GLP-1 Medications and Eating Disorders: What’s New

A new GLP-1 study and a new Medicare pilot both landed last week – and together, how they could change the risk landscape for anyone with a history of disordered eating is something we take seriously as dietitians.

GLP-1 medications are everywhere right now – on TV, all over social media, in conversations with friends, and increasingly, in conversations with your own doctor.

But there’s one piece of this story that keeps getting left out: how these medications can affect people who have an eating disorder, or who are at risk of developing one.

As eating disorder clinicians, we’re seeing more and more patients develop new eating problems after starting a GLP-1 or other weight-loss medication – and we think this deserves a much bigger conversation.

This is Part 1 of a three-part series on GLP-1 medications and eating disorders to help you understand the risks, recognize the warning signs, and know what questions to ask before you or someone you love starts one of these medications.

The New GLP-1 Study and the Medicare GLP-1 Pilot

Two developments landed within days of each other, and together they’re going to affect a huge number of people in the USA.

First, a new study made headlines everywhere, showing just how common GLP-1 use and misuse already are among people with eating disorders (more on those numbers below).

Second, a new federal pilot program launched, opening the door for millions more Medicare recipients to access GLP-1 medications at a fraction of the usual cost. Roughly 3.8 million Medicare beneficiaries who’ve been paying around $350 a month for medications like Zepbound, Wegovy, and other GLP-1s may now qualify for a $50 copay. It’s a significant shift – and it means many more people, including people who may not realize they’re vulnerable to disordered eating, are about to have access to these drugs.

This is where it gets personal for us as dietitians who work with people and families affected by eating disorders every day.

If any of this feels close to home, we’re here to talk it through – no pressure, no judgment.

Medicare eligibility starts at 65, which means the population this pilot reaches is disproportionately women in and after menopause – exactly the group we worry about most.

Without estrogen, bone density drops. Add a medication that suppresses appetite and reduces food intake on top of that, and you have a real risk of accelerated bone loss, osteoporosis, and hip fractures – not just muscle loss.

We go deeper on this in Part 2 of this series, and you can also access more background information on women and GLP-1s in these two articles:

Best Diet for Women Over 40 on GLP-1 Meds.

Losing Weight on GLP-1s Isn’t Just About the Scale: How to Avoid Muscle Loss

There’s also a practical concern buried in the fine print of this change:

This pilot is time-limited, running only through 2027. For Medicare recipients who can’t otherwise afford $350 a month, when the pilot ends, so does access – and without a plan in place, that often means regaining the weight.

This is why we want to have these conversations with as many people as possible, because it’s worth thinking about sustainability now, not after the program ends.

If you want the full rundown on what GLP-1 medications are and how they work, we cover that in detail in this article: GLP-1 Medications and Nutrition Risks for Women Over 40.

Today, we are focusing on something that conversations often miss entirely: the connection to eating disorders.

The GLP-1 and Eating Disorder Connection: What We Know (and What We Don’t)

Research on GLP-1 medications and eating disorders is still young. Most of what we know comes from clinical observation, case reports, and a small but growing number of early studies – not decades of long-term data.

One of the more striking findings comes from a research letter recently published in JAMA Psychiatry – the study that made headlines everywhere last week. Among more than 400 people with eating disorders, 32.1% reported having used GLP-1 drugs, and 22% reported current use. More than 10% said they had misused the medications – most often using off-label, compounded versions purchased online rather than FDA-approved prescriptions.

These numbers are a little scary to us, because we understand the risks.

And please know – we’re not the kind of dietitians who’ll turn you away for being on a GLP-1, in fact, our team is the opposite.

We would all prefer for clients to talk to us about GLP-1s, not hide them. We prefer you share what you’re going through because we know how critical it is for those at risk to have someone to guide them through managing and reducing those risks.

We’re not here to judge you when it comes to GLP-1s… no one should be!

Wanting relief, wanting to feel different in your body, wanting to try what everyone else seems to be trying – none of that makes you weak or wrong. It’s exactly why talking to a dietitian matters. We can help you figure out whether a GLP-1 is safe for you, and if you’re already on one, how to protect your recovery while you’re taking it.

The picture is genuinely complicated. Some research shows that GLP-1 medications, particularly semaglutide and liraglutide, can help reduce binge eating episodes in people with binge eating disorder.

For someone who struggles with compulsive overeating, quieting relentless food urges can feel like real relief – but it still needs to happen alongside a multidisciplinary team, not in isolation.

The same appetite-suppressing effect that helps one person can seriously harm another.

In Part 2 of this series, we’ll walk through exactly who’s most at risk, and what we believe needs to change about how these medications are prescribed.

Ready for Support?

If you’re currently taking a GLP-1 medication, considering one, or just have questions about how it might affect your relationship with food, you don’t need to figure it out on your own. Schedule a free 15-minute consultation with our team. We’ll talk about what’s going on, determine what type of support fits your needs, and see whether one of our dietitians is the right fit for you.

You don’t need to wait until things feel like a crisis to reach out. Whether you’re just starting to ask questions about a GLP-1 or you’re already noticing old patterns creeping back in, the sooner we talk, the more we can help protect your health and your recovery.

👉 Book a free 15-minute consultation with Erica to discuss working with our team

This is Part 1 of a three-part series. Continue to Part 2: “GLP-1 Medications and Eating Disorder Risk: Who’s Most Vulnerable.”

This blog is intended for educational purposes and does not constitute medical or nutrition advice. Please consult a qualified healthcare provider before making any changes to your care.