HealthRX.com · Printable question sheet
Off-label Wegovy for binge eating: decision sheet and weekly episode log
Take this to the prescriber and therapist before an off-label trial: your history, what the two studies on this page actually tested, the questions to settle first, and a weekly log that counts binge episodes separately from weight.
Your history
Binge eating disorder diagnosis: when, and by whom
Therapy now (CBT, DBT or other) and how often
Medicines tried for binge eating, and what happenedlisdexamfetamine, topiramate, others
Current weight and BMI
Any history of restricting, purging or another eating disorder
Current mood score, if one has been takenfor example a PHQ-9
What the two studies and the label say
- The randomized trial on this page tested liraglutide 3.0 mg, not semaglutide: in 27 adults over 17 weeks, remission rates were 44% on liraglutide and 36% on placebo, not a significant difference.[1]
- Weight was the clear difference in that trial: 5.2% lost on liraglutide versus 0.9% on placebo.[1]
- The semaglutide data come from an open-label chart review of 48 patients: scale scores fell 14 points on semaglutide alone and 5.9 on topiramate or lisdexamfetamine without semaglutide; the medicines were not randomized.[2]
- Wegovy's weight-loss use is for people with obesity, and for some adults with overweight who also have a weight-related medical problem.[3]
To settle before starting
- What would count as success for binge eating, apart from weight?
- How will we count episodes, and at which visit do we decide whether it is working?
- Should therapy continue alongside the medicine, and who coordinates the two?
- If my weight does not fit the label's use, is this still a reasonable option for me?
- What is the plan if binge eating returns after stopping?
- Will my plan pay for it for this use, and what will it cost if not?
- Which changes in eating, such as skipping meals, should I report straight away?
Weekly episode log
Count episodes, not just weight. Bring the log to every visit.
| Week starting | Wegovy dose | Binge episodes | Loss-of-control eating without a binge | Skipped meals or restricting | Nausea or vomiting | Mood (0 to 10) | Therapy session |
|---|---|---|---|---|---|---|---|
Call rather than wait for the next visit
- Severe stomach pain that will not go away, with or without nausea or vomiting: stop Wegovy and call your healthcare provider right away.[3]
- Pain in the upper stomach, yellow skin or eyes, fever, or clay-colored stools: call your healthcare provider (possible gallbladder problem).[3]
- Nausea, vomiting or diarrhea that does not go away: tell your healthcare provider right away.[3]
Sources for the facts on this sheet
- Allison KC, Chao AM, Bruzas MB, et al. A pilot randomized controlled trial of liraglutide 3.0 mg for binge eating disorder. Obes Sci Pract 2023. PMID 37034559. https://pubmed.ncbi.nlm.nih.gov/37034559/
- Richards J, Bang N, Ratliff EL, et al. Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study. Obes Pillars 2023. PMID 37990682. https://pubmed.ncbi.nlm.nih.gov/37990682/
- Novo Nordisk, via DailyMed. Wegovy (semaglutide) injection, for subcutaneous use, and Wegovy (semaglutide) tablets, for oral use: prescribing information and Medication Guide. Effective 2026-06-18. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.