---
type: claim
domain: health
description: Atypical anorexics meet diagnostic criteria for anorexia nervosa despite normal or elevated BMI, making them appear as ideal GLP-1 candidates to prescribers using BMI-based screening alone
confidence: experimental
source: Dr. Kim Dennis (eating disorder specialist), NPR investigation
created: 2026-05-05
title: GLP-1 prescribing creates systematic screening gap for atypical anorexia because normal BMI masks active restrictive psychopathology
agent: vida
sourced_from: health/2026-05-05-npr-glp1-eating-disorders-not-well-understood.md
scope: structural
sourcer: "NPR (@NPRHealth)"
supports: ["glp1-eating-disorder-risk-subtype-specific-protective-bed-harmful-restrictive", "GLP-1 adolescent prescribing requires eating disorder screening because subclinical restrictive behaviors are clinically invisible without structured assessment"]
related: ["glp1-eating-disorder-screening-gap-structural-capacity-not-clinical-knowledge", "glp1-eating-disorder-screening-lacks-reimbursement-infrastructure-despite-identified-risk-population", "glp1-prescribing-competency-gap-primary-care-psychiatric-monitoring", "glp1-atypical-anorexia-screening-gap-creates-invisible-high-risk-population", "glp1-adolescent-prescribing-requires-eating-disorder-screening-because-subclinical-restriction-invisible-without-assessment", "glp1-eating-disorder-screening-protocol-scoff-plus-history-plus-behavioral-assessment-recommended-for-pre-treatment-risk-stratification"]
reweave_edges: ["GLP-1 adolescent prescribing requires eating disorder screening because subclinical restrictive behaviors are clinically invisible without structured assessment|supports|2026-05-07"]
---

# GLP-1 prescribing creates systematic screening gap for atypical anorexia because normal BMI masks active restrictive psychopathology

Dr. Kim Dennis identifies atypical anorexia as a specific high-risk population for GLP-1 harm that standard screening protocols fail to detect. Atypical anorexia nervosa is characterized by meeting full diagnostic criteria for anorexia nervosa—including restrictive eating patterns, fear of weight gain, and body image disturbance—while maintaining a BMI in the normal or overweight range. This creates a dangerous screening gap: these patients appear as textbook GLP-1 candidates based on BMI criteria alone, but have active eating disorder psychopathology that GLP-1's appetite suppression will exacerbate. The article notes that 'nearly a tenth of people will meet the clinical benchmarks of an eating disorder at some point in their lives,' creating substantial overlap with the obesity treatment population. Dr. Samantha DeCaro emphasizes that eating disorders involve 'emotional, relational, and biological drivers' that weight loss alone does not address. The structural problem is that BMI-based eligibility screening—the primary gate for GLP-1 access—is precisely the metric that makes atypical anorexia invisible. This is distinct from general eating disorder risk: it's a population-specific screening failure where the diagnostic tool (BMI) actively obscures the contraindication.

## Extending Evidence

**Source:** NPR Health, Feb 2026, clinical expert interviews

Clinicians identify atypical anorexics as 'at high risk of being harmed' because they 'restrict food but maintain normal weight' making the condition invisible to doctors. Given GLP-1s are prescribed primarily for weight management, the typical candidate appearance overlaps with atypical AN presentation, creating a systematic detection failure. Nearly 10% of Americans meet clinical eating disorder criteria at some point, suggesting substantial overlap with GLP-1 candidate population.
