Glucagon-like peptide-1 (GLP-1) drugs are currently a major part of the national conversation regarding weight loss. From celebrity stories to everyday discussions, drugs like Ozempic and Wegoby are often touted as breakthrough drugs that help people lose significant amounts of weight.
But new research from Rice University suggests that the social experience of using these drugs is more complex. In some situations, those who use them may face even harsher judgment than those who don’t lose weight at all.
The unexpected results come from a study led by Erin Standen, an assistant professor of psychological science at Rice University, published in the International Journal of Obesity. Her co-authors include Sean Phelan, professor of health services research at the Mayo Clinic, and Janet Tomiyama, professor of psychology at the University of California, Los Angeles.
“We expected that there might be some bias against the use of GLP-1,” Standen said. “But what surprised us was the sheer scale of it.”
Study finds greater bias against GLP-1 users
In this study, participants were asked to rate a hypothetical individual based on their weight history. The person either lost weight using GLP-1 drugs, lost weight through diet and exercise, or did not lose weight at all.
A clear pattern emerged. Participants viewed those who used GLP-1 drugs more negatively than those who lost weight through traditional methods.
The findings went even further.
People rated GLP-1 users more negatively than people who hadn’t lost any weight.
“GLP-1 users were not only compared to people who lost weight through diet and exercise, but they were also socially punished,” Standen said. “They were also evaluated more harshly than those who didn’t lose weight in the first place.”
Prejudice doesn’t go away even if you lose weight
This result points to a more complex picture of weight-related stigma. Losing weight does not necessarily eliminate social stigma. Rather, the way in which that judgment is expressed may change.
“There’s this idea that if you lose weight, you might escape the stigma,” Standen said. “But what we’re seeing is that people can face judgment at multiple points. They can be judged for their weight and how they choose to manage it.”
This issue becomes particularly relevant as GLP-1 therapeutics become more widely used and discussed. Many of our decisions seem to be tied to perceptions rather than outcomes.
“There’s a theory that using these drugs is ‘taking the easy way out,'” Standen said. “And those beliefs seem to shape how people make decisions.”
What happens when you gain weight back?
The researchers also looked at common circumstances among people who stopped taking GLP-1 drugs. Many people discontinue treatment because of cost, insurance limitations, or side effects. It is common for weight to return when discontinuing.
The study found that this scenario also has social implications.
Participants viewed those who gained weight back more negatively than those who lost weight and kept it off, regardless of whether the weight loss was due to medication or lifestyle changes.
“There’s a lot of stigma around weight gain in general,” Standen says. “And it doesn’t seem to depend very much on how the weight was lost in the first place.”
How weight stigma affects health
Standen said these findings highlight concerns beyond social attitudes. Weight stigma is consistently associated with negative effects on mental and physical health. These include stress, avoidance of medical care, and unhealthy coping strategies.
“If people feel judged about their health choices, that can affect their motivation,” she says. “It can affect whether they seek care, whether they speak openly with their health care providers, and how they manage their overall health.”
As GLP-1 therapeutics continue to enter the mainstream, understanding these societal effects becomes increasingly important.
“This is a moment where these treatments are really becoming mainstream,” Standen said. “So it’s important to understand the social aspects of it.”
Rethinking how society views weight and health
This study is part of a broader effort to encourage healthier choices without reinforcing stigma. Standen said her goal is to better understand how people can be supported without feeling judged.
“There are very strong cultural beliefs about weight and what a ‘healthy’ body should look like,” she says. “And those messages can actually get in the way of people doing what’s best for them.”
She hopes the findings will help change public attitudes.
“At the end of the day, any form of stigma related to someone’s body or health choices is unhelpful,” Standen said. “People should be able to make decisions that are right for them without fear of being criticized.”
