made on the lands of the Wurundjeri people,
the Woi Wurrung and the Bunurong. We'd like to pay
respects to their elders, past and present, and emerging.
Nick Haslam (00:14):
From the Melbourne School of Psychological Sciences at the University
of Melbourne, this is PsychTalks.
Welcome back to a new season of PsychTalks. I'm Nick
Haslam and I'm joined as always by my co-host, Cassie Hayward.
Cassie Hayward (00:28):
Hi Nick, great to be back in 2025.
And for anyone new, we're here to explore the latest
research in psychology and neuroscience with our brilliant experts at
the University of Melbourne School of Psychological Sciences. We break
down the science behind how our mind works and what
these insights might mean for you at home.
Nick Haslam (00:47):
That's right. And this season of psych talks is set
to be a cracker. We'll be getting our teeth into
some really fascinating research, like how
self-compassion could ease the pathway through menopause. And why misinformation
has spread so rapidly online, just to name a few.
Cassie Hayward (01:01):
I can't wait. Now, today we're talking about Ozempic and
other GLP-1 receptor agonists, drugs that have become hugely popular
for weight loss. But there's a lot more to the
story than just numbers on a scale, especially when it
comes to their interactions with disorders like binge eating. Our
colleague and guest, Dr Trevor Steward, is investigating what these
medications do to the brain, not just our bodies.
Nick Haslam (01:28):
Welcome to PsychTalks, Trevor.
Trevor Steward (01:30):
Thanks for having me.
Cassie Hayward (01:31):
It's a fascinating area, Trevor, but could you start by
telling us a little bit about your background and your
research interests and how you've ended up studying Ozempic?
Trevor Steward (01:39):
Yeah, sure, Cassie. So, my background is in psychology. I
did my undergraduate degree in the United States and then
now
Afterwards moved to Spain to specialise in neuroscience and during
my PhD I was embedded in an eating disorders unit
in a public hospital and it was there that I
really saw firsthand the burden of eating disorders and how
much they can impact people's both physical and psychological well-being
(02:02):
as well as their caregivers.
And what really struck me was that there weren't any brain-
based interventions available for these disorders. You know, anorexia nervosa
is a perfect example. I recently went to a conference
and there was a professor there who got into psychiatry
and eating disorders, and he said in 1970, there wasn't
a single approved medication for anorexia nervosa.
(02:25):
And there still isn't a single approved medication for anorexia nervosa.
So that just really makes it evident that we need
to understand these disorders more in depth. Then I moved
to the University of Melbourne in 2019 and that's where
I sort of expanded my research program. But then just
in the past two years, much like everyone in in society,
we've really been awed by the emergence of these new
medications called GLP-1 receptor agonists.
(02:48):
Uh, for example, Ozempic, and these medications are absolute game
changer in the in the realm of treating obesity. And
then with more people using these, we started to get
more anecdotal evidence around other psychological effects that they're having
that are related to eating behaviours and eating disorders. And
so that's where I want to step in and try
to understand what's going on on a neurobiological level.
Nick Haslam (03:11):
So you talked about Ozempic - can you give us a
quick definition of what kind of drug it is, what
other drugs are in that class, and what they've mostly
been used for before they became revolutionary in this area
of weight?
Trevor Steward (03:23):
Yeah, for sure. So when we talk about drugs like Ozempic,
we're actually talking about a broader class of medication known
as GLP-1
receptor agonists. Now, GLP-1 stands for glucagon-like peptide-1. Don't worry,
you don't have to remember that. Which is a naturally
occurring hormone in the body involved in the regulation of
blood sugars. Now, after we eat, GLP-1 helps us to
(03:45):
stimulate the secretion of insulin, which lowers our blood glucose,
while then also, um, you know, helping to regulate our appetite.
Now, what we can do with these medications is basically
mimic the effects of this naturally occurring hormone, which will
then slow, for example, our gastric emptying, our digestion, that
makes us feel fuller for longer. And it also um
(04:06):
does other things in terms of metabolic health and uh
regulating insulin levels. Now, Ozempic is the most famous of
these types of medications, but its generic name is actually semaglutide.
Um, there's some several other ones out on the market
now that you might have heard of, for example, Mounjaro
or Zepbound, and all of these compounds are quite similar
in the sense that they mimic this GLP-1 hormone. Now, historically,
(04:31):
these medications were used to treat type 2 diabetes and
what they found was that these individuals who are using
these GLP-1 medications to regulate their diabetes were also losing weight.
