Just about anyone can get a GLP-1. For people with eating disorders, that’s the problem

Behind the hype for GLP-1s, which have rightfully transformed the treatment of metabolic conditions and obesity, a quieter crisis is unfolding. People with disordered eating are taking the drug — and ending up in treatment centers and hospitals. 

For people living with eating disorders like anorexia and bulimia, the danger is very real. Appetite suppression, which makes GLP-1 drugs so effective, makes them destabilizing for people whose recovery depends on rebuilding a relationship with hunger.

“These medications do the same things that actual anorexia does,” Wendy Oliver Pyatt, co-founder of the eating disorder treatment platform Within Health and the treatment center Galen Hope, told The Washington Post.

The scale of the problem is only beginning to come into focus. Rebecka Peebles, vice president of adolescent medicine at Monte Nido, a national eating disorder treatment provider, says that the rate of usage of the drugs is rising. Her team encounters at least three patients a day struggling from using GLP -1s — prescribed not for diabetes but for weight loss. Others developed disordered eating patterns only after starting the medications.

A perspective article in the New England Journal of Medicine estimated that more than 420,000 people in the United States could develop an eating disorder with long-term use of these drugs.

Compounding the problem is GLP-1s’ remarkable accessibility. Anyone with a credit card — teens included — can go online, misrepresent their weight and health history, and receive a prescription within days, sometimes hours.

Stevee Williams, 27, ordered Wegovy through an online platform after falsifying her stats. “I just wanted to be smaller,” she said. Williams, who had been diagnosed with anorexia at 17, stopped taking the medication before it produced results but says the feeling of control it gave her felt familiar and frightening.

For AJ Jasper, a 40-year-old social worker in Chicago who has battled anorexia for nearly three decades, the consequences were devastating. After purchasing GLP-1s through various apps without ever seeing a doctor, he dropped 50 pounds in just a few months, leading to triple organ failure. He has since returned to a healthy weight, but says plainly, “Anyone with an eating disorder should stay far away from these medications.”

Beyond online platforms that could use more restrictive processes to prescribe the drugs, medical organizations whose members treat patients with obesity and dietary issues recommend that physicians thoroughly screen for eating disorders before prescribing GLP-1s. Doing so could prevent harm to vulnerable patients before it occurs.

Still, providers emphasize that no screening protocol replaces specialized, trauma-informed treatment that addresses the psychological roots of disordered eating, not just its physical symptoms. Until that standard of care becomes the rule rather than the exception, the culture that made GLP-1s a phenomenon will continue to put the most vulnerable patients at risk.