GLP-1 eating disorder risk doubles with prior mental health history creating identifiable high-risk population

The ISPOR study analyzed over 60,000 GLP-1 users and found cumulative eating disorder incidence of 1.275% across all users, with a critical stratification: GLP-1 users with prior mental health conditions had MORE THAN DOUBLE the eating disorder risk compared to GLP-1 users without mental health history. This is a within-GLP-1-users comparison, not a comparison to non-GLP-1 controls, meaning the study identifies a behavioral substrate that predicts differential risk among those prescribed the medication. The finding establishes prior mental health history as the primary risk stratifier for GLP-1-associated eating disorders, creating an identifiable high-risk population. However, the study lacks a non-GLP-1 control group, so it cannot establish whether GLP-1 elevates absolute eating disorder risk above baseline in weight-management-seeking populations. The eating disorders were mainly anorexia nervosa diagnoses.