Emerging evidence suggests some people with eating disorders are misusing weight-loss drugs. GLP-1 weight-loss drugs are one of the biggest biotech breakthroughs of the last decade. But to some clinical psychologists, they can represent something more sinister—a potential trigger for eating disorders.
A new report suggests that the global incidence of anorexia nervosa and bulimia nervosa shot up between 1990 and 2023—by a whopping 71%. By 2023, there were an estimated 18.1 million people living with one of these two disorders. And, disturbingly, those in the field are already starting to see GLP-1 weight-loss drugs exacerbating the issue.
Cheri Levinson is a clinical psychologist at the University of Louisville in Kentucky who has specialized in eating disorders for almost 20 years. She says she’s now seeing more patients with more severe symptoms than at any other time in her career, and that many of them are misusing GLP-1s. “This is the worst I’ve seen things,” she says. Eating disorders are mental health conditions in which people’s eating behaviors impact their health.
They include anorexia nervosa (defined by a fear of weight gain), bulimia nervosa (in which people binge and purge), binge eating disorder, and others. It’s thought that some people have a genetic predisposition to certain eating disorders, but that some external factor is what triggers their onset. That might be stress, or social pressure to be skinny.
Often, simply restricting food intake can trigger an eating disorder, says Levinson. Eating disorders—along with the pressure to look thin—were already prevalent in the 1990s (the heroin chic era springs to mind). Ruhai Bai at the Children’s Hospital of Nanjing Medical University in China and his colleagues pulled together data from studies and surveys conducted on populations around the world.
The team used statistical models to fill in any data gaps. That research allowed the researchers to estimate the annual incidence of two eating disorders—anorexia nervosa and bulimia nervosa—for each of 204 countries and territories between 1990 and 2023. They also estimated the impact those disorders had on global health by calculating their disability-adjusted life years (one DALY represents a year of healthy life lost).
The findings, published in JAMA Psychiatry on Wednesday, are unsettling. Between 1990 and 2023, there was a 71% increase in the incidence of those two eating disorders, the team found. Those conditions had a huge impact on global health, too.
In 2023, they “cost the world the equivalent of about 3.83 million years of healthy life,” says Bai. Bai and his colleagues expect these figures to continue to rise. In 2023, an estimated 18.1 million people had either anorexia nervosa or bulimia nervosa; by 2050, the team predict, the two conditions could affect 21.8 million people.
It gets worse. Those two conditions represent less than half of all eating disorders, says Levinson, who was not involved in Bai’s study. The true impact of these disorders is “probably three times the rate that they’re reporting,” she says.
Social media may have played a role in the rise. “Social media comparisons, influencers, challenges, diet trends can all be precipitating ... events for an eating disorder,” says Cynthia Bulik, a clinical psychologist at the University of North Carolina, who was not involved in the new study. Bulik has been studying and treating eating disorders since the early 1980s. “Between 1990 and 2023 there has clearly been an upsurge of those types of environmental exposures,” she says. Many social media users are exposed to filtered and edited content that can trigger unhealthy comparisons and behaviors.
Source: MIT Technology Review · Summarized by HeadlinesBriefing