Growing concerns as GLP-1 weight-loss medicines rekindle old eating disorder fears

The rise of GLP-1 weight-loss drugs is intensifying cultural pressures around thinness, prompting fears among eating disorder experts that vulnerable individuals may face increased risks amid aggressive marketing and minimal oversight.

For Gabriela Ponce, the surge in popularity of GLP-1 weight-loss medicines has revived memories she would rather leave behind. After years of treatment for bulimia and anorexia, the New York-based mother said the renewed celebration of thinness feels deeply familiar, and deeply unsettling, because it echoes the same pressures that helped drive her into an eating disorder as a teenager.

Ponce said the cultural pull towards slimness was already powerful when she was growing up in Latin America, where body image carried heavy social value. But she said magazine covers, celebrity fitness routines and diet messaging in the 1990s hardened those expectations into something harder to resist. “It was so embedded in the culture that it was hard to escape,” she said.

Now, she said, the rise of GLP-1 medicines has intensified that atmosphere. Seeing acquaintances use the drugs to change their bodies quickly, and seeing public figures such as Serena Williams associated with telehealth brands that promote the medicines, has made recovery feel more fragile. Her social media feeds, she said, are crowded with advertisements from companies selling the drugs, including some that appear to offer limited mental-health screening or follow-up care.

Eating-disorder specialists say that concern is not anecdotal. Samantha DeCaro, a psychologist at The Renfrew Center in Philadelphia, warned that the easy availability of these medications can be dangerous for people with an eating disorder history or those at risk of developing one. She said some patients may be harmed by the drugs’ effects on appetite and body image, particularly when access is coupled with aggressive marketing and minimal oversight. Separately, Penn Medicine has reported that Rebecca Boswell, who directs the Princeton Center for Eating Disorders, has raised concerns about the lack of screening protocols before GLP-1 prescribing and the absence of monitoring for psychological and medical consequences linked to malnutrition.

The clinical evidence is still catching up with the pace of use. A study indexed in PubMed says GLP-1 receptor agonists are being adopted rapidly for weight management, with effects on appetite, satiety and eating behaviour that may have consequences for people with eating disorders. The National Eating Disorders Association has also warned that the medicines can be misused by people with restrictive patterns, potentially worsening malnutrition and disrupting regular meals. Experts writing in Wiley’s World Psychiatry have called for careful screening, closer monitoring and more research before the drugs are used in this context. For Ponce, the worry is less about the medicines themselves than the culture forming around them: one in which thinness is once again being sold as health, and for some people, that message is anything but benign.