Women using GLP-1 drugs face higher weight loss stigma

In a new study exploring stigma associated with the use of GLP-1 drugs for weight loss, women who lost weight using GLP-1 medications were judged more harshly than those who lost weight through diet and exercise, with negative reactions driven largely by beliefs that medication-assisted weight loss is a "shortcut." The study also found higher levels of stigma when the women in sample scenarios were portrayed as white rather than Black.

The findings, published April 9 in the American Psychological Association's journal Stigma & Health ("Social Perceptions of GLP-1–assisted Weight Loss in Black and White Women with Obesity"), highlight how social narratives about "acceptable" weight loss strategies can shape attitudes toward women with obesity, even when the weight loss is clinically significant.

More than 100 million people in America are clinically eligible to use GLP-1 medications, such as Ozempic, Wegovy, Mounjaro or Zepbound, for weight loss and approximately 18% of U.S. adults are currently using or have previously used a GLP-1 drug. 

GLP-1 medications can offer meaningful health benefits for people with obesity, but many patients report feeling shame and guilt for using them."

Stacy Post, PhD, social psychologist, postdoctoral researcher at Georgetown's Lombardi Comprehensive Cancer Center

Post conducted the research as a part of her PhD doctoral training at George Washington University. "Our results show that the 'easy way out' perception does more than spark casual criticism. It can translate into measurable stigma, including fat phobia and a desire for social distance."

For the study, Post and her colleagues recruited 402 U.S. women ages 30 to 49 who identified as Black or white and who also reported being overweight or having obesity. Participants were randomly assigned to read a brief vignette about a woman named Evette who lost 15% of her body weight either through diet and exercise or with a GLP-1 medication. Evette was depicted as either Black or white using a photo paired with the vignette. The images of Evette were pre-tested to ensure there were no perceptual differences between the two women.

Participants then rated Evette on multiple stigma-related dimensions, including fat phobia, dislike, blame, and desire for social distance, and reported whether they believed she took a weight loss "shortcut."

Stigma was higher when Evette lost weight with a GLP-1 medication rather than diet and exercise. The researchers found that "shortcut" beliefs were a key driver: perceiving GLP-1–assisted weight loss as an easy way out predicted higher fat phobia, greater dislike, more blame, and more desire for social distance.

Unexpectedly, stigma was also higher when Evette was portrayed as a white woman rather than a Black woman. When Evette was portrayed as white and as losing weight with a GLP-1, participants were more likely to endorse shortcut beliefs, which predicted greater stigma.

Interestingly, the race of study participants did not significantly influence stigma outcomes when Evette lost weight with a GLP-1, suggesting that assumptions about GLP-1s as a shortcut may operate similarly across groups.

Weight stigma is associated with harmful health outcomes, including stress, depression and anxiety symptoms, and negative health behaviors. Post and her colleagues say stigma related to GLP-1 medications may discourage people from seeking evidence-based care or may intensify shame for those already managing a chronic condition.

"Having obesity carries many health challenges including increased risk of cancer, diabetes and heart disease," said Post. "Treatment decisions should be guided by health, not judgments about how someone manages their weight. Reducing stigma means challenging the idea that there is only one 'right' way to lose weight, through willpower alone, especially for women, who face intense social scrutiny related to physical appearance and body size."

The researchers call for communication strategies that better explain how GLP-1 medications work biologically, emphasize positive health outcomes, and reduce the perception that medication-assisted weight loss is inherently less legitimate than lifestyle approaches.