The thinness bias and privilege remain strong and ever present in our culture. As much as various groups try to promote body positivity and the general notion that we are all built differently, thinness is still considered central to status and achievement.
The societal fallout from the thinness bias are mainly two things: low self esteem in young people and the high prevalence of eating disorders. The need to be thin means people never feel thin enough and scrutinize their bodies, and themselves, with a negative view. The urgency of being thin also determines the large number of people looking to lose weight. Restricting food is the number one risk factor for developing an eating disorder.
Only a couple of years ago, a turn for the better in popular culture through body positivity seemed imminent. The opening signaled the broader acceptance of varied body types and a turn away from vilifying larger bodies. Language started to change. The fashion industry started to shift. Some people tried to take back the word fat from a slur to use it literally and unemotionally. These steps were promising.
Yet the tide turned quickly. The pressure for thinness quickly overtook popular culture, and body positivity was just another failed attempt to normalize body types.
It’s easy to blame new trends. The most obvious change was the introduction of the GLP-1 agonist drugs (Ozempic et al.) which elevated weight loss as the number one goal and became the newest holy grail to magical changes in our bodies. People more focused on health and well being were inundated with ads for the new drugs. Social media zeroes in and people losing weight. Family and friends talked endlessly about the new drugs and marveled at their magic weight loss. A developing trend couldn’t withstand this cultural juggernaut.
These medications reflect not just the newest weight loss promise but the battle between attempts to shift cultural norms about body shape against capitalist pressures to make a buck on our fears. We live in a world where corporate demands triumph over our well being time and again. If new money making ventures exist, there is no one protecting our medical and mental health.
Weight is a very vulnerable part of our psyche. We have been programmed to focus on thinness as health and success and are susceptible as a culture to any promise of that achievement. Even when movements attempt to circumvent the pressure to lose weight, new options and advertising win each time.
The marketing of the GLP-1’s easily overtook a burgeoning social movement and has lined the pockets of the pharmaceutical companies and all the side businesses that cropped up around it, online doctors, pharmacies and compounding pharmacies.
I have written extensively about these drugs as the first of a series of gastrointestinal hormonal agents coming out in the next decade. We don’t really know what these drugs do yet but they’re not really weight loss drugs. Cynically, the pharmaceutical companies knew that’s where the money would be. These drugs will turn out to be very helpful but in ways we can’t yet understand.
People need knowledge and protection from big industry. Doctors need to inform patients about the true nature of weight and health and the risks and benefits of the GLP-1’s. People in the United States may often have access to top notch care but at what expense. I don’t know that these trends will change any time soon, but the healthiest patient is not only the one prioritizing health over weight but also the best informed.
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