How Do GLP-1s Affect Eating Disorders?

For National Eating Disorder Awareness Week, Molly Perlman, MD, MPH, CEDS-C, discussed the clinical implications of glucagon-like peptide-1 (GLP-1) receptor agonists for patients with eating disorders. Perlman, a board-certified psychiatrist with additional certification in addiction medicine, emphasized that psychiatrists must be prepared to address the growing prevalence of GLP-1 use and the cultural messaging surrounding weight loss.

Perlman underscored that traditional medical counseling focused on weight loss and lifestyle modification could be harmful for patients with eating disorders. She advised clinicians to “know your audience” and to recognize that “someone in a higher weight body does not equal poor health.” She stressed that weight loss was contraindicated in active eating disorders and that treatment goals should center on nutritional rehabilitation, weight stabilization, and restoration when indicated—even if this required return to a higher weight range.

In patients presenting on GLP-1 agents, Perlman described a careful assessment of indication and motivation. When prescriptions were driven by disordered eating or weight-loss goals, her team worked with patients to discontinue the medication.¹ However, when GLP-1 agents were appropriately prescribed for metabolic conditions such as diabetes, treatment was continued in collaboration with endocrinology, often at the lowest effective dose to minimize weight-loss effects.

Perlman expressed concern about aggressive marketing, online accessibility, and limited long-term data. She noted that GLP-1 agents had not been adequately studied in individuals with eating disorders and warned that weight loss could exacerbate or even precipitate pathology in vulnerable patients.² She emphasized that, “this is not indicated for eating disorders, period.”

Finally, Perlman encouraged psychiatrists to model weight-neutral language in clinical encounters, reconsider routine weighing practices, and remain vigilant to the ways in which cultural reinforcement of thinness complicated recovery and help-seeking behaviors.

Dr Perlman is chief medical officer at Monte Nido, an eating disorder care organization.

References

1. Eating disorders and GLP-1 RAs. National Eating Disorders Collaboration. 2025. Accessed February 26, 2026. https://nedc.com.au/eating-disorders/other-learning/eating-disorders-and-glp-1ra

2. The implications of GLP-1 medications for eating disorders care. Penn Medicine. June 3, 2025. Accessed February 26, 2026. https://www.pennmedicine.org/physicians-hub/physician-article/implications-of-glp-1-medications-for-eating-disorder-care