GLP-1 Medications Triggering New Eating Disorder Patterns
As millions of Americans continue using GLP-1 medications such as Ozempic, Wegovy, and Mounjaro for weight management and diabetes treatment, healthcare professionals across the country are reporting concerning developments. Doctors are observing that some patients are developing previously unrecognized eating disorders directly linked to these drugs' powerful appetite-suppressing effects.
The Emergence of 'Agonorexia'
Brad Smith, chief medical officer at The Emily Program, a national organization specializing in eating disorders, has identified a pattern he calls "agonorexia." This condition develops when GLP-1 agonists trigger an intense preoccupation with food and weight loss, driving behaviors that can endanger both physical and mental health.
"We've seen people that were prescribed these medications who have run into a slippery slope with it, bringing back their eating disorder symptoms and behaviors," Smith explained. "We've also seen people who have developed more disordered eating or eating disorders as a result of these medications, even without having an eating disorder in the past."
Beyond Traditional Categories
These emerging disorders often do not fit traditional eating disorder categories such as anorexia, bulimia, or binge eating disorder. GLP-1 medications are not FDA-approved for treating any eating disorder, according to the National Association of Anorexia Nervosa and Associated Disorders.
While similar issues have been observed with other weight-loss drugs, such as certain stimulants, Smith emphasizes that GLP-1 medications represent "a different animal" with far greater impact. "It's exceeded anything in the past already," Smith stated. "They've certainly had a much higher impact than any of those previous substances."
Inadequate Screening and Monitoring
The trend has alarmed eating-disorder specialists who caution that current medical screening and monitoring may not be adequate to identify patients at risk. Many people prescribed GLP-1 drugs are not evaluated for psychological vulnerabilities that could make appetite suppression dangerous.
Experts also note that stopping the medications does not always immediately reverse unhealthy eating patterns once they develop, creating long-term concerns about sustainable treatment approaches.
Research Limitations and Unknowns
Research on the relationship between GLP-1 receptor agonists and eating disorders remains limited. Evidence suggests that by increasing satiety and suppressing hunger, these drugs may encourage dietary restriction, a known risk factor for disordered eating, especially among people already seeking weight-loss treatments.
Dr. Rebecca Boswell, Director of Penn Medicine Princeton Center for Eating Disorders, highlighted the dosage concerns at last year's Eating Disorders Research Society Conference. "To lead to weight loss, these medications are prescribed in two to five times the dose needed to treat diabetes," Boswell explained. "This is a massive dose of hormone that affects not only the gut, but the entire body, with major implications for eating processes and eating disorders."
Intersection with Diabetes and Weight Stigma
Eating disorders are relatively common among people with diabetes, complicating the picture further. Between 12 percent and 40 percent of those with type 2 diabetes, and even higher rates in type 1 diabetes, experience disordered eating, according to Australia's National Eating Disorders Collaboration.
For these patients, GLP-1 medications may intersect with preexisting vulnerabilities, including fixation on food, restrictive behaviors, or misuse of medications. Weight stigma may further worsen the problem, as people with higher body weight are more likely to be recommended weight-loss interventions, which can reinforce harmful thoughts and behaviors around food.
Limited and Inconclusive Studies
Existing research on GLP-1 medications in people with eating disorders remains scarce, leaving many unknowns. While the drugs are widely used for weight loss and diabetes management, it remains unclear how they affect restrictive or binge-related eating disorders.
Clinical experience shows that recovery from eating disorders relies on consistent eating patterns, body acceptance, addressing weight stigma, tuning into hunger and fullness cues, and flexibility around food, but how GLP-1 medications impact these recovery strategies is not well understood.
Current studies are small and inconclusive. Some suggest the medications may reduce binge-eating episodes in patients with binge eating disorder or bulimia nervosa, but sample sizes have been limited, follow-up periods short, and long-term effects remain unknown.
According to the National Association of Anorexia Nervosa and Associated Disorders, one randomized controlled trial found no significant changes in binge eating disorder behaviors, indicating that GLP-1 drugs may not address the root causes of eating disorders and that symptoms often return once medication is discontinued.