And then someone came up with a genius idea of saying, oh,
what would happen if we really upped the dose of
these medications in people with obesity? Would they also lose weight?
(04:53):
And that's when we started to see the emergence of
these compounds. And there have been some very large clinical
trials for people with obesity that have found that it
can help people to lose weight, um, at levels that
you can't really ever see with other types of interventions. Um,
apart from that, it's also there's now emerging clinical trials
that have found that it's effective for conditions like sleep
apnoea or for fatty liver disease, and so we're only
(05:17):
um at the tip of the iceberg in terms of
what is indicated uses could be.
Cassie Hayward (05:22):
As you say, there's been this huge buzz about what
these drugs can do from a weight loss perspective.
But that's not entirely your focus, is it? You're looking
at what they might also be doing to the brain.
Can you tell us a little bit about what you're
doing there?
Trevor Steward (05:36):
Yeah, exactly. And so, um, our, uh, study is going
to be examining the effects of tirzepatide, which is also
known as Mounjaro or Zepbound, in adults with binge eating disorder.
Binge eating disorder is a very serious eating disorder. It's
the most prevalent eating disorder. Um, there's more people living
with eating disorder than bulimia nervosa or anorexia nervosa combined.
(05:57):
And binge eating disorder is characterised by the presence of
binge eating episodes, which are characterised by people eating large
amounts of food for a short amount of time, often
accompanied by feelings of loss of control, guilt, shame, and
they really get locked into this really
Um, difficult, entrenched cycle that impacts your quality of life
and impacts their health and makes it very difficult for
(06:19):
them to maintain a positive wellbeing. Whereas bulimia nervosa does
have bingeing episodes, but it's also characterised by the presence
of compensatory behaviours. So that could be, for example, someone
self-inducing vomiting or, you know, exercising to excess to try
to compensate for the previous binge eating episode.
And what we're interested in this study is to try
(06:40):
to understand how tirzepatide
impacts the brain processes linked to some of these core
eating disorder symptoms such as compulsions to eat, impulsivity around food,
or what you as often um heard of in social media,
food noise, which is these intrusive thoughts around food where people,
for example, can't get this idea out of their head
of how they're planning to binge eat.
(07:02):
Or a certain type of food that they would like
to eat. Now, there's a lot of anecdotal evidence around
drugs like Ozempic or tirzepatide, being able to lower the
volume of these intrusive thoughts around food. However, on a
neurobiological level, we just don't understand how this is occurring
and why this is happening. There are GLP-1 receptor, um,
GLP-1 receptors located throughout the brain.
(07:25):
But it's not really clear why uh a drug that's
targeting the gut would have such a huge impact on
these brain processes. And so we're really interested in trying
to interrogate that further.
Nick Haslam (07:36):
It is a bit surprising, as you said, I mean,
if the drug is primarily slowing the gastric processing or whatever, Uh, emptying,
is that what you, what you said? Uh, how does that,
how does that, um, have any effect whatsoever on attention
you pay to certain thoughts or any of the other
processes involved in binge eating disorder?
Trevor Steward (07:53):
No, that's a great question, Nick. And so we're stipulating
this is mainly based off of animal research because we
really don't have that much evidence in humans yet around
us that by um lowering or slowing down the gastric
emptying process, you are impacting food reward pathways. And so
For example, dopamine is probably the most well known neurotransmitter
(08:14):
out there. It's very much linked to motivation to find rewards.
And so if you are able to slow down the
emptying of someone's stomach and say, OK, now you don't
need to find that reward. That reward isn't as salient
for you anymore. Or if, if you even did find
that reward, you wouldn't get as much pleasure from it
as you would have previously. That's going to lead to
(08:34):
neurobiological changes that extend beyond the gut. It's going to
mean that these cues
around food are no longer as salient as they used
to be, or even the predictions that you make within
your mind about whether this, um, food will give you pleasure,
will start to be diminished. And so that really offers
a lot of hope for people with binge eating disorder
because it's breaking that cycle of like, oh, if I
(08:57):
want to find relief from the stressors of everyday life,
or I find myself entrenched in this pattern where as
soon as I come home, I start eating one thing,
which then leads to me eating everything in the kitchen.
That's essentially pumping the brakes on that because it's saying, oh,
this medication is telling me that, maybe that's not gonna
work for me this time.
Nick Haslam (09:14):
If it's changing pathways, or if it's in some way,
you know, breaking patterns in the way you say.
