Eating-disorder clinicians warn of a cultural swing back to the thin ideal
Eating-disorder specialists told USA TODAY that the GLP-1 boom echoes 1990s diet-pill culture, and that many people starting the drugs are never screened for disordered eating.
Clinicians who treat eating disorders say the surge in GLP-1 use, now including FDA-approved weight-loss pills, is reviving a cultural "thin ideal" that faded during the body-positivity years, and they warn that people with restrictive eating patterns are reaching for the medications with little screening or follow-up. USA TODAY reported the concerns on April 30, 2026 [1].
Sam DeCaro, director of clinical outreach and education at The Renfrew Center, which specializes in eating disorder treatment, described a "larger cultural swing towards the thin ideal yet again" [1]. DeCaro, who holds a doctorate in psychology, said that "a lot of people who are seeking out these medications are not being screened for eating disorders (and) they're also not being monitored for the onset of eating disorder symptoms once they're on the medication" [1]. Her hope is that treatment teams become standard practice — "not just a doctor, but also hopefully a therapist and a dietitian who specializes in eating disorders" [1].
A different drug, a familiar culture
Not everyone sees the comparison to fen-phen and Redux as medically apt. Dr. Sarah Gupta, a psychiatrist and medical director at the platform Modern Health, told USA TODAY that GLP-1 pills are "very different" from 1990s diet pills. "Many of those earlier drugs were focused almost entirely on weight loss, often without strong evidence of broader health benefits," she said, while GLP-1s have "growing evidence" of lowering the risk of heart attack and stroke and supporting metabolic health [1]. Northeastern University's Ashleigh Shields, a professor at the Bouvé College of Health Sciences, made a similar distinction, calling GLP-1s "mainstream and legit" compared with predecessors such as fen-phen, which led to a $3.75 billion class-action settlement, and ephedra supplements, which the FDA banned [2].
The worry, both say, is the culture around the drugs rather than the pharmacology. Gupta said that when something with real clinical value becomes highly visible, including among people not using it for medical reasons, "it can start to shape expectations around body size in ways that go beyond health," and that in some people the drugs "may also trigger, or worsen, disordered eating" [1]. Alexis Conason, author of "The Diet-Free Revolution," told Northeastern Global News that before the Ozempic era "there was more of a sense of rejecting the diet mentality"; now that weight looks controllable, thinness reads as personal responsibility [2]. Shields put it bluntly: "Unfortunately right now heroin chic is back," recast as "Ozempic body" [2].
The scale of the underlying problem is large. The National Eating Disorders Association reports that 9% of the U.S. population faces an eating disorder at some point in life — nearly 31 million Americans — and that a person dies as a direct consequence of an eating disorder every 52 minutes [2]. NEDA says the full effect of drugs like Ozempic on eating disorders is still unknown but urges caution for these groups [2].
One telehealth company addressed screening directly. A spokesperson for Ro told USA TODAY that all potential patients complete an online visit covering weight-loss goals, clinical status and medical history, "including diagnoses of disordered eating," and that people with a diagnosed history of disordered eating "are screened and recommended to seek in-person care rather than on Ro" [1].
Why it matters for patients
The practical gap described in the reporting is about process, not just prescriptions: whether anyone asks about eating disorder history before treatment starts, and whether anyone checks for new symptoms afterward [1]. That varies by prescriber and platform, and the sources do not report how often screening happens overall — that is not yet known.
DeCaro also noted two limits worth keeping straight: GLP-1s are not approved as a treatment for an eating disorder, and the long-term effects of the drugs are largely unknown [1]. "Weight loss is not a treatment or a cure for an eating disorder, either," she said, adding that treatment and support exist for people who are struggling [1].
Shields described a separate risk pattern she has studied: rapid loss can build momentum, compliments can reinforce it, and "once you get to that number, it's never enough" [2]. She also said tolerance can build over time, leaving some people regaining weight and in a vulnerable place [2]; the sources do not present clinical trial data behind that specific claim.
USA TODAY notes the National Alliance for Eating Disorders Helpline at 1-866-662-1235, and for 24/7 crisis situations, texting "ALLIANCE" to 741-741 [1].
Sources
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