Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

Effects of GLP-1 Receptor Agonist Therapy on Eating Disorder Risk and Psychological Distress in Adults with Class 3 Obesity.  (#14)

Sian Raubinger 1 , Ritesh Chimoriya 2 , Pamela Acosta-Reyes 2 , Kathy Grudzinskas 1 , Phillipa Hay 1 2 , Nic Kormas 1 , Milan K Piya 1 2
  1. South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, Campbelltown, NSW, Australia
  2. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia

Background: 

There is a high prevalence of eating disorders (ED) and psychological distress in people with class 3 obesity (BMI≥40kg/m2). With increasing use of glucagon like peptide-1 receptor agonists (GLP1-RA), there are concerns about the risk of worsening ED symptoms. The aims of this study were to compare the ED risk and psychological distress -1) Between people already on GLP1-RA vs those not; 2) Between baseline and 12-months in people started on GLP1-RA. 

 

Methods:  

This retrospective observational cohort study included all adults with class 3 obesity enrolling in a publicly funded multidisciplinary metabolic program in Sydney between January 2018 and June 2024. All participants completed questionnaires at baseline and 12-months; Eating Disorder Examination-Questionnaire Short (EDE-QS), Kessler Psychological Distress Scale (K10), and Depression, Anxiety and Stress Scale-21 (DASS-21). 

 

Results: 

Of 666 participants enrolled in the program, 59 (9%) were on GLP1-RA at baseline, with no significant differences in EDE-QS, K10 or DASS-21 scores between groups. Of 202 participants with baseline and 12-month data available, and not on GLP1-RA at baseline, 31 (15.3%) started treatment in the program. Those initiated on GLP1-RA had significantly lower baseline weight (135.3±27.1kg vs 152.0±35.5kg,p=0.01), BMI (50.0±9.0kg/m2 vs 53.8±10.5kg/m2,p=0.048), and higher incidence of type 2 diabetes (71.0% vs 38.5%,p<0.001) compared to non-initiated individuals. The mean duration of GLP1-RA use was 7.1±3.7 months in the 12-month period studied. At 12 months, both GLP1-RA (n=31) and non-initiated (n=171) groups had significant weight loss, with no significant difference between groups in weight loss (7.2% vs 4.9%,p=0.108) or change in questionnaire scores compared to baseline. 

 

Conclusion: 

The study found no significant differences in ED risk or psychological distress between people with class 3 obesity taking GLP1-RA or not at baseline, or on initiating GLP1-RA over 12 months, highlighting no evidence of GLP1-RA worsening ED risk or psychological distress.