Popularity of weight loss drugs soars, but weight stigma persists
Weight loss has always been a hot topic in the media, and now, with the rise in popularity of a class of drugs that induce weight loss, it's more controversial than ever. These drugs, including Ozempic, which is approved by the FDA only for treatment of type 2 diabetes, and Wegovy, which is approved for weight loss, work by mimicking a naturally occurring hormone, GLP-1 (glucagon-like peptide 1) to suppress appetite. A newer drug, tirzepatide, currently prescribed only to treat type 2 diabetes, is a dual agonist that shows even greater promise in terms of weight loss by users and is under review by the FDA to be prescribed for weight loss.
These treatments are rumored to be the weight loss tool of choice for many celebrities, influencers, and others who have gained access to the drugs. The media frenzy surrounding weight loss drugs has had both positive and negative impacts, says Judith Korner, MD, Ph.D., professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and director of the Metabolic and Weight Control Center at Columbia. On the positive side, Korner says, the media attention has introduced the idea of using medication as a treatment for obesity, a chronic disease that has long been difficult to treat. As these drugs become more mainstream, there is the potential for easier insurance approval so that more people who would benefit from these treatments can access them.
Even if more people are able to access these drugs, however, stigma around how weight loss is achieved may make patients hesitate to seek treatment. Korner says the media attention has popularized cosmetic uses of weight loss drugs that are often portrayed as "the easy way out," which she says is not true for her patients.
"The people who ask for these medications have had near lifelong struggles with losing and regaining weight," says Korner. "They've tried Weight Watchers, keto diets, and many other approaches, and they've realized that they need help, because what they have been doing is just not working. Weight loss drugs are a tool that people need to use alongside changes in their lifestyle and diet. It's not magic. You still need to work with it."
Weight stigma, a form of discrimination based on a person's body weight, is becoming more recognized and studied, both as an external social force and an internal force that impacts how people see themselves. Studies have shown that weight stigma may actually drive weight gain, as "anti-fat" bias in health care providers can result in patients who are overweight or obese receiving poorer care and having worse outcomes. The perception that people who are overweight or obese are simply not trying hard enough or lack the willpower to lose weight can even prevent people from seeking medical attention.
"When we hear in the media that people are using weight loss drugs as an easy way out, we can internalize that, and that can affect how we feel about ourselves," Korner says. "People shouldn't feel ashamed to take a medication that treats a chronic disease. We're not ashamed to take drugs for high blood pressure; why for obesity?"
While some people who are taking weight loss drugs would not ordinarily be prescribed the medications, Korner points out that has always been the case with medical weight loss treatments, including cosmetic surgery such as liposuction or abdominoplasty.
"Just because some patients are having surgery when it's questionable doesn't mean that we disallow that procedure from happening or that you put a black mark on the medication itself when it's being properly used and prescribed," Korner says. "We have a wonderful medication that is working and helping manage a disease that is so difficult to treat, but that message is not getting out there. What's getting out is that Kim Kardashian may be using the drug to fit in a dress."