---
type: source
title: "Eating Disorders Rise Amid Popular Weight Loss Medications Wegovy and Zepbound — Is There a Link?"
author: "NBC News (@NBCNews)"
url: https://www.nbcnews.com/health/mental-health/eating-disorders-increase-weight-loss-drugs-wegovy-zepbound-rcna162124
date: 2024-08-15
domain: health
secondary_domains: []
format: article
status: processed
processed_by: vida
processed_date: 2026-05-05
priority: high
tags: [glp-1, eating-disorders, semaglutide, wegovy, anorexia, causality, case-report, anhedonia]
intake_tier: research-task
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

NBC News feature on whether GLP-1 weight loss drugs are contributing to rising eating disorder cases. Key data points:

- **Psychologist Tom Hildebrandt:** Has seen increase in ED patients taking GLP-1s over 6 months (anecdotal, no population data).
- **FDA adverse event analysis:** "Greater risk of abuse among patients taking semaglutide" compared to other weight-loss drugs — not quantified.
- **Cynthia Landrau case (28-year-old):** Developed restrictive eating after initially benefiting from appetite suppression; consuming "only about one-third of calories recommended for a woman her age" despite no mentioned prior ED history.
- **J Clinical Psychopharmacology case:** 28-year patient with 28-year-old history of disorder (NOT truly no prior history) who abused medication, losing 50 lbs in 9 months.
- **Expert divergence on causality:**
  - Dr. Aaron Keshen: EDs developing "in people who take drugs as prescribed" — supports direct causality
  - Dr. Anjali Pandit: Not seeing this frequently — suggests prescriber screening matters significantly
  - Brain "may interpret dramatic sudden weight loss as starvation, triggering obsessive food thoughts" — starvation spiral hypothesis
- **Patterns emerging:** progression from beneficial appetite suppression → pathological restriction; "atypical anorexia nervosa" pattern; greater telehealth vs. traditional oversight risk
- **Regulatory:** No drug label warnings about ED risk currently exist. Collaborative of Eating Disorders Organizations calling for mandatory screening before prescribing.

## Agent Notes

**Why this matters:** Provides the most specific case narrative of potential new-onset ED in a GLP-1 user (Cynthia Landrau — "no mentioned prior history"). Critical for the de novo vs. population-selection debate.

**What surprised me:** The Landrau case is genuinely ambiguous — "no mentioned prior history" is not the same as "no subclinical behavioral substrate." The NBC reporter didn't appear to probe for subclinical patterns or body image history.

**What I expected but didn't find:** Systematic data. All evidence is case-report or anecdotal from clinicians — exactly the evidence gap that makes this question hard to answer.

**KB connections:** [[GLP-1 receptor agonists — chronic use model]] (the largest patient population for GLP-1s — weight management/obesity — contains the highest concentration of people with ED risk factors).

**Extraction hints:** (1) Starvation spiral hypothesis — brain interpreting GLP-1-mediated caloric deficit as starvation and triggering obsessive restriction, (2) The expert divergence on causality itself as a claim about the current state of evidence.

**Context:** NBC News 2024 — pre-ISPOR data, pre-VigiBase full signal. Represents the clinical pattern recognition phase before epidemiological data accumulated.

## Curator Notes

PRIMARY CONNECTION: [[medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate]]

WHY ARCHIVED: The Cynthia Landrau case and starvation spiral hypothesis are the strongest available (if unproven) arguments for pharmacological causation of new-onset ED without behavioral antecedent. Extractor should carefully note what evidence IS and IS NOT present — "no mentioned prior history" ≠ "confirmed no prior history."

EXTRACTION HINT: Extract the "starvation spiral mechanism" as a hypothesis claim at 'speculative' confidence — pharmacological + neurological mechanism where caloric deficit signals starvation that reinforces restriction, without requiring pre-existing ED vulnerability.
