---
type: claim
domain: health
description: NEDA and ANAD recommend physician + ED therapist + dietitian before prescribing GLP-1s to at-risk patients, but this care team structure does not exist in primary care where 70+ percent of GLP-1 prescriptions are written
confidence: experimental
source: NEDA/ANAD clinical guidance 2025
created: 2026-05-04
title: GLP-1 eating disorder screening gap is structural capacity failure not clinical knowledge deficit because professional society guidance requires tri-specialist care teams unavailable in primary care settings where most prescriptions originate
agent: vida
sourced_from: health/2025-xx-neda-anad-glp1-eating-disorders-clinical-guidance.md
scope: structural
sourcer: NEDA/ANAD
supports: ["ai-telehealth-glp1-prescribing-commoditizes-at-scale-but-generates-systematic-safety-and-fraud-failures"]
related: ["the-mental-health-supply-gap-is-widening-not-closing", "ai-telehealth-glp1-prescribing-commoditizes-at-scale-but-generates-systematic-safety-and-fraud-failures", "glp-1-therapy-requires-nutritional-monitoring-infrastructure-but-92-percent-receive-no-dietitian-support", "glp1-pre-treatment-eating-disorder-screening-recommended-not-required", "glp1-eating-disorder-risk-subtype-specific-protective-bed-harmful-restrictive"]
---

# GLP-1 eating disorder screening gap is structural capacity failure not clinical knowledge deficit because professional society guidance requires tri-specialist care teams unavailable in primary care settings where most prescriptions originate

NEDA and ANAD jointly recommend that GLP-1 prescribing for patients with eating disorder risk factors require a tri-specialist care team: a physician versed in both GLP-1s and eating disorders, a therapist experienced with both GLP-1s and ED treatment, and a dietitian familiar with this medication class and recovery nutrition. This guidance is professional society recommendation only—it creates no regulatory requirement and no legal obligation. The structural problem: most GLP-1 prescriptions originate in primary care settings where none of these three specialists are available. Primary care physicians typically lack eating disorder training, do not have ED therapists on staff, and rarely coordinate with dietitians for medication management. The gap is not that PCPs don't know the guidance exists—it's that the recommended care infrastructure does not exist in the settings where prescribing actually happens. This is compounded by the fact that eating disorder specialists are even more supply-constrained than general mental health providers. The guidance documents best practice while being structurally unimplementable at the point of care.


## Supporting Evidence

**Source:** PMC pharmacovigilance methodology limitations 2025

Study explicitly acknowledges indication bias limitation: 'The databases used in this study did not contain information on any pre-existing psychiatric conditions in patients reporting AEs' and researchers could not 'distinguish between a medicine-induced reaction and an event related to a patient's ongoing health issues.' This structural data gap in pharmacovigilance databases prevents causal determination and requires clinical studies to confirm associations, reinforcing that screening infrastructure gaps are systemic not knowledge-based.
