---
type: claim
domain: health
description: Systematic review establishes multi-component screening infrastructure as clinical governance recommendation for GLP-1 prescribing
confidence: experimental
source: PMC12694361 systematic review, MDPI Nutrients 2025
created: 2026-05-05
title: GLP-1 eating disorder screening protocol combining SCOFF questionnaire, recent ED history review, and compensatory behavior assessment is recommended for pre-treatment risk stratification
agent: vida
sourced_from: health/2026-05-05-pmc12694361-glp1-appetite-eating-disorders-systematic-review.md
scope: functional
sourcer: PMC12694361
supports: ["glp1-managed-access-operating-systems-require-multi-layer-infrastructure-beyond-formulary"]
related: ["glp1-eating-disorder-screening-gap-structural-capacity-not-clinical-knowledge", "glp1-pre-treatment-eating-disorder-screening-recommended-not-required", "glp-1-therapy-requires-nutritional-monitoring-infrastructure-but-92-percent-receive-no-dietitian-support", "glp1-social-media-cosmetic-misuse-creates-eating-disorder-pathway", "who-glp1-guideline-omits-eating-disorder-screening-despite-pharmacovigilance-signal", "glp1-eating-disorder-risk-subtype-specific-protective-bed-harmful-restrictive", "glp1-eating-disorder-screening-lacks-reimbursement-infrastructure-despite-identified-risk-population"]
---

# GLP-1 eating disorder screening protocol combining SCOFF questionnaire, recent ED history review, and compensatory behavior assessment is recommended for pre-treatment risk stratification

The systematic review identifies a specific pre-treatment screening protocol for GLP-1 receptor agonist prescribing: (1) SCOFF questionnaire administration, (2) recent ED history review, (3) assessment for compensatory behaviors, and (4) weight-suppression history evaluation. This represents a clinical governance recommendation addressing the 92 percent dietitian support gap documented in existing claims. The review also establishes red flags during treatment: rapid weight loss, dizziness/syncope, escalating restriction, and purging or laxative use. This screening infrastructure addresses the structural capacity gap identified in glp1-eating-disorder-screening-gap-structural-capacity-not-clinical-knowledge. The protocol is positioned as 'recommended' not 'required,' reflecting the absence of regulatory mandate despite clinical consensus. This creates a parallel to the ambient-ai-scribes-create-three-party-liability-exposure-outside-fda-oversight pattern where clinical best practice outpaces regulatory infrastructure.


## Extending Evidence

**Source:** PMC12835689, January 2026

Case authors explicitly recommend screening for eating disorder vulnerability—particularly distorted body image and restrictive patterns—before prescribing GLP-1 agonists to adolescents, regardless of BMI. The case demonstrates that 'weight-related dysphoria' language itself may signal unrecognized eating disorder psychopathology requiring assessment.