---
type: claim
domain: health
description: Clinicians disagree on whether EDs develop in properly-prescribed GLP-1 patients, with divergence driven by screening practices and patient population differences rather than resolved evidence
confidence: experimental
source: NBC News 2024, contrasting expert opinions from Dr. Aaron Keshen and Dr. Anjali Pandit
created: 2026-05-05
title: Expert divergence on GLP-1 eating disorder causality reflects fundamental evidence gap between clinical pattern recognition and epidemiological confirmation
agent: vida
sourced_from: health/2026-05-05-nbcnews-eating-disorders-rise-glp1-wegovy-zepbound.md
scope: structural
sourcer: NBC News
supports: ["glp1-eating-disorder-screening-gap-structural-capacity-not-clinical-knowledge"]
related: ["glp1-eating-disorder-pharmacovigilance-signal-class-effect-obesity-population-specific", "glp1-eating-disorder-screening-gap-structural-capacity-not-clinical-knowledge", "glp1-pre-treatment-eating-disorder-screening-recommended-not-required", "glp1-eating-disorder-risk-subtype-specific-protective-bed-harmful-restrictive", "glp1-psychiatric-effects-directionally-opposite-metabolic-versus-psychiatric-populations", "glp1-anorexia-nervosa-evidence-absent-despite-pharmacovigilance-signal", "glp1-eating-disorder-causality-expert-divergence-reflects-evidence-gap"]
---

# Expert divergence on GLP-1 eating disorder causality reflects fundamental evidence gap between clinical pattern recognition and epidemiological confirmation

Dr. Aaron Keshen reports EDs developing 'in people who take drugs as prescribed' supporting direct causality, while Dr. Anjali Pandit states 'not seeing this frequently' suggesting prescriber screening matters significantly. This is not a scientific debate about interpretation of shared data — it's a pre-data debate where different clinical populations and practices produce different observed patterns. Keshen's observation supports pharmacological causation; Pandit's suggests population selection (careful screening prevents cases). The divergence itself is evidence of the current state: we are in the clinical pattern recognition phase before systematic epidemiological data. NBC News notes 'no drug label warnings about ED risk currently exist' and the Collaborative of Eating Disorders Organizations is 'calling for mandatory screening before prescribing' — regulatory and professional responses to uncertainty rather than established risk. This represents the characteristic evidence gap where case reports accumulate but incidence rates, risk factors, and causal pathways remain unquantified.


## Supporting Evidence

**Source:** PMC12694361 systematic review

Systematic review characterizes current evidence state as 'low-to-moderate confidence throughout' with BED/BN findings 'preliminary' and restrictive ED evidence 'scarce and inconclusive.' Explicitly identifies methodological limitations: 'most studies are short-term, narrowly sampled, and methodologically limited.' Long-term follow-up data (>1 year) identified as missing.


## Extending Evidence

**Source:** NPR investigation, absence of cohort data

Article provides no quantitative incidence data, only qualitative expert opinion. Curator notes: 'The article is entirely qualitative/expert opinion—no cohort data.' This confirms that the evidence gap is not just about causality but about basic epidemiological measurement—we don't have population-level data on eating disorder incidence in GLP-1 users.


## Supporting Evidence

**Source:** STAT News, April 27, 2026

STAT News explicitly states 'actual research on this topic is scant' in April 2026 investigative feature. The article's framing around 'true risk' indicates ongoing debate about causality versus population selection. The ISPOR analysis provides incidence data but lacks control group, leaving the causal question unresolved.
