Eating disorders are on the rise. GLP-1s could make things worse.

What’s worse is that the number is likely to be much higher than that once we factor in other eating disorders. And, disturbingly, those in the field are already starting to see GLP-1 weight-loss drugs exacerbating the issue.

Cheri Levinson is a clinical psychologist at the University of Louisville in Kentucky who has specialized in eating disorders for almost 20 years. She says she’s now seeing more patients with more severe symptoms than at any other time in her career, and that many of them are misusing GLP-1s. “This is the worst I’ve seen things,” she says.

Eating disorders are mental health conditions in which people’s eating behaviors impact their health. They include anorexia nervosa (defined by a fear of weight gain), bulimia nervosa (in which people binge and purge), binge eating disorder, and others.

It’s thought that some people have a genetic predisposition to certain eating disorders, but that some external factor is what triggers their onset. That might be stress, or social pressure to be skinny. Often, simply restricting food intake can trigger an eating disorder, says Levinson.

Eating disorders—along with the pressure to look thin—were already prevalent in the 1990s (the heroin chic era springs to mind). To find out how things might have changed since then, Ruhai Bai at the Children’s Hospital of Nanjing Medical University in China and his colleagues pulled together data from studies and surveys conducted on populations around the world. The team used statistical models to fill in any data gaps.

That research allowed the researchers to estimate the annual incidence of two eating disorders—anorexia nervosa and bulimia nervosa—for each of 204 countries and territories between 1990 and 2023. They also estimated the impact those disorders had on global health by calculating their disability-adjusted life years (one DALY represents a year of healthy life lost).

The findings, published in JAMA Psychiatry on Wednesday, are unsettling. Between 1990 and 2023, there was a 71% increase in the incidence of those two eating disorders, the team found. Those conditions had a huge impact on global health, too. In 2023, they “cost the world the equivalent of about 3.83 million years of healthy life,” says Bai.