The return of extreme thinness and the non-clinical use of GLP-1 agonists: a blind spot in current eating disorder classification systems?
DOI:
https://doi.org/10.25118/2763-9037.2026.v16.1667Keywords:
eating desorders, Body Dysmorphic Disorders, body imageAbstract
This letter discusses the comparison between DSM-5 and ICD-11 for eating disorders (ED) published by Hiluy et al. in this journal, proposing that the recent resurgence of an extreme-thinness aesthetic ideal, driven mainly by social media and the non-clinical popularization of GLP-1 agonist use, reveals a gap in current diagnostic criteria. The sociocultural pressure faced by women today cannot be ignored in this context. It argues for the need for active clinical vigilance regarding aesthetic behaviors that, although not new, have found a new tool in their favor (GLP-1 agonists).
Downloads
Metrics
References
1. Hiluy J, Nunes FT, Pedrosa MAA, Appolinário JCB. Os transtornos alimentares nos sistemas classificatórios atuais: DSM-5 e CID-11. Debates Psiquiatr. 2019;9(3):6-13. https://doi.org/10.25118/2763-9037.2019.v9.49
2. Mingoia J, Hutchinson AD, Wilson C, Gleaves DH. The Relationship between Social Networking Site Use and the Internalization of a Thin Ideal in Females: A Meta-Analytic Review. Front Psychol. 2017;8:1351. https://doi.org/10.3389/fpsyg.2017.01351 PMid:28824519 PMCid:PMC5545754
3. Bartel S, McElroy SL, Levangie D, Keshen A. Use of glucagon-like peptide-1 receptor agonists in eating disorder populations. Int J Eat Disord. 2024;57(2):286-93. https://doi.org/10.1002/eat.24109 PMid:38135891
4. Krug I, Dang AB, Portingale J, Li Y, Won YQ. Beyond Weight Loss: GLP-1 Usage and Appetite Regulation in the Context of Eating Disorders and Psychosocial Processes. Nutrients. 2025;17(23):3735. https://doi.org/10.3390/nu17233735 PMid:41374025 PMCid:PMC12694361
5. Santomauro DF, Melen S, Mitchison D, Vos T, Whiteford H, Ferrari AJ. The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019. Lancet Psychiatry. 2021;8(4):320-328. https://doi.org/10.1016/S2215-0366(21)00040-7 PMid:33675688 PMCid:PMC7973414
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Thaíse Lyra, Gabriella Zimmer Monteiro, Natalia dos Anjos Mello, Barbara Prodossimo Fontoura

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria allows the author (s) to keep their copyrights unrestricted. Allows the author (s) to retain their publication rights without restriction. Authors should ensure that the article is an original work without fabrication, fraud or plagiarism; does not infringe any copyright or right of ownership of any third party. Authors should also ensure that each one complies with the authorship requirements as recommended by the ICMJE and understand that if the article or part of it is flawed or fraudulent, each author shares responsibility.
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) - Debates em Psiquiatria is governed by the licencse CC-By-NC
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
























