GLP-1 medications, disordered eating, and the clinical risks Australia isn’t talking about
There is a version of the GLP-1 story that is entirely positive. Millions of people with obesity, type 2 diabetes, and cardiovascular disease are experiencing genuine clinical benefit from a class of medications that work in ways previously thought impossible. For many, the psychological relief alone — the quieting of what patients and marketers alike have taken to calling “food noise” — has been profound.
But there is another version of the story that is receiving far less attention.
It concerns a population that was barely considered when these medications became a cultural phenomenon: the more than one million Australians already living with a diagnosed eating disorder, and the far larger number living with disordered eating that has never been formally named.
Where we are: disordered eating in Australia in 2025
The Butterfly Foundation’s Paying the Price 2024 — the most comprehensive analysis of eating disorders in Australia in more than a decade — found that an estimated 1.1 million Australians are living with a diagnosed eating disorder. That represents a 21% increase since the previous report in 2012. The economic cost has grown by 36% over the same period, to approximately $69.7 billion per year.
These figures capture only diagnosed conditions. The number of Australians experiencing clinically significant disordered eating — restrictive patterns, binge-purge cycles, obsessive food rituals, or deeply disordered relationships with body and weight that fall short of a formal diagnosis — is substantially higher.
Women are disproportionately affected: two-thirds of those with diagnosed eating disorders are female. Young people bear the heaviest burden, with prevalence highest in the 15–19 age bracket, where up to 12% of adolescents had an eating disorder in 2023. But the idea that eating disorders are primarily a young woman’s condition is increasingly outdated. Presentations are rising across genders, age groups, and socioeconomic backgrounds.
Enter the GLP-1 medications
Since 2020, the use of GLP-1 receptor agonists — the drug class that includes semaglutide and tirzepatide — has grown almost ten-fold in Australia, reaching approximately half a million units dispensed every month by 2024/25, according to a longitudinal study published in medRxiv in late 2025. Close to 500,000 Australians — roughly 2% of the adult population — are now using these medications.
The semaglutide formulation specifically approved for weight loss reached the Australian market in August 2024. The PBAC has since recommended PBS listing for further populations, including those with established cardiovascular disease and obesity. Broader subsidised access is expected to accelerate uptake significantly.
These medications work, in part, by acting on the brain’s reward and appetite circuits — reducing not just physical hunger but the intrusive, persistent thoughts about food that many patients describe as consuming. Clinicians and researchers have recently formalised a term for this experience: “food noise” — defined in a 2025 peer-reviewed paper in Nutrition & Diabetes as “persistent thoughts about food that are perceived by the individual as unwanted and/or dysphoric.” The pharmaceutical industry has leaned heavily into this language, positioning the constant pull toward eating as a problem to be medically silenced.
It is here that clinicians working in eating disorder settings have become concerned.
The problem with silencing hunger
Laura Smolcic, an Australian psychologist with more than two decades of experience in eating disorder clinical practice, has been direct about the cultural shift these medications represent. “I think the GLP-1 drugs and what we are currently seeing in terms of extreme weight loss is just taking us backwards,” she told The Nightly in 2026 — backwards, she means, toward a cultural framework that treats hunger as a flaw and thinness as the goal.
The framing of hunger as noise — unwanted, pathological, something to be suppressed — is not clinically neutral. For someone with a history of restrictive eating, it validates the disordered belief that has driven their illness: that hunger is an enemy, that eating less is always better, that the goal is to need food as little as possible.
Clinical evidence is starting to reflect this. A 2024 case report in the Journal of Clinical Psychopharmacology documented a woman with a history of anorexia who deliberately exceeded her prescribed GLP-1 dose in order to accelerate weight loss, resulting in multiple emergency hospital admissions for malnutrition. She persistently refused nutrition even during hospitalisation.
Australian researchers are among those documenting this pattern. A 2025 narrative review led by researchers at the University of Melbourne and La Trobe University found that GLP-1 medications can “reactivate” restrictive patterns in people with a history of anorexia — including cases where tirzepatide appeared to unlock disordered thinking that had been dormant for years. One case involved a woman who relapsed into full anorexia after a decade of recovery following the prescription of a GLP-1 medication for an unrelated metabolic condition.
In Australia, the Therapeutic Goods Administration (TGA) updated its safety warnings for all GLP-1 medications in late 2025, directing clinicians to monitor patients for worsening depression and unusual changes in mood or behaviour. The TGA warnings do not yet specifically address eating disorder risk, which is precisely the gap that clinicians in this field are calling attention to.
The Butterfly Foundation — Australia’s leading national eating disorder organisation — has consistently emphasised that eating disorders require specialist assessment that goes well beyond weight and appetite metrics, and that any intervention affecting hunger signalling warrants careful consideration for those with a history of disordered eating. Professor Phillipa Hay, Chair of Mental Health at Western Sydney University and one of Australia’s foremost eating disorder researchers, has noted that fewer than 20% of Australians with an eating disorder currently seek appropriate treatment — meaning the population at unidentified risk from GLP-1 prescribing is far larger than clinical caseloads suggest.
A 2025 narrative review published in Nutrients, drawing on studies from 2015 to September 2025, concluded that GLP-1 medications “may shape eating behaviours, emotions, and body image, raising new challenges for eating disorder research and clinical care” — and called for far greater caution in how they are prescribed in populations with vulnerability to disordered eating.
It is a perspective shared by Raindrum’s Clinical Director, Dr Tonya Coren, who sees the limits of pharmacology play out in clinical practice.
“A prescription can change someone’s appetite within a fortnight. It cannot change their relationship with food, their body, or the reasons they were struggling in the first place — and when those things go unaddressed, the weight loss is rarely the end of the story.”
