Introduction

How would you like to defend yourself about the weight losing tips from people around you? Is it acceptable?

• As New Year’s resolutions are into high gear, weight loss goals are among the top of many people’s lists. Like clockwork, advertisements for weight loss programs and supplements are popping up on social media, ready to pounce on the demand.
• The weight loss drugs market is exploding, with new products entering the scene to compete with big names like Ozempic. It is no surprise, considering the millions of people worldwide struggling with obesity, PCOS and diabetes.
• The medications’ promise of weight loss without a complete lifestyle overhaul has sparked hope and controversy, and the market shows no signs of slowing down. Ozempic, Wegovy, Mounjaro and other GLP-1 drugs have transformed how obesity is treated and have corresponded with a 25% decrease in weight-loss surgeries.
• Sixteen new drugs are set to enter the market in the coming years, per Reuters, and analysts estimate the overall market could expand to $200 billion by 2031.
• In America, the steepest increase in the prevalence of hyper-palatable foods occurred between 1988 and 2001 — the era when [tobacco conglomerates] Philip Morris and R.J. Reynolds owned the world’s leading food companies,” Washington Post health columnist Anahad O’Connor wrote last year. “The foods that they sold were far more likely to be hyper-palatable than similar foods not owned by tobacco companies.”Many of these ultra-processed foods are specially marketed to children, which in turn can change their brain chemistry to desire those foods for life. Today we would be appalled at the idea of marketing tobacco to children, but the same companies pushed addictive foods onto kids. And even though Big Tobacco is no longer in the business of food, its practices remain widespread.

  As obesity rates have risen, there’s an all-too-familiar blame game that individualizes the harm being caused by a system that thrives off addiction.

  Doctors warn people struggling to manage their weight to restrict their calories and do vigorous exercise. Reality shows like The Biggest Loser have cemented the narrative that obesity is the result of individuals not managing their urges to eat. And American pop culture’s obsession with unattainable thinness generates shame spirals and further fuels the idea that people are fat simply because they’re too weak to control themselves.

  Meanwhile, there are few if any government regulations on unhealthy foods in this country. Instead, the solutions being offered are individualized, often spawning lucrative industries of their own.

  Alongside the aggressive marketing of hyper-palatable foods is a massively profitable weight loss industry that preys upon individual shame to the tune of more than $60 billion a year. In fact, some of the same companies pushing high-calorie foods are in the business of weight loss.

  Today, the manufacturers of weight-loss drugs are clear winners in the changing landscape of food consumption and weight, charging tens of thousands of dollars for a year’s supply — and ensuring that only the wealthy have access to the thinness our culture celebrates.

• After all, nearly 42% of American adults are considered to have obesity, a condition that puts them at increased risk for heart disease, stroke, type 2 diabetes and certain types of cancer.

  On the other hand, it seems to have given some people license to unnecessarily comment on others’ appearance, weight and weight loss efforts. The comments include: telling others they should use Ozempic, chastising those using weight loss medications for “taking the easy way out,” and comparing Ozempic users to thieves (as Ozempic was originally developed for the treatment of type 2 diabetes). There’s even a term for this negative commentary: “Ozempic shaming.”

  Why do people care so much about others’ weight? And why do they feel like they have the right to comment on it? The answer lies in societal expectations around thinness. From a young age, we are exposed to sociocultural pressure through the media, our parents, and our peers to embrace the “thin ideal”—to work toward a physical figure that is slender or lean.

  At the same time, we are also exposed to weight stigma—or the social denigration of individuals who don’t conform to these slender standards. And it may be that this combination of pressures has led us to believe that we are justified—moral, even—in calling people out for their weight.

  We’re not. In fact, doing so is dangerous. The reality is that millions of Americans are living with obesity. Obesity is the second leading cause of preventable death in the United States.

  Shaming individuals with obesity can have serious negative effects on their health. Studies have shown that individuals who experience weight stigma exhibit less motivation for and adherence to treatment, and are at increased risk for anxiety, depression, low self-esteem and suicidal thinking.

