Poster Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2026

A systematic scoping review of eating disorders and obesity: overlap, risks and integrated management in the era of incretin-based anti-obesity therapies (#128)

Mohammad Riashad Monjur 1 , Chantale Boustany 2 , Milan Piya 1 3 , Phillipa Hay 1 3
  1. South Western Sydney Metabolic Rehabilitation and Bariatric Program, Sydney
  2. Mental Health Research and Teaching Unit, South Western Sydney Local Health District, Sydney
  3. Western Sydney University, Sydney

Background

Eating disorders (EDs)/disordered eating behaviours (DEBs) commonly intersect with obesity, yet clinical pathways for each have been siloed. The advent of GLP1 receptor agonists (GLP1-RAs) and related medications has raised concern about safe prescribing in adults with, or at risk of, EDs. This systematic scoping review mapped contemporary evidence on EDs and obesity in adults, and the impact of GLP1-RAs on ED risk.

Methods

Following PRISMA-ScR guidance and a registered protocol (OSF: osf.io/ra9wk), MEDLINE and Scopus were searched for peer-reviewed studies dated 01/2021 to 04/2026. Four domains were examined: prevalence and characteristics of EDs/DEBs in adults with obesity; impacts of weight stigma and restrictive dieting; ED screening and integrated treatment models; and effects of GLP1-RAs on ED risk. Findings were synthesised narratively.

Results

From 4,622 records, 118 publications were included. The prevalence of EDs, particularly binge eating disorder (BED), was explored in 10 cross-sectional analyses across several countries. The most comprehensive pooled analysis reported a 17% prevalence of BED in treatment-seeking adults with obesity (95% CI:12 – 22%; n=13,447). In adults with class 3 obesity, over half had clinically significant ED symptoms. Behavioural interventions for weight loss improved symptoms in EDs/DEBs. Pooled analysis of 3 small studies, including one RCT, demonstrated a consistent signal of benefit of GLP1-RAs on binge-eating outcomes in BED compared with controls (pooled weighted mean difference for BES score -8.14; 95% CI -13.13 to -3.15), with no clear signal of harm when delivered within multidisciplinary care. Evidence on restrictive-spectrum EDs, higher-dose or newer GLP1-RAs, and post-discontinuation outcomes was absent.

Conclusions

There is limited evidence of harm with GLP1-RA use in people with obesity, with a suggestion of benefit in those with BED. Adequately powered, blinded trials with ED-specific endpoints and post-discontinuation follow-up, particularly with the more recent GLP1-RAs, are urgent research priorities.