A distinction that matters: binge eating is not the same as eating disorder recovery
One area where the picture is genuinely more complex concerns binge eating disorder (BED). Several short-term studies have found that GLP-1 medications can reduce the frequency of binge episodes — and for some patients, this represents meaningful relief from a condition that is deeply distressing and difficult to treat.
But clinicians and researchers have been careful to draw a distinction that the popular coverage of these findings often obscures: a reduction in binge frequency is not eating disorder recovery. Binge eating disorder involves not just behavioural patterns but the emotional dysregulation, shame, and loss of control that drive them. A medication that suppresses appetite may interrupt the behaviour while leaving the underlying architecture of the disorder entirely intact — and may, in some individuals, shift the clinical picture from binge eating toward restriction.
The randomised controlled evidence is also more modest than the headlines suggest. The one RCT conducted specifically in patients with BED found no significant change in eating disorder behaviours. Researchers at the University of Melbourne noted in their 2025 review that evidence on the long-term psychological effects of these medications in people with eating disorders remains “almost entirely absent.”
For the person sitting with a deeply painful relationship with food, the distinction matters enormously. Eating less is not the same as eating well. And the absence of a binge is not the presence of recovery.
Who is most at risk
The population of greatest clinical concern is not only those with a current diagnosis. People with a history of restrictive eating disorders — even those in long-term recovery — are particularly vulnerable. GLP-1-induced appetite suppression can reactivate disordered patterns that were managed but never fully resolved, sometimes after years of stability. The cases documented in clinical literature are not outliers; they are early signals from a field that has not yet had time to properly study this.
People using these medications without adequate clinical oversight face a different but related risk. In Australia, a significant proportion of GLP-1 prescriptions — particularly through private channels — occur without systematic screening for eating disorder history or mental health vulnerability. A patient who presents to a GP with weight concerns and leaves with a semaglutide prescription, without any assessment of their relationship with food, is a patient whose risk has been neither identified nor managed.
Then there is the dimension that clinical literature is only beginning to catch up with: social media. TikTok and Instagram have become primary vectors for GLP-1 culture among young Australians, normalising appetite suppression, celebrating rapid weight loss, and reframing hunger as a weakness to be pharmacologically overcome. For adolescents and young adults — precisely the demographic in whom eating disorders have their highest prevalence — this cultural saturation is not a backdrop to the clinical risk. It is part of it.
Finally, anyone on GLP-1 therapy who is experiencing severe caloric restriction warrants urgent clinical attention. A 2025 review in Obesity Reviews found that some patients were consuming fewer than 800 calories per day during treatment, with many receiving inadequate nutritional guidance. That level of intake is not a side effect to monitor. It is a clinical emergency in the making.
What good care looks like
None of this is an argument against GLP-1 medications. For appropriate populations, with appropriate clinical oversight, they offer genuine benefit. The argument is for something more straightforward: that eating disorder risk should be a standard part of the assessment before these medications are prescribed, and that nutritional and psychological support should be integrated — not optional — throughout treatment.
For people who are already navigating a difficult relationship with food, body image, or weight — whether or not that relationship has a formal diagnosis — a pharmaceutical intervention that further disrupts hunger signalling and accelerates weight loss is not a neutral event. It requires clinical attention that, at present, most people are not receiving.
A note from Raindrum
Disordered eating sits at the intersection of the physical, psychological, and deeply personal. At Raindrum, programs addressing eating disorders are built around the full picture — the medical and nutritional dimensions that require clinical management, the psychological architecture underneath that drives the behaviour, and the individual history that explains how someone arrived here. That integration is not incidental to the work. It is the work.
GLP-1 medications may be part of the picture for some of the people who come to us. What matters is that they are assessed, understood, and managed within a program that treats the whole person — not just the symptom the prescription was written for.
If you or someone you know is struggling with their relationship with food, weight, or body image — whether or not GLP-1 medications are part of the picture — a confidential conversation with our team costs nothing and commits you to nothing.
1300 007 607 | programs@raindrum.com.au | raindrum.com.au
Raindrum — Private Rehabilitation, Byron Bay NSW
Sources
Butterfly Foundation, Paying the Price 2024: The Economic and Social Impact of Eating Disorders in Australia — butterfly.org.au
Deloitte Access Economics / Butterfly Foundation (2024) — eating disorder prevalence and cost data — eatingdisorders.org.au
Meyn et al. (2025), The GLP-1 RA boom: Trends in publicly subsidised and private access in Australia, 2020–2025, medRxiv — medrxiv.org
PBS/PBAC, Advice on equitable access to GLP-1 obesity treatments (November 2025) — pbs.gov.au
Therapeutic Goods Administration (TGA), GLP-1 RAs: warnings aligned over potential risk of suicidal thoughts or behaviours (December 2025) — tga.gov.au
Krug I, Dang AB et al. (November 2025), Beyond Weight Loss: GLP-1 Usage and Appetite Regulation in the Context of Eating Disorders and Psychosocial Processes, Nutrients — University of Melbourne & La Trobe University — mdpi.com/2072-6643/17/23/3735
Bartel S et al. (2024), Use of GLP-1 receptor agonists in eating disorder populations, International Journal of Eating Disorders — doi.org/10.1002/eat.24109
Professor Phillipa Hay, Western Sydney University Eating Disorders and Body Image (EDBI) group — westernsydney.edu.au
Laura Smolcic, eating disorder psychologist, cited in The Nightly, April 2026 — thenightly.com.au
Obesity Reviews (2025), nutritional guidance and caloric restriction in GLP-1 users
Journal of Clinical Psychopharmacology (2024) — case report, anorexia and GLP-1 misuse
This article is for informational purposes only and does not constitute medical advice. If you are currently taking or considering GLP-1 medication and have a history of disordered eating, please discuss this with a qualified medical practitioner.
