Tennis legend Billie Jean King says she’s using weight loss medication to help treat her binge eating disorder. Experts explain how it works.

Billie Jean King
Tennis legend Billie Jean King. (Getty Images)

Billie Jean King is trying weight loss medication to address her binge eating disorder (BED), revealing on the April 24 episode of actress Julia Louis-Dreyfus’s Wiser Than Me podcast that it was recently recommended by her doctor. The 80-year-old tennis icon told Louis-Dreyfus she’s had a few injections to start and is waiting to see how it affects her thoughts about food. (While King referred to Ozempic as a catch-all term for weight loss drugs, she didn’t specify which medication she is taking.)

What has King said about her struggle with binge eating, and how might weight loss drugs have an impact? Here’s what to know.

King wrote about her experience with eating disorders in her 2021 memoir, All In, saying that she was formally diagnosed with BED — which involves a loss of control over eating behavior, eating large amounts of food in a specific period of time and then feeling depressed, disgusted, ashamed, guilty or upset — at age 51. Speaking to Louis-Dreyfus, King provided more details about what she was going through at the time, including coming to terms with her sexuality after being publicly outed in 1981. “I think that caused a lot of my eating disorder,” she said, along with the attention paid to her diet as an elite athlete. Around 1995, King sought out inpatient treatment at The Renfrew Center in Philadelphia.

“I went to therapy and I lived there for six weeks,” she told Louis-Dreyfus. It led her into recovery at the time, although she continues to deal with her eating disorder to this day. “I still go to therapy, I still think about it.”

And she still often struggles with obsessive thoughts about food. “I have, like, two voices in my head, sometimes that argue,” said King. “Let’s say I want a quart of ice cream — one side will say, ‘Yeah, baby, I’m gonna have that ice cream no matter what!’ And the other side says, ‘No, don’t do that, it’s not healthy. You don’t need it, you’re not gonna miss it.’ The other side says, ‘Screw you! I’m having this ice cream.’ So I have this discussion that goes on in my head and sometimes it’s very elevated. … [It] gets exhausting and tiring and I don’t want to fight over these things.”

Although King didn’t use the term herself, the thoughts she describes having are commonly referred to as “food noise” — something weight loss medications may be able to suppress.

“I don’t want to lose weight fast because I think it looks horrible. I don’t think it’s healthy,” she said of starting her drug regimen. “I would like to lose slowly. But the important thing my therapist asked me, which I hadn’t thought about, is that she said, ‘Has it quieted your mind? … ’ Because that would be really great.”

How might that work? Here’s what experts say about food noise and what experts say about using weight loss drugs to address it.

It’s the experience of having frequent thoughts about food that a person finds to be intrusive, according to Dr. Melanie Jay, director of NYU Langone's Comprehensive Program on Obesity. “People describe it as always thinking about the next thing they will eat, spending a lot of time trying to decide whether to eat something they are craving, thinking about lunch while they are eating breakfast,” she tells Yahoo Life.

A 2023 review of the term by nutritional scientists determined that there’s little research available on food noise. Psychologist Samantha DeCaro, director of clinical outreach and education at The Renfrew Center, where King previously received treatment in the '90s, tells Yahoo Life that “food noise” isn’t an official medical or clinical term with a clear definition.

“The experience of food noise is a subjective experience that likely varies significantly between people. These thoughts can be cognitive symptoms of a clinical eating disorder, but they can also be the brain’s attempt to fight against a chronic state of dieting, excessive exercise, malnourishment or food insecurity,” she says. “It’s not uncommon for people to experience frequent thoughts about food when they restrict their intake, eat irregularly, struggle to access adequate amounts of food or consistently deny themselves the foods they enjoy. In certain cases, this can simply be a survival strategy or a helpful signal from our brains that we need more food or more variety.”

Food noise has also been associated with the "destructive thoughts about food" Jay and other experts have seen among those with binge eating disorder.

“The term food noise may be an attempt to describe the distressing experience of having obsessive, intrusive or simply unwelcome thoughts about food. For people with eating disorders, these obsessive and intrusive thoughts are frequently part of the clinical picture and fuel disordered cycles and symptoms such as restricting, bingeing and purging,” says DeCaro. “Irregular eating patterns can certainly contribute to an experience of food noise and can contribute to a binge eating episode.”

But experts also note that BED is a mental health diagnosis that requires intervention of symptoms and behaviors far beyond food noise.

Dr. Jennifer Kraker, a psychiatrist with expertise in metabolic health and eating disorders, tells Yahoo Life that she’s found weight loss medications very effective for treating BED patients. As the New York Times has reported, many people who take Ozempic have credited it with helping to silence food noise.

Beyond the component of food noise, however, Kraker says that “dopamine dysregulation and satiety signaling are underlying components of binge eating disorder.” Liraglutide and semaglutide (the active ingredients in medications like Victoza and Wegovy) have been shown to reduce the effect of dopamine released while eating, allowing for better control around food. The medications’ appetite-suppressing effects also contribute.

The studies illustrating these effects are limited but promising, with one study suggesting that semaglutide may be more effective at treating BED than lisdexamfetamine (Vyvanse), which is FDA-approved for the eating disorder.

A growing number of physicians, including Kraker, are also reporting positive changes with patients. Dr. Michael Lutter, a psychiatrist focused on depression, anxiety and eating disorders, told the Wall Street Journal that he’s been prescribing weight loss medications to BED patients since 2019 and has found that they “respond amazingly well.” He said that their bingeing is brought under control when using the drugs in conjunction with treatment by therapists and dietitians.

Weight loss, however, does occur, which is cause for concern among experts like Jay, who says, “More studies are needed to make sure that it doesn’t worsen eating disorders.”

DeCaro is also wary, and says that eating disorders are more complex and require more comprehensive treatment than weight loss medications alone would provide.

“Eating disorders are complex psychiatric disorders; they aren’t just about food or weight. Weight loss medications will never address the underlying emotional and psychosocial factors that contribute to the development of eating disorders,” says DeCaro. “These medications can potentially cause, maintain or worsen binge eating symptoms, especially if someone needs to stop the medication due to an adverse side effect. There is the possibility that these medications can interfere with eating disorder treatment goals, as they may enable restriction, interfere with establishing a consistent eating schedule, shift the client’s focus to appearance and reduce a client’s willingness to participate in the highly effective food exposure work.”

Jay recommends that individuals work with a multidisciplinary team to determine the best course of treatment.