teleo-codex/domains/health/glp1-eating-disorder-screening-recommended-not-mandated-creating-structural-safety-gap.md

type	domain	description	confidence	source	created	title	agent	sourced_from	scope	sourcer	related
claim	health	The gap between pharmacovigilance signal detection and clinical practice intervention mirrors SDOH screening adoption failure	experimental	NPR Health, February 2026, interviews with Robyn Pashby (psychologist) and Samantha DeCaro (clinician)	2026-05-04	GLP-1 eating disorder screening is recommended but essentially never practiced because no regulatory body mandates it and no reimbursement exists for the time required	vida	health/2026-02-04-npr-glp1-eating-disorders-anorexia-unknown-risks.md	structural	NPR Health	SDOH interventions show strong ROI but adoption stalls because Z-code documentation remains below 3 percent and no operational infrastructure connects screening to action value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk glp1-pre-treatment-eating-disorder-screening-recommended-not-required ai-telehealth-glp1-prescribing-commoditizes-at-scale-but-generates-systematic-safety-and-fraud-failures glp1-anorexia-nervosa-evidence-absent-despite-pharmacovigilance-signal glp1-eating-disorder-risk-subtype-specific-protective-bed-harmful-restrictive

GLP-1 eating disorder screening is recommended but essentially never practiced because no regulatory body mandates it and no reimbursement exists for the time required

Despite professional recommendations for eating disorder screening before GLP-1 prescription and documented pharmacovigilance signals (aROR 4.17-6.80 for eating disorders), most patients receive NO evaluation for eating disorders before prescription. The drugs are 'easy to obtain online, with little screening' according to clinicians interviewed. This represents a structural misalignment: the signal exists in pharmacovigilance data, professional guidelines recommend screening, but no regulatory body (FDA, CMS, state medical boards) mandates it, and no reimbursement mechanism exists for the time required to conduct proper psychiatric screening in primary care settings where most GLP-1s are prescribed. The result is that a known high-risk population (nearly 10% of Americans meet clinical eating disorder criteria at some point in their lives) receives a medication that 'suppresses natural hunger cues more profoundly' than earlier weight-loss drugs without any systematic screening to identify contraindicated patients. This mirrors the SDOH screening adoption failure documented in the KB: interventions that produce better outcomes but that no system rewards doing remain at negligible adoption rates despite evidence of benefit.