  Calling people out for their chosen method of weight loss is also unjustified. Obesity and weight loss are complex. While lifestyle habits such as diet and exercise are obviously important factors in a person’s weight, there are many other variables, such as genetics, environment, family history, personal health history and more.

  Choosing to use weight loss medication doesn’t indicate that a person lacks willpower; rather, it signals that obesity simply isn’t easy to treat. Asking for help when faced with a daunting challenge is a sign of strength.

  So, what can you do if you’ve been subject to unwelcome comments about your weight or your weight loss journey?

  1. Remember that your body is your business. No one should be able to tell you how to feel about it or what to do with it. If you find yourself unmoored by others’ commentary about your body, try closing your eyes, grounding yourself with a few deep and slow breaths, and repeating this to yourself: My body is my house, my temple. It is mine, and mine alone.

  2. Have a response ready for when someone asks you about your weight or weight loss journey. Sometimes, the best response is a direct (and polite) one: Thanks for being concerned about me. I’m not interested in talking about my weight.

  3. Be proud of what you’re doing in service of your own health. Whatever weight loss treatment you’ve chosen for yourself is likely to have a positive impact on your mental and physical health. Reward yourself for investing in yourself and celebrate your successes.

  And how can you support others who have expressed to you that they are struggling with their weight—without talking about their body?

  1. Ask them for what they need. Sometimes people just want a listening ear or a shoulder to cry on. Sometimes they want help solving their problems. Sometimes they need something else. Learn what they need to feel supported and see if you can offer it.

  2. Remind them that they are so much more than their body or their weight. Move away from the body talk and encourage people to remember what makes them unique, whether it be a special talent or a cool hobby.

  The buzz about weight loss is likely to continue as weight loss medications become more common. But the shaming of those who are trying to lose weight doesn’t have to. Together, we can make a commitment to living our best lives—and supporting others as they do the same however they choose to.

There’s an ongoing debate about how GLP-1 drugs fit into a comprehensive strategy for managing obesity, their potential side effects and costs.

The growing market also has revealed societal attitudes that include complicated layers of stigma and misunderstanding.

How shame boosted GLP-1 drugs

Fat-shaming is not a new concept. “In western society, fatphobia and anti-fatness are so ingrained in how we think about body size, health and self-worth,” said Katherine Metzelaar, dietitian and owner at Bravespace Nutrition. “There’s this belief that being thin equals being beautiful, disciplined and healthy while being fat is often unfairly linked to laziness or a lack of self-control.”

“It all leads to this idea that fat people are somehow less deserving of respect or dignity,” she said. “Diet culture plays a significant role in pushing this, too, making people believe that anyone in a larger body is just not trying hard enough, leading to the scorn and derision we see.”

The use of GLP-1 drugs sparked the term “Ozempic shaming” to describe the negative perceptions faced by those who choose medical interventions for weight management. Some critics argue that using the drugs is akin to “taking a shortcut,” overlooking the complex factors that contribute to obesity.

“Some people think weight loss has to be grueling to be ‘real’ or ‘earned’ and see things like surgery or medication as taking shortcuts,” said Dr. Raj Dasgupta, chief medical advisor for Garage Gym Reviews. “This belief overlooks how tough those options are and ignores that everyone’s journey is different. It’s an outdated mindset that simplifies a very complicated issue.”

Joshua Collins, licensed clinical social worker at SOBA New Jersey, said “medications like Ozempic (Semaglutide) help address underlying metabolic and hormonal issues, such as insulin resistance and appetite regulation.”

GLP-1 competitors also use shame

The rest of the weight loss-market has tried to capitalize on this criticism through a marketing approach that devalues GLP-1 medications. Advertisements tout over-the-counter supplements as “Nature’s Ozempic,” and warn that “GLP-1 meds are effective but come at a steep price.”

Dr. Michael Chichak, medical director at mental health clinic MEDvidi, said GLP-1 medications come with benefits and risks like any other treatments, but “fear-mongering tactics and misinformation are done to further a certain agenda.”

