Will Popular Weight Loss Drugs Increase Eating Disorders?

Some experts are concerned the popularity of the glucagon-like peptide-1 receptor (GLP-1) agonist semaglutide for weight loss could trigger a rise in eating disorders, CNN recently reported.

“We noticed clinically that we were getting more and more people into our clinical services that had been started on GLP-1 agonists and had experienced new onset or worsening eating disorder symptoms,” Aaron Keshen, MD, codirector of the Nova Scotia Provincial Eating Disorder Service and assistant professor in the Dalhousie University psychiatry department in Halifax, Nova Scotia, told the news outlet.

Jennifer Gaudiani, MD, medical director of the Gaudiani Clinic, Denver, Colorado, who specializes in eating disorders, said she had heard stories of patients in remission who re-experienced disordered eating symptoms after starting a GLP-1 agonist. In some users, weight loss can trigger restrictive dieting and the return of “old gremlins” associated with disordered eating, she said in the article.

Although research on the connection between weight loss medications and eating disorders is scant, restrictive food intake and weight loss are known to be associated with the development of eating disorders. Furthermore, the article points out that GLP-1 agonists are appetite suppressants that can cause sensations of fullness, even sickness, after intake of a limited amount of food. The exaggerated response could create a disconnect from a person’s natural cues for hunger and fullness.

Eating disorder experts encouraged prescribers to screen for a history of, or a vulnerability to, eating disorders in patients before prescribing semaglutide for weight loss. Patients should also be coached on the importance of structured meals and nourishing food. If patients feel they could be falling into disordered eating, they should seek support.

“If somebody has had a history of an eating disorder, or indeed just has temperamental traits, and is surrounded by a society that is extremely focused on weight loss and fatphobia, and they begin to lose weight,” Dr Gaudiani told CNN, “it’s not unimaginable … that could devolve into something that becomes quite obsessive and quite mentally and physically unhealthy for them.”

Reference

Holcombe M. The questions eating disorder experts have about weight loss medications. CNN. February 26, 2024. Accessed February 27, 2024. https://www.cnn.com/2024/02/26/health/semaglutide-weight-loss-eating-disorders-wellness/index.html