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However, for patients with very high blood sugar at diagnosis (HbA1c above 10 percent) or symptoms of hyperglycemia, insulin may be started right away, bypassing the usual stepwise approach
A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society explicitly states that restrictive eating disorder is a general contraindication to GLP-1 use and that individuals with a history of eating disorders should be referred to an eating disorders specialist before these medications are prescribed ( Mozaffarian et al., Am J Clinical Nutrition, 2025 )
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