Weight-loss drugs: why mental health matters in the use of GLP-1 medicines

GLP-1 medicines have moved in just a few years from a mainly clinical setting, linked to the treatment of type 2 diabetes and certain cases of obesity, into the broader social conversation around weight, eating habits and body image. Their use has grown, but it has also opened an important debate about how they are prescribed, who receives them and what kind of follow-up they require. This week, a study published in JAMA Psychiatry focused on a particularly vulnerable group: people with eating disorders.

What GLP-1 medicines are and why they have become so prominent

GLP-1 receptor agonists are medicines that mimic the action of a hormone involved in the regulation of glucose, satiety and gastric emptying. In practice, they help improve metabolic control, increase the feeling of fullness and can reduce appetite. That is why they are used to treat type 2 diabetes and, in some cases, as part of the medical management of obesity. When there is a clear indication and appropriate supervision, they can become a very useful tool for patients who have not been able to improve their condition through lifestyle changes alone or who have complications associated with excess weight.

When the expected effect takes on another meaning

The problem appears when that same mechanism comes into contact with a damaged relationship with food. In a person with obesity and metabolic risk, feeling less hungry can be part of the expected effect. In someone with a history of anorexia, bulimia, binge eating, food restriction or simply an intense fear of gaining weight, that effect can take on a different meaning. Rapid weight loss, reduced intake or the feeling of control over the body can reinforce patterns linked to the disorder, make recovery more difficult or contribute to relapse.

What the JAMA Psychiatry study adds

The study published in JAMA Psychiatry on June 24, 2026 specifically analyzes the use of these medicines among people with eating disorders. The research, carried out in the United States with 436 participants, found that 32.1% had used GLP-1 receptor agonists at some point, while 22% were using them at the time of the study. In addition, 10.1% reported some form of misuse, such as changing the dose, extending treatment beyond what had been indicated, manipulating the injection device or sharing it with other people.

Beyond the figures, the value of the study lies in the warning signal it raises. In people with eating disorders, these medicines may be used to sustain restrictive behaviors, accelerate weight loss or reinforce a sense of control over eating. The research itself has limitations, as it is based on self-reporting and a specific sample, but it serves as a reminder that the use of GLP-1 medicines cannot be separated from a patient’s psychological state, clinical history and relationship with food.

Before prescribing, professionals also need to ask

That is why, before starting this type of treatment, it is important to assess more than body mass index or metabolic markers. Asking about previous episodes of eating disorders, binge eating, severe restriction or fear of regaining weight can help detect warning signs. This evaluation should not be understood as a barrier, but as a way to protect the patient and adapt the intervention to their reality.

Follow-up throughout the process is also important. Loss of appetite, changes in eating habits or weight reduction can alter the way a person relates to their body. In vulnerable patients, monitoring makes it possible to identify problematic behaviors in time and, when necessary, adjust goals, review expectations and coordinate care with Psychology and Nutrition professionals. Pharmacological treatment should not move forward in isolation from the patient’s emotional and nutritional context.

The weight of social pressure

Another important factor is social pressure. The popularity of these treatments has grown at the same time as social media has filled with images of celebrities showing visible thinness, testimonies of physical changes in a short period of time and messages that present weight loss as an almost immediate goal. This environment can particularly affect young people and those with a fragile relationship with eating or body image. When the medicine becomes a symbol of easy and rapid weight loss, the problem is no longer only in the prescription, but also in the meaning it takes on for the person using it.

Neither trivializing nor demonizing

Health communication has an essential role here. Talking about GLP-1 medicines requires avoiding two extremes: trivializing them as if they were just another cosmetic resource, or demonizing them as if their use were always problematic. In reality, their value depends on the clinical context, the indication and the follow-up. For many people, they can bring real improvements in metabolic health, mobility or quality of life. For others, especially when there is an active or previous eating disorder, they may intensify harmful thoughts and behaviors that were already present.

Health does not fit into one number

In this scenario, patient education is just as important as the pharmacological plan. Explaining what can be expected from treatment, which signs should be discussed with a professional and why weight loss should not become the only indicator of progress helps prevent inappropriate use and build safer goals.

This debate reflects an increasingly clear reality in healthcare: pharmacological advances need professionals capable of interpreting them with judgment. A medicine can be safe and effective for many people, while requiring caution in others. The difference lies in the indication, the clinical history, the follow-up and the ability to detect when a physical benefit may be accompanied by psychological harm.

GLP-1 medicines should not be presented as either a threat or a universal solution. They are a relevant medical tool with proven benefits in suitable patients, but their use requires a broader perspective. In the case of eating disorders, that perspective is essential. Taking care of health is not only about changing numbers, reducing sizes or reaching metabolic targets. It also means building sustainable habits and protecting the relationship with food, the body and one’s own mind.