GLP-1 eating disorder screening protocol combining SCOFF questionnaire, recent ED history review, and compensatory behavior assessment is recommended for pre-treatment risk stratification

The systematic review identifies a specific pre-treatment screening protocol for GLP-1 receptor agonist prescribing: (1) SCOFF questionnaire administration, (2) recent ED history review, (3) assessment for compensatory behaviors, and (4) weight-suppression history evaluation. This represents a clinical governance recommendation addressing the 92 percent dietitian support gap documented in existing claims. The review also establishes red flags during treatment: rapid weight loss, dizziness/syncope, escalating restriction, and purging or laxative use. This screening infrastructure addresses the structural capacity gap identified in glp1-eating-disorder-screening-gap-structural-capacity-not-clinical-knowledge. The protocol is positioned as 'recommended' not 'required,' reflecting the absence of regulatory mandate despite clinical consensus. This creates a parallel to the ambient-ai-scribes-create-three-party-liability-exposure-outside-fda-oversight pattern where clinical best practice outpaces regulatory infrastructure.

Extending Evidence

Source: PMC12835689, January 2026

Case authors explicitly recommend screening for eating disorder vulnerability—particularly distorted body image and restrictive patterns—before prescribing GLP-1 agonists to adolescents, regardless of BMI. The case demonstrates that 'weight-related dysphoria' language itself may signal unrecognized eating disorder psychopathology requiring assessment.