Altered eating experience during GLP-1 receptor agonist therapy: a sensory-liking-wanting framework for food preference and nutritional behaviour.

Eating experience is shaped not only by oral sensory input, but also by hedonic evaluation, interoceptive state, and cue-driven motivation. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used for obesity treatment, offer a clinically relevant model for examining how these processes interact during appetite regulation. Some patients receiving GLP-1RAs report that food tastes different, is less enjoyable, or becomes less tempting, yet these experiences are often grouped together as "taste changes." This review argues that such reports should be interpreted through a sensory-liking-wanting framework rather than as evidence of a uniform gustatory disorder. We synthesise evidence from peripheral taste signalling, brainstem interoceptive integration, and central food reward pathways. Current evidence does not support a consistent primary impairment of basic gustatory function during GLP-1RA treatment. Instead, altered eating experience appears more consistent with state-dependent food revaluation and reduced reward-driven motivation. However, these responses are heterogeneous and may include limited response, persistent appetite, weight regain, or atypical behavioural phenotypes in some individuals. This framework may help clarify how incretin-based therapies influence food preference, dietary intake, nutritional behaviour, and treatment adherence.