Researchers call for eating disorder screening as GLP-1 use grows

Adelaide University researchers say the fast growth of GLP-1 medicines such as Ozempic (semaglutide) and Mounjaro (tirzepatide) has pushed obesity care and eating disorder care together, and they are calling for eating disorder screening before and during treatment ^[1][2]. Their argument was published in the Journal of Eating Disorders ^[1].

The paper comes out of the Consortium for Research in Eating Disorders (CoRe-ED), an international independent charity initiative founded by Professor Gemma Sharp, a clinical psychologist and eating disorder researcher at Adelaide University ^[1][2]. Sharp said the long-standing split between the two fields no longer matches what clinicians see.

"For too long we've treated obesity and eating disorders as though they're opposing health conditions, but they actually have more in common than many people realize," Sharp said ^[1][2].

She added that the common image of an eating disorder — someone who is very thin — is "one of the biggest misconceptions in this field," and that most people living with an eating disorder are not underweight ^[1][2]. Many go undiagnosed, she said, because care focuses on weight rather than on recognizing the eating disorder itself ^[1][2].

In Australia, about one in three adults lives with obesity, and around 5% of Australians — roughly 1.1 million people — experience an eating disorder, according to the figures cited with the paper ^[1][2]. Comparable US figures were not included.

On the medicine itself, the researchers describe the evidence as emerging and preliminary: it suggests GLP-1 drugs may reduce binge-eating behaviors in some people, while questions remain about whether their appetite-suppressing effects could pose risks for some people with eating disorders ^[1][2]. Sharp said the medicines are only one part of the solution.

"The priority now is identifying which patients are most likely to benefit, which patients are at greatest risk of harm, and ensuring appropriate screening, monitoring and multidisciplinary care become part of routine prescribing," she said ^[1][2].

Why it matters for patients

The paper's central claim is that the same person may be treated for obesity in one setting and for an eating disorder in another, sometimes moving between them ^[1][2]. Because most people with eating disorders are not underweight ^[1][2], a visit focused on weight or on a GLP-1 prescription may not surface an eating disorder that is already present.

Sharp framed the open questions as who benefits most and who faces the greatest risk of harm ^[1][2]. The specific symptoms, screening tools or warning signs that should trigger a referral are not spelled out in the published description of the paper, and no threshold for stopping or adjusting GLP-1 therapy in a patient with an eating disorder is stated ^[1][2].

Whether screening happens now depends on the individual clinician or program. It has not been reported that any guideline body requires eating disorder screening before or during GLP-1 prescribing.

What happens next

No timeline has been disclosed for turning the researchers' call into formal guidance, and no guideline body, regulator or professional society is named as taking up the recommendation ^[1][2]. Sharp said the issues are being discussed through CoRe-ED, which brings together researchers, clinicians, people with lived experience, advocates, nonprofit organizations, industry and partners in related fields such as obesity ^[1][2].

"GLP-1 medicines are a perfect example of why CoRe-ED was established," she said. "Complex issues like this require us to bring different voices and disciplines to the same table, rather than approaching obesity and eating disorders in isolation" ^[1][2].