Tag Archives: eating disorder

“GLP-1 Receptor Agonists and Eating Disorders — Cause for Concern”

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A Banks. N Engl J Med 2026;394:1665-1667. GLP-1 Receptor Agonists and Eating Disorders — Cause for Concern.

An excerpt:

Constraining the growth of the global obesity epidemic would have clear benefits at the individual and population levels. Use of GLP-1 drugs has been linked in some patients to improved cardiovascular outcomes, a reduced risk of kidney disease, a reduced desire to drink alcohol, and potentially protective effects against neurodegenerative diseases. It is therefore easy to understand the substantial interest in investing in the development of these products and the optimism about their public health effects.

Nonetheless, some worrisome signals have emerged…The proportion of GLP-1 receptor agonist prescriptions that were written for people without diabetes, obesity, or overweight increased from 4.5% in 2018 to 17% in 2023…1

There is also compelling preliminary evidence suggesting that the use of these drugs could exacerbate and lead to new diagnoses of restrictive eating disorders, including anorexia nervosa…3 Lifetime prevalence of anorexia nervosa is as high as 6.3% in women and 0.3% in men,4 and the risk of death from any cause among people with anorexia nervosa is more than five times as high as that in the general population…5

Nutrient deficiencies, electrolyte abnormalities, orthostatic hypotension, osteopenia, sarcopenia, thinning hair, and other signs of malnutrition have been observed [in users of GLP-1 agents], and the effects of long-term use are still largely unknown…

The cumulative incidence of new eating-disorder diagnoses (most commonly anorexia nervosa) in the full study population was 1.275%…3 this proportion translates to more than 420,000 people who could develop a related eating disorder with long-term use.

Physicians, trialists, regulators, policymakers, and drug developers are unprepared for this coming wave.

My take: GLP-1 RAs are not for everybody; they will likely contribute to eating disorders in many patients.

GLP-1 RAs also have been associated with a higher risk of Nonarteritic Anterior Ischemic Optic Neuropathy (aka ‘eye stroke’) in approximately in 1 in 10,000 recipients. One reference: JAMA Ophthalmology. 2026;144;(3):259-264. New-Onset Nonarteritic Anterior Ischemic Optic Neuropathy and Initiators of Semaglutide in US Veterans With Type 2 Diabetes

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Trail to Mt Fitz Roy (Argentina)

Should We Be Screening for Eating Disorders in Teenagers with Constipation?

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HB Murray et al. Clin Gastroenterol Hepatol 2020; 18: 2471-2478. Frequency of Eating Disorder Pathology Among Patients With Chronic Constipation and Contribution of Gastrointestinal-Specific Anxiety

Key findings:

  • In an analysis (n= 279 adults, 70% female, average age 47 years) of patients with chronic constipation at a tertiary center who were referred for anorectal manometry, 19% had symptoms consistent with an eating disorder; this assessment was based on the Eating Attitudes Test (EAT-26).
  • “Gastrointestinal-specific anxiety fully mediated the relationship between the severity of ED pathology and constipation (standardized β, 0.11–0.16; P = .026–.024).”

The authors note that screening for eating disorders “is of particular importance before prescribing dietary interventions.”

My take: While this was a study with adults, it is likely that chronic constipation may be a presenting feature of an eating disorder in teenagers as well.