"They're not shortcuts": How weight loss drugs became the business of shame

As New Year's resolutions kick into high gear, weight loss goals top 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 drug 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.

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."

"They're not shortcuts; they're tools — much like using medication to manage diabetes or high blood pressure," he said. "Criticizing someone for using Ozempic reflects a misunderstanding of weight science and reinforces harmful stereotypes about health and effort."

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."

“My doctor thinks I am being scammed,” some ads say, with the taglines "This is NOT Ozempic, but Your Metabolism Will Love It," "Ozempic Power In a Capsule” and "Works 3x Faster than Ozempic."

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."

Combating the stigma requires increased awareness and education about the legitimate medical purposes of these medications while providing evidence-based, personalized care that considers the patient's unique circumstances and goals and treats them with dignity, experts said.

"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."