Does that imply that potentially after a course of treatment
with the drug, the problem might be fixed as it were,
or does it imply that instead you have to continue
to use indefinitely?
Trevor Steward (09:32):
Yeah, and so there's a lot of unknowns around that,
and that's something that we are particularly cautious around for
this study because studies in
individuals with obesity have found that when individuals stop taking
these medications that most often it's accompanied by weight regain,
not necessarily to the same level that they had before,
they began using the drug, but they do go back
(09:54):
to or the weight is gained again.
And also anecdotal evidence has shown that individuals who stopped
taking the drug also report the re-emergence of, you know,
intrusive thoughts around food or compulsions to eat and cravings.
And what I'm really concerned about in this population is
we're talking about people here with this severe psychiatric disorder
and often they will report that starting to take these medications,
(10:18):
opens up a lot of mental space for them. They
feel as if they're, you know, much freer than they
had been before or
ever in their lives around the relationship with food. But
what would happen if they were to suddenly stop taking
this medication? Would these intrusive thoughts come back with a vengeance?
Would they, for example, feel as if they had failed?
And so we have to have a lot of care
when we're dealing with this population and this medication. So
(10:41):
that's why for this study we're using a multidisciplinary team
involving psychiatrists, endocrinologists, and importantly, clinical psychologists that will be
delivering CBT in conjunction with the tirzepatide.
Nick Haslam (10:53):
So, obviously, it's early days and you haven't got all
your findings yet, but is it your sense that you
can't simply give someone a prescription and expect it to
be beneficial overall for binge eating disorder, you'd need to
have adjunct treatments as well?
Trevor Steward (11:07):
I would advocate for that position. I don't think the
evidence is there to say that tirzepatide alone or any
other GLP1 receptor agonist alone is enough to treat, uh,
an eating disorder or binge eating disorder specifically. And it's
also important to remember that psychiatric disorders
rarely exist in isolation. They're often accompanied by comorbid, um,
(11:28):
for example, anxiety disorders or depressive disorders. And so, yes,
this medication may prove to be effective at treating some
of the core symptoms of binge eating disorder or reducing
the frequency of bingeing episodes, but that doesn't mean that
it's gonna necessarily help the patient to deal with, for example,
the underlying trauma that caused them to use binge eating
(11:50):
episodes as a form of coping.
Or for example, if it will then lead to, OK,
less mental space is being dedicated to seeking out food
or that type of reward, but then now they're gonna
be spending more time thinking about, you know, for example,
entrenched negative thought patterns or anxious thought patterns. And so
that's why I think from a duty of care perspective,
(12:11):
we need to accompany it with CBT, which we know
is effective for some individuals with binge eating disorder.
Nick Haslam (12:17):
So by CBT, Trevor, you mean cognitive behaviour therapy.
Trevor Steward (12:20):
That's right.
Cassie Hayward (12:20):
So just on that, you mentioned the food noise issue,
and you see that a lot on social media, just anecdotally,
people talking about these drugs, just dialling down that noise.
And you mentioned that with obesity and binge eating disorder.
Are you saying that there's not clinical evidence that that
that's actually happening, or we just don't know the pathways
by which that food noise dials up and down?
Trevor Steward (12:43):
Yeah, that's a great question. So the, the situation is
that the evidence is lacking. Um, most of these randomised
control trials weren't specifically looking at intrusive thoughts around food.
Their main primary outcome measure was weight loss, changes in BMI,
and some of them maybe they had a questionnaire around
food cravings pre-post, 6 months later after taking it, but
(13:05):
they're not really
getting into the granular details of how food cravings are
being modified, and when it's happening to these participants, or
even their food choices. And so for our city, what
we'll be using is something called ecological momentary assessment or EMA,
which essentially uses prompts on participants' mobile phones to ask
them throughout the day how they're feeling from a mood
(13:28):
and affect point of view.
Some of their core binge eating behaviours and also how
they're feeling around food cravings because I'm really interested in
trying to understand the dynamics, the temporal dynamics of what
happens first is it the food cravings that happen and then
that go down and then the bingeing episodes that disappear
or is it the other way around, or are the
folks that respond best, the ones that lose the cravings
(13:48):
right away and we don't really have that richness in
the data yet at all. But I'm also concerned around
the way that food noise is being used in social
media because
there's a lot of evidence demonstrating that people that with
an eating disorder
Suffer from problems with interoception. When I say interoception, it
means that someone's ability to perceive internal bodily states, and
(14:09):
that could be, for example, feelings of fullness, uh, you know,
feelings of hunger, or even simple things like, you know, um,
being able to count one's heart, heart rate or, you know,
sensitivity to touch. And we don't understand whether or not
these medications are gonna impact those interoceptive pathways as well.