“The weight loss industry already preys on individuals, using fear and shame as they are known to be more emotional triggers as opposed to using scientific evidence when marketing their product,” he said. “These companies begin by diffusing trust in the medical and pharmaceutical industry, advertising themselves as a safer option, highlighting how GLP-1 medications are more dangerous and encouraging using ‘natural’ alternatives.”

This can discourage people from seeking treatment altogether, experts said. Many patients may feel pressured to justify their treatment choices, which can lead to stress and feelings of inadequacy, affecting their overall well-being.

Treating obesity as a moral failing rather than a medical condition has been “immensely harmful to patient care,” said Dr. Rehka Kumar, chief medical officer at online weigh loss program Found.

“As a physician, I find it deeply troubling when patients are shamed for using evidence-based treatments, whether anti-obesity medications or bariatric surgery,” Kumar said. “This stems from the persistent but incorrect view that body weight is a matter of willpower. Science shows that weight regulation involves genetic, environmental, hormonal and neurological factors. This bias results in inadequate care, with less than 10% of eligible patients being offered evidence-based medical treatments for weight management and insurance coverage for obesity treatment being denied at rates three to four times higher than other chronic conditions.”

“We have the opportunity to reshape the culture and impact a realistic symbol of beauty which is based on healthier standards and body types, genetics, among other factors,” said Max Banilivy, clinical psychologist and vice president of education, training & client/staff well-being at WellLife Network. “We need to teach children and families and the media to have accurate and healthy messages. Not all bodies are the same.”

How Weight Loss Drugs Are Fueling Weight Stigma

The recent eruption of weight loss drugs is strengthening weight stigma. Here are the most prominent ways people are being impacted.

It Upholds Fatphobic Beliefs

The weight loss drug obsession feeds the false, deeply ingrained belief that larger bodies are unworthy and to be feared and fixed. Combine that with the promise that weight loss can happen easier on these medications, and it further perpetuates the belief that larger bodies are bad, wrong, and have no place in our world today, shares psychotherapist Amanda Marks, LPC, RYT, CPCS, a counselor and owner of Resilient Counseling.

“My clients in bigger bodies have expressed sadness and frustration that yet again they are being discriminated against and told their existence in their current bodies is wrong and bad,” she says.

Healing body relationships already involves a significant amount of grief work, Marks adds. But weight loss drugs add another layer of hard emotions for larger-bodied people to navigate. “It causes sadness and anger, among other emotions, to work through, to then hopefully come back to a place of dismantling their worth being connected to their body size or weight.”

The obsession around weight loss drugs also can be triggering. As an eating disorder dietitian, Pruteanu has had countless conversations with clients who feel heightened pressure to control their bodies as they observe others jumping on the weight loss drug bandwagon.

“Discussions about Ozempic and Wegovy have become a daily occurrence in my sessions,” she says. “The widespread popularity of these medications has inadvertently intensified discussions about weight loss, dieting, and food, creating an environment where my clients feel inundated by these topics. Many of them express a sense of helplessness, feeling unable to escape these conversations.”

It Communicates Being Thin Should Be Sought After

We know weight loss drugs often cause negative side effects affecting people’s quality of life and health, yet they are increasingly popular, which sends the message that trying to be thin is worth your well-being and should be attempted at all costs.

“Although one may be suffering from these dangerous side effects, they’re being praised by providers and loved ones for the weight loss,” says Eden Davis, RDN, LDN, a registered dietitian Pearl Wellness who works with those who have binge eating disorder.

Davis says she’s had several clients on weight loss drugs and has observed declining and worsening physical and mental health than before. She also has noticed side effects like malnourishment (in all body sizes), skewed hunger and fullness cues, nausea and fatigue, and severe gastrointestinal complications.

After people come off the drug, she says the majority of people will regain the original weight lost within the first year. Plus, overeating and binge eating typically resume. “This can leave the individual feeling defeated on their wellness journey after not seeing behavioral changes and regaining the original weight.”

It Fuels Illusion Thinness Equals Wellness

The weight loss drug obsession reiterates the false belief that weight is synonymous with health — that living in a larger body is an unhealthy condition requiring a drug. Simultaneously, it encourages us to forget about actual health markers, like lab values, financial wellness, sleep quality, stress levels, physical activity, nutritional status, food accessibility, and emotional well-being.

