Here’s How the Weight Loss Drug Explosion Amplifies Weight Stigma

For starters, it feeds the false belief that larger bodies are something to be fixed.

As a registered dietitian who believes that weight does not equal health, it’s exciting to witness a slow rise of weight-neutral practices in the nutrition and medical fields. BMI is losing its street cred and the body neutrality movement is gaining traction, but the current obsession with weight loss drugs feels like a real backtrack.

“In recent months, the names Ozempic, Wegovy, and Mounjaro have become virtually inescapable, saturating media coverage due to the weight loss potential these drugs offer,” says Ana Pruteanu, MS, RDN, LDN, CEDS-C, a registered dietitian with Be Well Nutrition Counseling.

Such drugs were originally created to treat diabetes, but they are now being widely used for weight loss, despite what we are learning about their negative side effects, like nausea and vomiting. In fact, new research shows associations between weight loss drugs and severe stomach issues in people without diabetes. But what about how they impact weight stigma?

What Is Weight Stigma?

According to Ester Tambe, MS, RD, CDN, CDCES, a registered dietitian, “Weight stigma is any type of negative, ill feeling, or discrimination toward someone due to their body shape and size.”

Look around, and you’ll find examples of weight stigma everywhere. Airplanes, amusement parks, theaters, and waiting rooms all are equipped with too-small seats, and clothing stores and brands have non-inclusive sizing.

Pruteanu says weight stigma can also manifest as various forms of bullying, body shaming, and seemingly benevolent — yet unsolicited advice — about health, nutrition, or weight loss. It can even include assumptions that someone in a larger body automatically desires or needs to lose weight.

Related: The 'Health at Every Size' Approach to Health Care Is Aiming to Put an End to Weight Stigma

Consequences of Weight Stigma

Unfortunately, weight stigma also runs rampant in healthcare settings. Several of my clients living in larger bodies express anxiety about visiting their healthcare providers' offices, fearing judgment from their physician or other providers, usually because they experienced weight stigma there in the past.

In fact, research shows such weight stigma can prevent people from seeking medical treatment and receiving appropriate, humane medical care. It can also cause people in larger bodies to avoid health-supporting behaviors, like regular physical activity.

Alarmingly, research shows weight stigma can also negatively impact diagnosis, treatment, and recommendations for eating disorders, which are life-threatening mental illnesses found in people of all body sizes. The internalization of weight stigma is also associated with poorer mental and physical health and even increased risk of suicide.

Contrary to our societally conditioned belief that weight is always the problem, research shows weight stigma is the factor causing harm to those living in larger bodies — not their weight.

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 [my clients] 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 [you] 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 [your] motivations and help [you] make an informed decision that aligns with [your] overall well-being goals.”

Related: The 7 Biggest Nutrition Mistakes You're Probably Making, According to a Dietitian

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