We have evidence
showing that there's a risk of people with obesity taking
(14:31):
these medications, often skipping meals or eating very little because
they don't feel hunger. And these GLP-1 medications are maybe
working too well if weight loss is your primary objective,
which we, I really want to reiterate, isn't the primary
objective in this population. Our our interest is understanding how
it impacts the brain and how it impacts binge eating behaviours,
(14:54):
not necessarily weight.
And when we're talking about a population that's so used
to this, you know, restrictive and then binge eating cycle
that's been probably defining a lot of their adult life,
we have to be extremely cautious around whether or not
this medication is hijacking those interoceptive pathways and not allowing
them to eat in a healthy way.
Cassie Hayward (15:15):
And the food noise, as you say, there's a lot
of anecdotal stuff on, on TikTok, recognising that's not the
most scientific kind of way of gathering data, but I
was looking at some TikToks in preparation for this. And
the way people talk about food noise being turned off
with these medications is just fascinating and
I was listening to one woman from Australia, and she
(15:35):
said she started taking Ozempic, and she said, Is this
how normal people live every day? She said, she had
no idea how much of her brain power was being
taken up with, you know, and it wasn't binge eating,
it was, it was mild obesity, but she was saying,
I was constantly thinking about, well, should I eat this?
And if I eat this, what do I have to
do and what exercise will I do to counteract it?
And she said, once she started taking this, that just
(15:56):
simply went away, which is fascinating from a kind of
brain function point of view.
But as you say, with your binge eating disorder, um, clients, uh, population,
if that then goes away and
The trauma that might be underlying the binge eating disorder
then takes over. How do you balance that kind of,
(16:16):
maybe the food noise goes away, but is it worse
then to have the trauma take up more space?
Trevor Steward (16:22):
Yeah, that's a really good question. And what you described
there from the TikTok evidence, uh, is actually very commonly
reported in, in just based on, you know, my interactions
with endocrinologists and GPs and what their uh patients are
telling them.
And I think when you imagine someone with binge eating disorder,
imagine that dialled up to 11, you know, they're basically
constantly thinking about, OK, well, when I finish this activity,
(16:44):
I'm gonna go home and I want to binge or
this is gonna be my way of managing the situation
and
they want relief from that. I remember just seeing firsthand
when I was working in the disorders unit, how much,
how debilitating these intrusive thoughts were. It wasn't just around
the food itself, it was the actual act of binge
eating and just being able to carry out those motions
of eating to find that relief. And so if we
(17:06):
can open up that mental space for them by giving
them this this medication, our hope is that it will
then allow them to engage in a more effective way
with therapy.
Because often a big part of CBT is, for example,
identifying triggers, restructuring negative thought patterns, but if you've gone
through multiple courses of CBT and you're finding like, oh,
(17:26):
this still isn't helping me stop this compulsive behaviour.
Maybe it's time to find something else that can sort of,
you know, tip the scales a little bit and allow
that intrusiveness to go down and then to be able
to face the other issues going on around it. I
think the same goes as well in terms of other
things like meal planning, or for example, one thing that
I'm particularly concerned about around is
(17:47):
with this population is, most people with binge eating disorder
do have obesity. They're going to be somewhere between 70
and 80%. And so I'm concerned that these individuals, most
likely based on the evidence we have, will begin to
lose weight over the course of the study because it's
going on for 24 weeks. And they're going to start
to receive messages from society, from their peers, from colleagues
(18:09):
around their body shape. And this is going to start
to internalise, you know,
fat biases, you know, internalise the stigma that they may
have around their body, and how will they deal with
that when on the one hand they're feeling fantastic because
they have all this mental space that's been opened up
with the food noise, you know, going away and being
able to have a better and healthier relationship with food.
(18:29):
But then also being reminded of, oh, people did used
to perceive me in this way and now they're making
these comments around my body. And so that's why going
back to your previous question, I think it's so important
to accompany this with CBT or with some sort of
psychological counselling because they're going to be facing a whole
slew of new problems as they begin taking this medication.
Cassie Hayward (18:49):
And, as we talked about, may have to keep taking it.