“This is one reason weight stigma is dangerous because we’re not looking at their overall health profile, only their size,” Davis explains. “However, these weight loss drugs don’t offer a behavioral change to better one’s wellness, but instead short-term weight loss. Apart from the alarming side effects of these drugs, they can also create a barrier to pursuing true wellness.”

In fact, research shows that not focusing on weight can help improve heart health, eating behaviors, quality of life, and psychological wellness. “By shifting our focus from weight to true behavioral changes, individuals are more likely to improve on their health and wellness journey,” Davis adds.

It Leads to Unsolicited Prescriptions and Advice

When I work with larger-bodied clients on their metabolic health such as cholesterol or blood pressure, we focus on eating patterns, physical activity, hydration, and stress. They are often surprised when their labs and vitals improve.

Pruteanu says her clients have similar experiences. But she’s noticed lately that even those who reach good metabolic health are contemplating using weight loss drugs.

“This consideration often stems from concerns expressed by their healthcare providers or well-meaning loved ones who remain fixated on their higher body weight,” she says. “Many people in larger bodies now report feeling coerced into taking these medications or losing weight, often driven by targeted online advertisements, unsolicited prescriptions during medical appointments, and pressure from friends and family.”

Plus, healthcare providers don’t always properly assess and educate before prescribing weight loss drugs, Davis says. “Most of the time, the provider does not review their medical and health history, hold space for a conversation around possible side effects, or discuss alternatives to the medication.”

At the end of the day, weight-inclusive care should include body autonomy or the right for people to make their own body choices, Tambe says. “I will not shame for wanting to lose weight in a society where their body is not deemed acceptable.”

The Bottom Line

If you’re thinking about trying a weight loss drug, Davis suggests questioning if it’s because you believe weight loss will make you healthier in the long run, or if there’s pressure from a healthcare provider or loved one.

Pruteanu also suggests checking in with the reasons why and if they align with your life values.

“It’s valuable to ponder what hope to change or improve through weight loss and explore if there are alternative avenues to achieve these objectives,” she says. “This introspection can provide valuable insights into motivations and help make an informed decision that aligns with overall well-being goals.”

FAQs

1. What are weight loss drugs, and how do they work?
   Weight loss drugs are medications designed to help individuals lose weight by suppressing appetite, increasing metabolism, or reducing fat absorption. They are typically prescribed to individuals with obesity or weight-related health conditions.
2. Why is the weight loss drug industry calling a ‘business of shame’?
   The industry is often criticized for exploiting societal pressures and stigmas around body image to sell products. Marketing strategies frequently emphasize unattainable beauty standards, leading to feelings of inadequacy and shame among consumers.
3. Are weight loss drugs effective in the long term?
   While some weight loss drugs can produce significant short-term results, their long-term efficacy varies. Sustained weight loss often requires lifestyle changes like a balanced diet and regular exercise. Many individuals regain weight once they stop using the medication.
4. What are the risks and side effects of weight loss drugs?
   Common side effects include nausea, diarrhea, constipation, and insomnia. More serious risks can include increased heart rate, high blood pressure, and in rare cases, severe mental health effects. Consultation with a healthcare provider is essential before use.

1. How does the weight loss industry contribute to body image issues?
   The industry often reinforces unrealistic beauty standards, promoting the idea that thinner bodies are inherently more valuable. This messaging can lead to poor self-esteem, disordered eating, and mental health struggles.
2. Who benefits most from the weight loss drug industry?
   Pharmaceutical companies and marketers benefit financially, often at the expense of consumers. Critics argue that instead of addressing root causes of obesity—such as access to healthy food, stress, and genetic factors—the industry focuses on short-term fixes.
3. What alternatives exist to weight loss drugs?
   Alternatives include dietary counseling, behavioral therapy, increased physical activity, and addressing underlying medical or psychological conditions. Holistic approaches often produce healthier and more sustainable outcomes than relying on medication alone.