America’s weight loss boom has entered a darker phase. As injectable GLP-1 drugs like Ozempic and Wegovy explode in popularity, doctors and therapists say they are seeing something troubling alongside dramatic weight loss. Old eating disorders are returning, and entirely new ones are forming. Some clinicians now use a new term for what they are witnessing: agonorexia.
The reporting cited here originates with the New York Post and reporting by McKenzie Beard, drawing on interviews with doctors, therapists, and patients across the country.
A New Disorder Takes Shape
Doctors say agonorexia describes an obsessive relationship with food restriction and weight loss driven by GLP-1 agonists. These medications suppress appetite so effectively that they can turn food avoidance into a reinforced habit rather than a medical side effect.
“We’ve seen people that were prescribed these medications who have run into a slippery slope with it, bringing back their eating disorder symptoms and behaviors,” said Dr. Brad Smith, chief medical officer for The Emily Program. “We’ve also seen people who have developed more disordered eating or eating disorders as a result of these medications, even without having an eating disorder in the past.”
Smith emphasized that this goes beyond anything clinicians have seen before. “It’s exceeded anything in the past already,” he said. “They’ve certainly had a much higher impact than any of those previous substances.”
GLP-1 medications mimic gut hormones that regulate hunger and blood sugar. They slow digestion, reduce appetite, and quiet what many patients describe as “food noise,” the constant mental chatter about eating.
Doctors say that same effect can be dangerous for people vulnerable to eating disorders. “I’ve seen individuals say it’s a healthier way to engage in traditional eating disorder behaviors,” said psychologist Dr. Zoe Ross-Nash.
She warned that the medication often reinforces restriction even after the drug is stopped. “What the GLP-1 is encouraging are eating disorder behaviors,” she said. “So then it makes sense that when those behaviors are reinforced, they continue.”
Old Disorders Returning, New Ones Emerging
Clinicians report a resurgence of anorexia, bulimia, binge-purge cycles, and restrictive eating patterns that had been dormant for years. At the same time, patients without any eating disorder history are developing new fixations around food, calorie intake, and weight.
“It doesn’t just affect people who are in the throes of acute illness,” Smith said. “It can affect people who’ve been in recovery or have had good functioning for a long time.”
Several providers told the New York Post they have treated patients who actively sought GLP-1 drugs through telehealth platforms with minimal screening, even when they did not medically qualify.
Side Effects That Reinforce Harm
Gastrointestinal side effects play a major role. Nausea, vomiting, and stomach pain often lead to skipped meals or purging behaviors.
“When you’re nauseous, you don’t eat,” Ross-Nash said. “So not only are we restricting because we don’t feel good, but then we’re also purging the food that is in our system because we’re nauseous. Both restriction and purging behaviors are then reinforced by GLP-1s.”
Dr. Thea Gallagher of NYU Langone warned that rapid weight loss can distort perception and worsen body dysmorphia. “When you’re underweight, it can increase body dysmorphia and make those things even worse in the long run,” she said.
The Crash After Quitting
Many patients stop taking GLP-1 drugs within a year or two. Doctors say stopping can be just as destabilizing as starting.
“We’ve had clients come in who have developed a very negative body image and disordered eating,” said psychotherapist Sarah Davis. “Starting the medication and going off of it have been big turning points.”
Ross-Nash said weight regain after stopping the drug often triggers shame and relapse. “They’re going to be perceived as a failure, when, in reality, it’s the medication.”
One patient described lingering effects even after quitting. “I took this, and now I can’t get my body out of my mind,” Ross-Nash said. “I’m off the medication, and I still feel like it has taken over my entire life.”
Several experts expressed frustration that patients are rarely warned about eating disorder risks before starting GLP-1s.
“No one says, ‘Here’s your GLP-1. By the way, you might get an eating disorder,’” Ross-Nash said. “People get blindsided by it, and that’s where informed consent needs to be much stronger.”
Guidelines instruct doctors to ask about mental health history, but clinicians say this step is often skipped. Davis compared it to bariatric surgery, where psychological screening is standard. “Here, with this, that’s not really happening,” she said.
A spokesperson for Novo Nordisk, which manufactures semaglutide used in Ozempic and Wegovy, told the New York Post that “patient safety is our top priority” and emphasized the drugs’ proven benefits for obesity and metabolic disease.
Still, all six experts interviewed stressed the need for better screening and monitoring. They urged prescribers to consider personality traits like perfectionism, body dissatisfaction, and mental health history, including anxiety, depression, OCD, or substance use disorders, factors identified by the National Eating Disorder Association.
Dietitians and therapists should also be part of the treatment plan, even for patients without a known eating disorder. “Folks that are on these medications often need to get really creative about how they sustain their energy and preserve muscle mass,” said dietitian Rachel Naar.
Gallagher said the cultural conversation around GLP-1 drugs needs to change. “We need to be bringing the focus back to health,” she said. “Because losing weight, in and of itself, is not healthy.”
Smith echoed that concern, warning that appetite suppression can become mentally consuming. “We have to be really careful that it doesn’t become something that takes over the mind,” he said. “Because it absolutely can.”
As prescriptions surge, clinicians say awareness may be the only safeguard against turning a powerful medical tool into a trigger for lifelong psychological harm.