Trevor Steward (18:53):
Yes, exactly, and that's something that we're, it's probably the
thorniest ethical issue that we're dealing with in the study
is we're gonna, you know, be in direct contact with
all of our participants, GPs and explain to them, OK,
they're participating in the study, receiving tirzepatide over the course
of 6 months, and then as the study begins to
wind down.
(19:13):
Being in contact with their GPs and saying, OK, do
you want to continue to take this? And if so,
this is the dosing that they've been using. Um, is
there a possibility of a maintenance dose? Where, what would
be the best option for their patient? Um, and then
that also opens up a whole can of worms around
the economics of this
Cassie Hayward (19:31):
Because it's not cheap, right?
Trevor Steward (19:33):
Exactly, um, and it hasn't Been, you know, um, I'm sorry,
what you call it in Australia?
It hasn't been exactly, it hasn't been approved yet by
the PBS for obesity, um, let alone for binge eating disorder,
and so there's a lot of, you know, issues around
access that we need to be cognizant of.
Nick Haslam (19:50):
What do you hope will come of your own research? What, what, uh,
will be the fruits of, uh, your labours?
Trevor Steward (19:57):
Yeah, I think one of the first things that I
want to study, um, or understand from my study is
what's occurring on a neurobiological level with these medications. Um,
why is it having these effects on, you know, intrusive
thoughts around food, food craving, or even taste perception, that's
something that we didn't have a chance to get into
very much now, but there are, there's a lot of
anecdotal evidence of individuals taking these medications
(20:20):
who suddenly find that they're not drawn to complex carbs
or highly processed foods and they're going straight to the
vegetable aisle and they don't when they've never done that
in their entire lives and we don't really understand why
that's happening.
Cassie Hayward (20:32):
And not drinking.
Trevor Steward (20:33):
And not drinking. That's another example of, not drinking, not smoking,
other compulsive behaviours. And so I'd be really interested in understanding, OK,
why is it that this
medication that mimics a hormone in the gut is causing
all these other effects on the brain, and specifically what
circuits and pathways are being impacted by that. And so
that's something more in the short term. And then after that,
(20:55):
I would like to get a more nuanced picture of
what I was describing before and being able to really
track on a very detailed level, the course of treatment
and understanding, OK, at what time point do the intrusive
thoughts stop, at what dose were these individuals taking these medications?
That will then give us some
indications around, OK, whether these treatments are fit for purpose,
(21:15):
for example, for people that don't have obesity, but that
have binge eating disorder. We really can't gauge that now
because in our study, we'll only be recruiting participants with
both obesity and binge eating disorder. But I hope that
that level of detail will allow us to do that.
And then the third and the biggest goals are eventually
to be able to run a large scale randomised control
(21:36):
trial where you know, you have half the participants receiving
the treatment, the other half not receiving the the treatment
and being able to really gauge whether or not this
is effective for binge eating disorder. Now that's a really, uh,
you know, big ask and so now I can pass
a hat around and take donations and try to get
some money for that.
Cassie Hayward (21:54):
Trevor, it's such fascinating research in terms of the clinical
uses of these drugs. One thing we're certainly seeing is
that people who wouldn't at all qualify as obese are
using these drugs just to get kind of super skinny.
We're seeing that kind of return to super skinny people
on red carpets. I know this isn't your area of research,
(22:15):
but do you think these medications
have some unintended consequences of just bringing us back to a,
you know, we talked about the importance of society, expectations
and fat stigma and those sorts of issues. I think when,
when we see celebrities going back to, you know, late 90s,
early 00s levels of skinniness, is there a danger that
that just feeds that cycle of skinny being the, the,
(22:39):
the way to go?
Trevor Steward (22:40):
Absolutely. And that's something that I'm quite concerned of, especially
with this population that I
I spend a lot of time interacting with and setting
because they are receiving these really harmful messages on a
constant basis, especially with social media, and it's quite disheartening
when you, you know, look up Ozempic on TikTok or
Instagram or any of these things. The images you see
(23:02):
are all based around body image and, uh, really putting
that thin ideal on a pedestal and it's difficult to
then
have conversations around these medications that focus on the well-being
of patients, their health, their mental health, because we know
that they're going to probably start receiving comments from their,
(23:22):
you know, friends and family around these medications specifically about
their body image. And so I think it's something that
we need to try to shift the dialogue to more
of the potential benefits of this in terms of health.
