‘Very worrying’: Study sounds alarm on GLP-1 misuse

Up to one-third of patients with eating disorders could be using GLP-1 RAs to maintain ‘rapid dietary restriction’, according to alarming international findings.
 
New research out of the United States analysed 436 patients with eating disorders, finding 32.1% had used a GLP-1 RA, and 22% are currently using them.
 
Australian experts say the research shines a spotlight on the importance of GPs conducting in-depth screening of patients before they start the weight-loss medications, as well as asking if they are accessing drugs from other sources.
 
The research also found that 10.1% of those surveyed had misused GLP-1 RAs, and 9.9% had used compounded products.
 
‘GLP-1 RA pharmacovigilance is urgently needed as the commercial market expands from injectable to oral products and new formulations,’ the study concluded.
 
‘People with eating disorders are also navigating a rapidly evolving risk environment of compounded GLP-1 RAs that are easily obtained without medical or regulatory oversight.’
 
Dr Karen Spielman, a GP with a special interest in eating disorders, said that while the research was not done with Australian patients, and the US market differs greatly, the results still ‘scare the living daylights out of me’.
 
‘We need to be thinking about it in the context of how one manages the complex comorbidities, such as in binge eating disorder, but it’s very worrying in atypical anorexia, which is a dangerous, restrictive illness that can happen in people at normal or higher body weight,’ she told newsGP.
 
‘People present more for help with weight loss than they do with eating disorders, so we’re going to have a significant proportion of people presenting for weight management who have got clinically significant eating disorders.
 
‘The biggest message that I’d really like to get across to my colleagues is that if you are not screening for eating disorders in people who are presenting for weight loss, then you are doing harm.
 
‘As GPs with patients presenting for help with weight management, we must be screening them for eating disorders and be very, very cautious in that population.’
 
In Australia, sales of GLP-1 medications increased almost tenfold between May 2020 and April 2025, with 500,000 people, almost 2% of the adult population, using the medicines every month.
 
These legal sales are occurring alongside a flourishing illicit market, with the Therapeutic Goods Administration so concerned about unapproved peptide use in Australia, it has made the issue a compliance priority.
 
The US analysis came on the same day as research from private health insurer, Bupa, found 19% of Australians surveyed would consider using medications such as Ozempic if they wanted to lose weight.
 
Dr Kristi Griffiths is Senior Research Fellow at the InsideOut Institute, Australia’s national eating disorder research centre, and is currently conducting similar research.
 
Echoing Dr Spielman’s calls, she said screening is crucial, as well as GPs creating a safe space for people to disclose information about an eating disorder or medication use.
 
‘There is a lot of fear: patients feeling that they’ll be denied if they do disclose,’ Dr Griffiths told newsGP.
 
‘But they need to know that just because I say that I have difficulties with a relationship with food, doesn’t mean they’ll be denied this, I’ll just be given extra support.
 
‘I don’t think it’s about saying no, you can’t have it, it’s about harm minimisation and making sure people are taking it safely.’
 
Last year, 15% of GPs said they have multiple patients each day asking about weight-loss medications, a further 32% were asked once a day, and 36% were asked once each week.
 
And with interest in these drugs showing no sign of slowing down, Dr Spielman acknowledges her calls for in-depth screening comes at a time when GPs are increasingly time poor.
 
‘We’re being asked to do more and more with less and less time, and more and more complexity,’ she said.
 
‘It’s very easy for me to say, “take your time, do our assessment, get to know your patient”, but we all know the real pressures that GPs are under.
 
‘There is such a tension between doing the right thing and staying afloat.’
 
Dr Spielman recommends GPs use the InsideOut Institute’s screening tool to help assess patients.
 
The US researchers say more data is now needed to provide ‘more precise estimates among eating disorder subtypes, evaluate demographic differences, and examine key correlates, such as patterns of misuse, sources of acquisition, reasons for use, off-label use, and marketing exposures’.
 
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eating disorders GLP-1 RAs weight loss