J.ess, 38, has lost 75 pounds since starting taking Wegovy last year. She’s thrilled with the results—in addition to losing weight, her blood tests and sleep apnea have improved—but the changes in her life and body seem too complicated to discuss with her friends, who want nothing to do with them. with your weight loss.
Years ago, Jess, who asked to use only her first name for privacy, and her friends embraced the principles of Health at Every Size Movement, which fights anti-fat prejudice and argues that weight is not an accurate indicator of health. But last summer, despite her support for that school of thought, Jess decided she wanted to lose weight to feel better about her body. When she mentioned this decision to her friends, “they told me, ‘We have no interest in this conversation. We don’t want to discuss this with you. We don’t agree with your choice,’” she recalls. “I respect their boundaries, but it’s been hard not to share certain milestones with them or even talk about everyday things. It’s been kind of sad and lonely.” These days, she only discusses her weight loss with her doctor and her husband.
Weight loss has always been a sensitive topic. But it’s especially complex to talk about in 2024, as body positivity movements collide with the popularity of drugs like Ozempic, Wegovy and Zepbound. Largely because of these medications, weight loss is all over the news and on social media — and no one, it seems, knows exactly how to feel or talk about it.
“It’s a very sensitive topic because we can hide a lot of things about our lives,” says Rachel Goldman, a New York City-based clinical psychologist who specializes in weight management and has consulted for a health care company that prescribes weight loss medications. -obesity. “But if you’re gaining or losing weight, someone will notice.”
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Even many health care providers, who talk about sensitive topics all day, find weight loss a particularly challenging topic, says Charlotte Albury, a medical anthropologist at the University of Oxford in the United Kingdom who studies communication in healthcare settings. health care. This is partly because there is a lot of “shame, guilt and stigma that society perpetuates around obesity,” she says, and partly because “many doctors feel very untrained to talk about obesity.”
If doctors feel undertrained, where does that leave the rest of us?
When it comes to society’s views on weight loss, the pendulum has swung a lot in just a few decades. Not long ago, almost all of mainstream culture treated weight loss as an aspiration. Now, although weight stigma is still a significant problem in the USThe weight loss discussion includes many more dissenting voices than ever before.
In March, when Oprah Winfrey aired a (mostly positive) television special about the drugs GLP-1, the technical name for drugs like Ozempic and Wegovy, she alluded to the numerous opinions on modern weight loss. “To people who feel happy and healthy celebrating life in a bigger body and don’t want the drugs, I say, ‘God be blessed,’” Winfrey said. “To all the people who believe that diet and exercise are the best and only way to lose excess weight, bless you too if this works for you. And for people who think this could be the relief and support and freedom… that you have been looking for all your lives, God bless you, because there is room for all points of view.”
Often, however, these views clash. Some people trying to lose weight, like Jess, feel conflicted, happy that society is taking a hard look at diet culture and at the same time hesitant to say anything positive about their weight loss for fear of being accused of fatphobia. (A recent report from New York Times article highlighted the sticky situation some body positivity influencers face when they get smaller, with their followers sometimes seeing weight loss as a “betrayal.”) Margit Berman, a Minnesota psychologist who fights diet culture in her practice, says Some of their clients also hide that they are using GLP-1 medications for diabetes, a condition for which Ozempic and Mounjaro are approved, because they are afraid of being blamed for being sick because of their weight.
Other people apparently don’t feel so conflicted. Demand for GLP-1 drugs is growing, with some projections estimating that about 10% of the US population will use one of these medications by 2030. And although many people use these medications based on a doctor’s advice and prescription, some are so eager to lose weight that they are willing to purchase medications like Ozempic from compounding pharmacies, medical spas, Internet companies, and other questionable sources.
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Then there are people who are open to wanting to lose weight, but just the old-fashioned way – that is, with diet and exercise, rather than “cheating” with medication. In a 2024 Pew Research Center survey, about half of U.S. adults said medications like Ozempic are good weight-loss options for people with obesity, while about the same number said they are not good options or didn’t know what. what to think.
Similar trends are occurring among doctors. Some doctors speak of GLP-1 as revolutionary treatments for the chronic disease of obesity, praising not only its ability to help people eliminate about 20% of your body weight but also yours cardiovascular health benefits. Goldman adds that anti-obesity medications can help reduce weight stigma because they can help people see obesity like any other disease that requires treatment.
Other doctors, however, argue that GLP-1s have significant drawbacks – side effects include gastrointestinal problems and possibly increased risk of thyroid tumors, and most people gain back the weight they lost if they stop taking them – and help perpetuate harmful beliefs that smaller bodies are automatically better and healthier. Berman believes GLP-1 drugs contribute to the “magical thinking” rooted in anti-fat prejudice: that weight loss is the easiest path to a good life.
Silvana Pannain, director of the University of Chicago Medicine’s weight-loss program and a consultant for companies that make GLP-1 drugs, thinks the disagreement has probably always been there, but social media and the buzz about GLP-1 drugs they are now amplifying it. “It’s not necessarily about a different way of thinking, but rather that more people feel entitled to express their opinion on obesity,” says Pannain.
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Berman, however, noticed a change. When she began speaking out against weight loss culture in the early 2000s, “people looked at me like I had three heads,” she recalls. “The culture was that fat hatred was acceptable and that everyone should try to lose weight. It wasn’t the same [weight-positive] countercultural current that exists now.”
Still, the preference for thinness remains dominant in the United States. Even though more people outwardly embrace body positivity and recognize that weight loss is a complex topic, a significant percentage of U.S. adults say they want to lose weight.by 2023, around 55% of women and 47% of men, roughly the same numbers as a decade ago. Nearly 30% of U.S. adults said in a 2023 study that concern about obesity has increased since the COVID-19 pandemic, with around 6 million people saying they have considered surgery or medication in recent years. Americans still want to lose weight; they simply may no longer feel comfortable announcing that intention proudly.
Jess, the woman who uses Wegovy, says all she wants is to find a happy medium, somewhere between crash diet culture and feeling rejected by her friends because of her GLP-1 prescription. “We need to somehow neutralize” the idea of weight loss by removing the moral baggage associated with the decision to lose weight or the decision not to, she says. “In a world where many of us believe that our body is our choice, this is another one of those things that should fall into that category.”
This story originally appeared on Time.com read the full story