But then also be aware that these can, you know,
throw more fuel on the fire in terms of fat
biases and stigma that these patients are living with.
Nick Haslam (23:46):
So Trevor, for someone who's listening and thinking about taking
a Ozempic or a similar medication, either for eating disorder
or just for weight loss, what would you recommend they
consider first?
Trevor Steward (23:56):
Yeah, so I think the first thing is you need
to speak about this with your doctor. Um, I would
really discourage people from trying to obtain these medications through
online pharmacies and compounding pharmacies, which, you know, is, uh,
readily available option nowadays, unfortunately, it's quite
dangerous sometimes because you don't necessarily know what you're going
(24:17):
to get, if it's gonna really be GLP-1 receptor agonists
that you think you're ordering. And then when you're having
that conversation with your GP or medical professional, um, be
very transparent about any sort of eating disorder symptoms that
you might be experiencing. Even if you say, oh, I
don't have any eating disorder, you might have other preoccupations
(24:37):
around your body image, or maybe you have a history
of engaging in something like purging behaviours and
Your doctor might not necessarily ask that question unless you
prompt it. And so I would really recommend going to
that appointment prepared, knowing that they might be willing to
give you the medication without necessarily asking all the questions
of you that are necessary to make sure it's the
(24:57):
safest decision. And also being aware of the fact that
that if you do start taking this, it's a possibility
that you might need to start taking it for a
long time. What impacts would that have for you in
terms of economic impacts or family planning, things like that.
Nick Haslam (25:12):
Uh, it's just such fascinating work, Trevor. What's one final
takeaway or piece of advice you'd like to leave our
listeners with?
Trevor Steward (25:19):
Yeah, well, I, if I could leave, um, our listeners
with one thing, I'd just say, uh, be mindful with
the words that you use around body image and weight.
You never really truly know what someone else is dealing
with and even, um, you know, casual remarks can cause harm.
And y'know, if you are someone that's living with an
eating disorder, I, um,
(25:39):
I can understand that it's so frustrating having to go
through different courses of treatment, having to navigate the healthcare system,
and just feeling as if nothing's working. And so I
really really want to encourage someone if they are living
with eating disorder or they're caring for someone with an
eating disorder, not to lose hope around that. Um, for example,
Eating Disorders Victoria has some wonderful peer support groups that
(26:00):
you can look up online if you are living with
these types of eating disorders and not sure what to do.
And then on another point, I think it's really worth reiterating,
and this is something that I try to emphasise to
patients that I'm speaking to is that, be critical of
what you are engaging with on social media. It's hard
because it's almost like a knee jerk reaction. I find
myself doing this where the second you take out your phone,
(26:21):
you're consuming content and you don't necessarily know why just
sort of passively getting into your psyche.
But I just really wanted to emphasise, you don't need
a stranger on the internet telling you how to live
your life in terms of body image ideals or what
medications to take. So I think that's something that I
really want to encourage people like, OK, well, question what
advice you're getting is really thinking whether or not they
(26:44):
have your best interests in mind.
And then last point, which I realised this isn't one,
this is like more like 4 or 5 is um.
It's important to remember that these medications and the use
of these medications and mental health care, it's a political issue,
let's not beat around the bush. Right now, there's very
strong evidence linking obesity and binge eating to socioeconomic status
(27:05):
and you know, for example, food deprivation or living in food,
food deserts. And what's really troubling is that this these
medications are so expensive that down the line we might
be in a situation where only people from privileged backgrounds
are going to be really able to access them. And
so we need to
make sure that we're engaging politically within the space to,
you know, are we endorsing calls to actually believe in,
(27:27):
you know, a humane health system that, you know, allows
people to access these.
Cassie Hayward (27:31):
Oh, it's fascinating. Thank you for joining us, Trevor. I
think it's just, there's so many things in there that
we could have spent another hour talking about, but, um, yeah,
fascinating research and good luck with your future research.
Trevor Steward (27:41):
Right, thanks, Cassie. Thanks, Nick.
Cassie Hayward (27:45):
You've been listening to Psych Talks with me, Cassie Hayward,
and Nick Haslam. A big thank you to our guest today,
Dr Trevor Steward.
Nick Haslam (27:54):
This episode was produced by Carly Godden with production assistance
from Mairead Murray and Gemma Papprill. Our sound engineer was
Jack Palmer. Thanks
Cassie Hayward (28:01):
for tuning into PsychTalks, and we'll see you again in
two weeks. Bye for now.
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