Doctors alarmed as GLP-1 drugs spread among eating disorder patients

Doctors are increasingly confronting a hard clinical contradiction: the same GLP-1 drugs driving the weight-loss boom are turning up in patients seeking care for anorexia, bulimia and binge eating disorder. Providers say the appetite-suppressing effect can hide worsening restriction, intensify misuse, or push vulnerable patients toward relapse, forcing sharper screening and closer follow-up as prescribing expands.

That alarm lands at a moment when semaglutide has moved from diabetes care into mainstream weight management. Ozempic first won U.S. approval in 2017 for type 2 diabetes, and Wegovy followed in 2021 for chronic weight management. The drugs have since spread quickly across the country, helped by intense demand for obesity treatment and by a public health backdrop in which obesity remains widespread. The Centers for Disease Control and Prevention’s 2024 adult obesity maps showed 23 states with adult obesity prevalence at or above 35 percent, based on 2023 data.

Use is already broad. A KFF poll in May 2024 found that about 12 percent of U.S. adults said they had ever taken a GLP-1 agonist, while 6 percent said they were currently taking one. That scale is raising the stakes for eating-disorder specialists, who say these drugs can be especially risky when patients already struggle with body image, compulsive restriction or binge-restrict cycles.

The National Institute of Mental Health describes eating disorders as serious and sometimes fatal illnesses that cause severe disturbances in eating behavior. The National Eating Disorders Association says about 9 percent of the U.S. population, nearly 31 million Americans, will have an eating disorder in their lifetime, and it flags GLP-1 medications as a particular concern for people with an active eating disorder, a history of one, or high susceptibility to developing one.

The clinical debate is not purely one-sided. Review literature has found limited evidence that GLP-1 agonists may reduce binge-eating symptoms in some patients, but experts also warn that the same appetite suppression can be misused or can trigger relapse in vulnerable people. That leaves doctors trying to distinguish between appropriate obesity treatment and dangerous reinforcement of disordered eating, a task made harder by telehealth prescribing and the speed at which the drugs have entered routine care.

Wegovy’s FDA label includes a boxed warning about thyroid C-cell tumors and lists contraindications unrelated to eating disorders, underscoring that concerns about anorexia, bulimia and binge eating disorder are being driven by clinicians and advocacy groups rather than written into the formal label. For now, the warning is clinical rather than regulatory: the drugs are here, the patient pool is large, and screening, monitoring and informed consent are becoming central to how doctors decide who should receive them.