Facing GLP-1 Stigma? What to Know and How to Cope

GLP-1s, like other prescription medications, carry potential side effects. For many, these include feelings of shame brought on by GLP-1 stigma.

At the same time, public opinion has shifted in a more positive direction now that weight loss drugs have been on the market for a while — and it might help that celebrities like Oprah Winfrey and Elon Musk have been honest about their experiences with taking them.

Still, the stigma can be tough to shake, leaving many GLP-1 users feeling ashamed. Here, we explain what’s behind the GLP-1 stigma and how to keep it from impacting your self-esteem.

Taking GLP-1 Medications: Cheating or Not?

One common argument is that people should be using healthy lifestyle strategies like diet and exercise to lose weight — that turning to medications is “cheating.”

So, are you “cheating” if you take a GLP-1 (glucagon-like peptide 1) for weight loss?

Meghan Garcia-Webb, MD, a board-certified internal medicine, lifestyle medicine, and obesity medicine physician in Wellesley, Massachusetts, who specializes in sustainable weight loss, doesn’t think so.

“Of course, as a physician, I want people to be eating healthy and exercising, but it’s a flippant argument to make because obesity is such a heterogeneous disease, and there are many different reasons some people might have a higher BMI than somebody else,” says Dr. Garcia-Webb. She adds that those reasons may include genetics, medications, and a history of extreme dieting.

Misconceptions of people with larger bodies may contribute to the “cheating” rumors. “The general public tends to view larger-bodied individuals as lazy, when in actuality, such individuals may be highly motivated,” says Cynthia Shaw, PsyD, a New York–based licensed therapist who specializes in self-esteem and identity development.

Garcia-Webb adds, “I have so many patients who have really optimized all the lifestyle changes and their weight still won’t move beyond a certain point.”

Why GLP-1s Are a Legitimate Option for Weight Loss

GLP-1 medications like semaglutide (Wegovy) help people who have health problems related to obesity lose weight, per the National Institute of Diabetes and Digestive and Kidney Diseases. These issues may include diabetes, high blood pressure (hypertension), heart disease, and more.

Medications like semaglutide mimic a gut hormone known as GLP-1. According to UCLA Health, this hormone gets released when you eat and interacts with parts of the brain that signal satiety.

“Many people eat all the right things, but their portion sizes are just too big,” Garcia-Webb says, noting it’s because their satiety signal is weak. Research has found that people with weak satiety signals don’t experience the normal spike in cortisol (a stress hormone) following a meal, which suggests a dysregulated stress response may be partly to blame.

“One of the great things about GLP-1 medications is they strengthen the satiety signal from the stomach to the brain, so people feel a sensation of fullness that they’ve never felt before,” Garcia-Webb says.

Research indicates this effect creates successful weight loss when combined with a healthy diet and exercise program. For example, one clinical trial found that 282 men and women with obesity (average age 47) who took semaglutide for two years lost an average of 15.2 percent of their starting weight. And an earlier study reported an average weight loss of 14.9 percent in 1,950 men and women with obesity (average age 46) who took semaglutide for 68 weeks.

Weight loss medications aren’t a magic pill — you still have to make healthy lifestyle changes to see lasting results. Otherwise, poor eating and exercise habits can cause you to regain weight once you stop taking the medication, per a review. Still, medications can offer you a weight loss “win.” If you’re like many of the individuals Garcia-Webb sees, that “win” can make a significant difference in your outlook.

“Many people come to me feeling hopeless because they’re tired of trying and having things not work. They feel a sense of despair about their weight and that nothing’s going to help, so why bother?” Garcia-Webb says. “When they start this medication and they see it working, that can really help them build momentum to make other lifestyle changes.”

How to Maintain Your Self-Esteem While Taking a GLP-1

You may be inclined to keep your weight loss medication a secret to protect your self-esteem. Ultimately, it’s your right to keep your health information to yourself, “and you certainly don’t owe anybody an explanation,” Garcia-Webb says.

However, keeping a noticeable weight loss private is easier said than done; inevitably, someone will ask how you did it.

“People will always comment and ask questions at all ends of the weight spectrum. If somebody has a very low BMI, people will ask, ‘Why aren’t you eating more?’ If you lose weight, there will be people who ask, ‘Did you take a medication?'” Garcia-Webb says. “It’s annoying but pretty normal.”

So, be prepared for questions — and, if you share that you’re taking a weight loss medication, for pushback.

“If people are happy for you, great, and if they’re not, that might be a good indicator that this person doesn’t have your best interests at heart and you don’t need to spend much time with them,” Garcia-Webb says.

You can’t control how others respond to your health choices, and you shouldn’t feel pressured to convince others that you made the right decision. But you can take steps to ensure that others’ feelings about GLP-1 therapy don’t affect your self-esteem.

Start by reminding yourself why you’re taking medication, Garcia-Webb suggests. Feeling good about your decision to take a GLP-1 should help you maintain your self-esteem when others make negative comments.

“While others are free to pass judgment, we are free to make choices that best align with our needs, medical recommendations, and personal values,” Dr. Shaw notes.

Conclusion

Despite the stigma and misconceptions surrounding them, weight loss medications can provide a much-needed tool for achieving and maintaining a healthier weight. For many, the results are well worth the effort. Yet, if you still find that your experience while taking a GLP-1 challenges your self-esteem, try to keep your focus on your health goals above all else.

FAQs

• What are GLP-1 medications, and how do they work?

GLP-1 medications mimic a gut hormone known as GLP-1, which gets released when you eat and interacts with parts of the brain that signal satiety. This helps people feel full and reduces hunger, leading to weight loss.

• Are GLP-1 medications a magic pill?

No, GLP-1 medications are not a magic pill. You still need to make healthy lifestyle changes, such as a balanced diet and regular exercise, to see lasting results.

• Will I regain weight after stopping GLP-1 medication?

Yes, if you stop taking GLP-1 medication without making healthy lifestyle changes, you may regain weight. Poor eating and exercise habits can cause weight gain even after stopping medication.

• How do I cope with the stigma surrounding GLP-1 therapy?

You can start by reminding yourself why you’re taking medication and focusing on your health goals. Try not to feel pressured to convince others that you made the right decision. Remember that you are free to make choices that best align with your needs, medical recommendations, and personal values.

Editorial Resources and Fact-Checking

• Prescription Medications to Treat Overweight & Obesity. National Institute of Diabetes and Digestive and Kidney Diseases. March 2023.
• Semaglutide for Weight Loss – What You Need to Know. UCLA Health. January 12, 2023.
• Drapeau V et al. Behavioural and Metabolic Characterisation of the Low Satiety Phenotype. Appetite. November 2013.
• Garvey WT et al. Two-Year Effects of Semaglutide in Adults With Overweight or Obesity: The STEP 5 Trial. Nature Medicine. October 10, 2022.
• Wilding JPH et al. Once-Weekly Semaglutide in Adults With Overweight or Obesity. The New England Journal of Medicine. February 10, 2021.
• Wadden TA et al. The Role of Lifestyle Modification With Second-Generation Anti-Obesity Medications: Comparisons, Questions, and Clinical Opportunities. Current Obesity Reports. 2023.