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COUNTERPOINT: Weight loss medications, body image and health -- What happened to body positivity?

Charlotte Markey, InsideSources.com on

Published in Op Eds

The rapid adoption of weight-loss medications such as Ozempic, Wegovy and Zepbound represents one of the most striking cultural shifts in weight management I’ve witnessed in nearly 30 years of studying and writing about body image.

These medications were developed to treat diabetes and, more recently, approved for weight management for people who meet specific medical criteria. However, their use has expanded far beyond those original purposes, becoming not just a medical intervention but a new social norm.

As a body image scientist, I’m intellectually curious and deeply concerned about what this shift signals, especially for young people developing a sense of self in a world already saturated with appearance-based expectations.

When a society widely publicizes a pathway to weight loss, the pressure to pursue it rarely stays contained. It becomes a new benchmark, a new moral shorthand, a new way to sort bodies into “before” and “after.” And that matters because the people most drawn to GLP-1 medications may be the people who are already vulnerable to body image distress.

In a 2025 study I published with colleagues, we found that higher body shame, body surveillance, weight concerns, and anti-fat bias were associated with greater interest in trying GLP-1s and greater willingness to tolerate side effects. Body appreciation appeared to be somewhat protective.

In other words, our cultural enthusiasm for these drugs may land hardest on those already struggling, and we have no evidence that taking a GLP-1 improves body image. Changing the body is not the same as changing body image.

Another concern is how quickly these medications have helped re-center weight loss as a primary “health” goal. For years, many clinicians, researchers and advocates have emphasized that weight alone is not a reliable proxy for health. Health behaviors such as adequate nutrition, enjoyable movement, sleep, stress management and social connection are far more predictive of long-term well-being than body size itself.

Yet, the excitement around GLP-1s risks reinforcing an old idea in a new form: that smaller bodies are inherently healthier bodies and higher-weight bodies are medical problems in need of correction. That framing doesn’t just shape medical practice; it encourages stigma. And weight stigma is not benign. It’s associated with worse mental and physical health outcomes and with avoidance of healthcare.

Speaking of mental health, most people are not screened for eating disorder history or symptoms before being prescribed these medications. Eating disorder specialists and advocacy organizations have raised concerns about what happens when appetite suppression becomes culturally celebrated. For some, medicated appetite suppression may feel like relief at first, especially if they’ve spent years in diet-and-shame cycles. Relief can slide into rigid control.

The focus on weight loss can intensify preoccupation with food, body checking and fear of regain. When rapid weight-loss tools are normalized, disordered eating can become easier to excuse and harder to detect.

Which brings a deeper worry: Weight-loss drugs are reshaping the body image conversation. For years, we’ve tried to move away from “thinness equals virtue” and “fatness equals failure.” Now the message increasingly sounds compassionate: It’s not your fault; your body is a medical condition that needs treatment.

 

If body size is framed primarily as pathology, then higher-weight bodies are positioned as problems to solve. Even worse, a “treatment” can become an expectation: if weight can be medically reduced, then people who remain the same size may be judged as noncompliant or irresponsible, rather than as presenting a natural variation in body size.

This is also why I disagree when people declare that body diversity was a myth or that body positivity is no longer needed. Body positivity, at least as body image scientists define it, was never about celebrating every body. It was about decoupling appearance from worth and helping people treat their bodies with respect and compassion. Rejecting that goal doesn’t just reject a movement; it rejects a fundamental component of mental health.

Finally, I worry about what this discourse teaches young people. When the loudest cultural message is that hunger can be pharmaceutically muted, we risk sending a confusing lesson: that a “good” body is a controlled body, possibly even a medicated one. When did hunger become a problem? Why give up on enjoying food? Do we really want adolescents growing up believing that only small, controlled bodies are acceptable?

We are conducting a massive, real-time social experiment, and scientists have barely considered the psychological consequences. Weight-loss medications may treat diabetes and other health conditions with remarkable success, but I am doubtful they can treat body dissatisfaction.

If the next generation learns that the “best” body is the one that needs the least food, we shouldn’t be surprised when body dissatisfaction and life-threatening eating disorders increase.

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ABOUT THE WRITER

Charlotte Markey is a professor of psychology at Rutgers University, a body image scientist, clinician and author of “The Body Image Book” series. She wrote this for InsideSources.com.

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©2026 Tribune Content Agency, LLC

 

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