A GLP-1 injection pen is shown wrapped in measuring tape

The implications of GLP-1 medications for eating disorders care

Director of Princeton Center for Eating Disorders, Rebecca Boswell, PhD, shares her perspectives on the implications of GLP-1 medications for patients with eating disorders.

  • June 3, 2025
headshot of Rebecca Boswell, PhD
Rebecca Boswell, PhD

Glucagon-like peptide-1 (GLP-1) receptor agonists have had a positive impact for many people with diabetes. However, the implications for these medications in their application to weight loss, including the potential exacerbation of eating disorder pathology, are understudied.

Rebecca Boswell, PhD, director of Penn Medicine Princeton Center for Eating Disorders and administrative director of Psychiatric Services at Princeton Medical Center, recently shared her perspectives on this topic at the Eating Disorders Research Society Conference in Sitges, Spain.

“To lead to weight loss, these medications are prescribed in two to five times the dose needed to treat diabetes,” Dr. Boswell says. “This is a massive dose of hormone that affects not only the gut, but the entire body, with major implications for eating processes and eating disorders. In addition, this treatment may prove to be unsustainable in the longer term.”

GLP-1s: A mixed blessing

Dr. Boswell notes that for the GLP-1s, mixed evidence exists regarding side effects like anxiety and depression, possibly stemming from users’ complicated immune responses to these medications or the speed of weight change they experience. While the medications’ apparent role of attenuating the brain’s reactivity to reward and an associated reduction in binge eating or overeating may be beneficial, the question remains whether interfering with the body’s internal cues is wise.

“These medications don’t allow people to experience their hunger cues and practice intuitive eating, which is an important goal in eating disorders treatment,” says Dr. Boswell.

GLP-1s and behavioral health

For those with eating disorders, the GLP-1s can be tempting as a form of restriction or compensatory behavior and may be misused.

“There’s no protocol in place to screen for eating disorders prior to prescribing GLP-1 receptor agonists,” says Dr. Boswell. “In addition, those taking these medications are not monitored for the psychological, social, or medical effects of malnutrition, which can be an issue at any body size.”

Because there is so little data at present, the responsibility falls to providers to screen for eating disorders, anxiety, depression, and malnutrition in people using the GLP-1s.

“As providers, we want patients to have bodily autonomy, and that can be achieved when they know all the pros and cons of a treatment.”

Rebecca Boswell, PhD

For providers with patients who may ask about these medications, Dr. Boswell notes that it is important to examine the potential health benefits in the context of metabolic disease, not just changes in body size. This is critical because the popularity of GLP-1 receptor agonists and their integration into social conversations can reinforce weight bias and the thinking that living in a larger body is problematic or not acceptable. Paired with the lack of data on long-term effects, this issue should give providers pause, at least until there is more research or perhaps advanced formulations, according to Dr. Boswell.

“As providers, we want patients to have bodily autonomy, and that can be achieved when they know all the pros and cons of a treatment,” explains Dr. Boswell. “Knowledge is power, particularly when living in a weight-biased world.”

Refer a patient

To schedule an evaluation for your patient, or to learn more about the Princeton Center for Eating Disorders program, call 888-437-1610.

About the Princeton Center for Eating Disorders

The Penn Medicine Princeton Center for Eating Disorders is an inpatient program for patients aged 8 to adult with acute eating disorders. Patients benefit from treatment for the physical, psychosocial, and nutritional aspects of their eating disorder, with immediate access to full-service care for any other medical needs. Princeton Center for Eating Disorders is approved by most insurance plans.

Follow us

Physician updates straight to your inbox

Subscribe to receive the latest clinical updates and news for physicians—including research highlights, case reports, and expert perspectives.