The Return of Idealizing Thinness at All Costs

I have written extensively about the GLP-1 medications over the last couple of years because of the impact on people with eating disorders. Posts have ranged from concern about this new powerful class of medication, the ease with which people can attain them basically unsupervised, the potential benefits to some people with eating disorders and the haphazard regulation of the use of this new medical intervention.

The most significant effect of the widespread use of the GLP-1’s is the societal shift over the last few years about body and weight, especially for women. In light of the last few posts in this blog, I feel compelled to discuss the changes.

Prior to the explosion of Ozempic use, there had been a movement towards body acceptance, also called body positivity. Despite the many complicated factors about this movement, one effect for many women was the possibility of seeing their bodies, and often themselves, in a new and less critical light.

I found that body positivity enabled treatment to be more successful for many of these women with more progress than I had seen before. Instead of the constant battle upstream against the current of idealizing thinness, some women could visualize a body that did not fit the societal ideal but instead matched who they were physically as a person. The newfound freedom to see herself more clearly allowed for personal growth as well.

Ozempic and the like pushed even the most conservative women about medication to consider and often try the new drugs. Without any medical indications for use, women can easily find ways to procure them for the sole purpose of weight loss. Even though many people can’t tolerate the drugs, enough women now are in much smaller bodies and the societal pressure to be thin has rebounded very powerfully headlined by the message that weight loss is attainable for all.

Women finally seeing the possibility of settling into a place of acceptance and even comfort with their bodies now suffer with negative thoughts about their bodies and themselves again. The end of any semblance of body positivity renewed the onslaught of women’s body hatred.

I don’t think these new medications are intended for social ills. The benefit for diabetes, metabolic disorders and some eating disorders is profound. The pharmaceutical industry, however, is a for profit business so the pressure to take as much of the financial pie always wins over thoughtful and regulated use of powerful new drugs.

Patients and clinicians alike need to face the reinvigorated desire for thinness by doubling down on work aimed at giving women freedom and direction. Life needs to mean more than the number on a scale or meeting the societal norm at all costs. GLP-1’s or not, these goals can’t change. External factors will come and go. The overvaluing of body won’t stop being a way to disempower women any time soon, but treatment needs to see the barriers and continue to move forward.