Date Approved

5-12-2026

Graduate Degree Type

Thesis

Degree Name

Clinical Dietetics (M.S.)

Degree Program

Health Professions

First Advisor

Libby MacQuillan, PhD, RDN, CHSE

Academic Year

2025/2026

Abstract

Introduction: The use of the medication, GLP-1 receptor agonist (GLP-1 RA), for weight loss has increased exponentially in the United States over the past decade. The continuing rise in demand for the use of GLP-1 RAs for weight loss justifies the need to better understand the physical and psychological effects that can occur with significant weight loss. By combining a standardized screening tool for eating disorder (ED) risk with narratives from patients undergoing GLP-1 RA treatment for weight loss, this study examines associations between GLP-1 RA use patterns and risk of ED and explores patient experiences, including the role of registered dietitian nutritionists (RDNs). Methods: A mixed-methods study was conducted using a survey of adults (N=843) currently or previously using GLP-1 RAs for weight loss. The Eating Attitudes Test-26 (EAT-26) assessed ED risk (≥20 indicating risk). Quantitative analyses included chi-square tests and logistic regression. Qualitative responses were analyzed using thematic analysis. Results: Most participants (73.5%) were not at risk for EDs; the mean EAT-26 score was 15.5. Shorter duration of GLP-1 RA use was associated with greater ED risk (χ²=22.47, p< .001). Intermittent medication use was also associated with increased risk, with each stop–restart episode nearly tripling odds of scoring at-risk for ED (OR=2.99, 95% CI: 1.36–6.62). No significant differences in disordered eating behavior (DEB) prevalence were observed by RDN use. Qualitative findings indicated that supportive RDN involvement improved nutrition knowledge, self-management skills, and side effect management. Participants also reported reduced food preoccupation and, in some cases, improvement in pre-existing disordered eating symptoms.

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