GLP-1 medications have changed the conversation around weight loss, appetite and metabolic health. But for people with eating disorders, medications that can reduce appetite and lead to rapid weight loss may bring risks that deserve closer attention.
A new cross-sectional study published in JAMA Psychiatry found that GLP-1 receptor agonist use and misuse were common in a targeted sample of people with eating disorders. The study suggests clinicians may need to ask more careful questions, screen for eating disorder symptoms and monitor patients closely as access to GLP-1 medications continues to expand.
GLP-1 receptor agonists are a class of medications used to treat type 2 diabetes and, in some cases, chronic weight management. They work partly by helping regulate blood sugar, slowing digestion and affecting appetite signals. Their growing use has also raised new questions about how these medications fit into a culture already shaped by dieting, weight stigma and pressure to lose weight.
The study included 436 people with eating disorders in a targeted sample. Researchers reported that 32.1% had used a GLP-1 receptor agonist at some point in their lives and 22% were currently using one. They also found that 10.1% reported lifetime misuse and 9.9% reported lifetime use of compounded GLP-1 products.
Those numbers should be interpreted carefully. Because the study used a targeted sample, it cannot show how common GLP-1 use or misuse is among all people with eating disorders. It also relied on self-reported information and cannot prove that GLP-1 medications caused or worsened eating disorder symptoms.
Still, the findings raise an important concern. People with eating disorders are not a single group with one set of needs. The study included people with anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder and other specified feeding or eating disorders. Some people may have medical reasons to use a GLP-1 medication, while others may be more vulnerable to using appetite suppression or rapid weight loss in ways that reinforce eating disorder symptoms.
That distinction matters. GLP-1 medications can be useful, evidence-based treatments for some patients. But appetite suppression, reduced food intake and weight loss can also overlap with behaviors that are dangerous for people struggling with restriction, purging, compulsive weight control or fear of weight gain.
The study authors noted that lifetime GLP-1 use in this sample was higher than the 15% observed in the general adult population. They also warned that some people with eating disorders may be using GLP-1 medications in ways that maintain eating disorder patterns through rapid restriction and weight loss.
The study should not be read as a reason to shame patients or withhold care based on diagnosis alone. A more useful takeaway is that prescribing and monitoring may need to include more direct conversations about eating disorder history, current behaviors, medication access and reasons for use.
That may be especially important as compounded products and informal access routes remain part of the broader GLP-1 landscape. Patients may not always tell a clinician they are using a GLP-1 medication, especially if they fear judgment, losing access to treatment or being misunderstood. A careful, nonjudgmental approach can make it easier for people to be honest about what they are taking and why.
The study was supported by the University of Louisville Joint Pilot Project Program. Some authors reported outside financial relationships with Abbott Laboratories, Gilead Sciences, Meru Health, Novo Nordisk, AbbVie, Be Well and Sylvia Precision Health. These relationships were reported outside the submitted work.