2647-P: GLP-1 Receptor Agonists (GLP-1RAs) and Clinical Outcomes of Binge Eating Disorders

Introduction and Objective: Mechanistic studies suggest that glucagon-like peptide-1 receptor agonists (GLP-1RAs) modulate appetite and may reduce compulsive eating behaviors through centrally mediated mechanisms involving hypothalamic and mesolimbic pathways. However, clinical evidence remains limited. We therefore aimed to evaluate the association between GLP-1RA use and clinical outcomes among patients with coexisting obesity and binge eating disorders. Methods: In this retrospective cohort study, we used 2015-2024 OneFlorida+ electronic health record data to identify individuals with obesity and coexisting binge eating disorder or binge-eating-associated bulimia nervosa. Using a target trial emulation framework, we compared the risks of emergency department (ED) visits and hospitalization between GLP-1RA users and non-users. An innovative machine-learning-based, time-conditional 1:1 propensity score matching was applied to balance baseline confounders between groups, followed by Cox proportional hazards models to estimate outcome risks. Results: After 1:1 propensity score matching, 448 matched pairs were included. In the overall cohort, there were no significant differences in the risks of ED visits (hazard ratio [HR], 1.02; 95% confidence interval [CI], 0.75-1.35) or hospitalization (HR, 0.82; 95% CI, 0.60-1.10) between GLP-1RA users and non-users. In stratified analyses, GLP-1RA use was associated with a significantly lower risk of ED visits (HR, 0.56; 95% CI, 0.49-0.65) and hospitalization (HR, 0.82; 95% CI, 0.76-0.88) among patients with type 2 diabetes (T2D), but not among those without T2D. Conclusion: GLP-1RA use was associated with a significantly lower risk of ED visits and hospitalization among patients with binge eating disorders who also have T2D, whereas no such association was observed in patients without T2D Disclosure S. Guo: None.