While GLP-1 drugs are revolutionizing obesity treatment, new research reveals a surprising reality. People can face stigma whether they lose weight, gain it back, or don’t lose weight at all.
Research: An experimental study of the use and discontinuation of GLP-1 receptor agonists to blame for weight loss and recovery. Image credit: KaterynaBorodina/Shutterstock.com
In a recent study published in International Journal of ObesityA group of researchers investigated whether people experience stigma after losing or regaining weight after using and discontinuing glucagon-like peptide-1 receptor agonist (GLP-1RA) drugs.
Public attitudes toward GLP-1 weight loss remain divided
Weight loss drugs such as GLP-1RA improve obesity treatment, and drugs such as semaglutide and tirzepatide help many people lose significant weight. However, public opinion regarding these treatments remains divided.
Weight loss through pharmacotherapy is viewed by some as “taking the easy way out,” and this theory has gained public attention and generated new forms of social judgment regarding obesity treatment. This is especially important because many people end up gaining weight back when they stop treatment due to high costs, side effects, or loss of insurance coverage. Multiple studies suggest that weight stigma can negatively impact mental health, well-being, and health care utilization.
Further research is needed to understand how medication-based weight stigma affects long-term health.
Two randomized experiments testing responses to weight change
The researchers conducted two randomized experimental studies with participants recruited through the US online survey platform Prolific. Study 1 included 607 adults and Study 2 included a total of 706 adults. Participants were 18 years of age or older, spoke English fluently, and were not informed prior to participation that the study was specifically about weight, diet, or GLP-1 medication.
In both studies, participants read a description of a hypothetical 38-year-old individual who had experienced obesity since adolescence. The gender of the target was intentionally not specified to reduce gender-related bias.
In Study 1, participants were assigned to read about individuals who lost weight using GLP-1RAs drugs, individuals who lost weight through diet and exercise, or individuals who did not lose weight and maintained a high body weight. Study 2 measured participants’ responses to individuals who regained weight after discontinuing either a GLP-1RA drug or a diet and exercise program. Additional groups included those who maintained their weight loss and those who did not lose weight.
Participants rated the goals on a variety of positive and negative personality traits, single-item measures of perceived health status (“unhealthy”), and willingness to interact socially.. Measures of explicit weight bias, internalized weight bias, and perceived socioeconomic status were also considered. One-way analysis of variance (ANOVA) with follow-up comparisons was used for statistical analysis.
GLP-1 weight loss is associated with more negative judgments
The findings showed that both the use of GLP-1RAs for weight loss and the experience of regaining weight after discontinuing treatment is surrounded by social stigma. In Study 1, participants judged people who lost weight using GLP-1RA more negatively than people who lost weight through diet and exercise. Using drugs to lose weight was seen as lacking discipline and being less proactive, and was rated as more “unhealthy” on this scale. Participants were also less likely to interact with the person compared to their diet and exercise goals.
One particularly surprising finding was that GLP-1RA users were judged to be less positive, and in some cases less desirable, in terms of social desirability than those who did not attempt to lose weight and maintained a high body weight.
Participants rated untreated high weight goals as having more positive characteristics than medication-induced weight loss goals, but no differences were observed across all negative or health-related measures. This finding goes against the researchers’ initial expectations that heavier people would be most stigmatized and suggests that weight loss through medication, despite its medical efficacy, may be perceived by some as socially undesirable or morally questionable.
In Study 2, participants observed those who regained weight after discontinuing GLP-1RA medication to be similar on most criteria to those who regained weight after discontinuing diet and exercise. Both were given lower ratings than those who were successful in maintaining their weight loss. Those who maintained their weight loss were rated as healthier, more disciplined, and more socially desirable than those who regained the weight after discontinuing weight loss treatment.
The results also showed that participants were less willing to date people who gained weight back after discontinuing medication compared to those who maintained their weight loss. In some cases, people who gained weight back were evaluated less positively than those who didn’t lose weight, highlighting the persistence of prejudice.
Interestingly, the methods used before weight regain did not significantly change stigma levels. Participants responded similarly whether they gained weight back after drug use or after behavioral weight loss.
The researchers also investigated whether people thought people taking GLP-1RAs were of higher socio-economic status because of the higher cost of the drug. The researchers found no significant differences in the perceived socioeconomic status of individuals taking the medication compared to the diet and exercise group.
People who had more explicit prejudice against overweight people, had lower levels of empathy for overweight people, and believed that people were fully responsible for their weight showed a tendency to judge GLP-1RA users more harshly in one study, but these effects were modest and not consistently observed in both studies.
Individuals face stigma regardless of treatment or outcome
This study showed that individuals may face stigma throughout the cycle of weight loss and weight gain associated with GLP-1RA use. People who lost weight using drugs were often judged more negatively than people who lost weight through lifestyle changes, and people who regained weight after stopping treatment also experienced social stigma.
The findings suggest a “no-win” situation in which individuals can face stigma whether they lose weight with medication, gain it back, or keep gaining weight. These findings highlight how obesity stigma persists even when people pursue medically approved treatments. This result is particularly important as GLP-1RA is becoming increasingly common around the world.
The researchers emphasized the need for public education, health care provider training, and implementation of stigma reduction programs to support people seeking treatment for obesity.
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Reference magazines:
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Standen, E. C., Phelan, S. M., and Tomiyama, A. J. (2026). Experimental investigation of the use and discontinuation of GLP-1 receptor agonists to blame for weight loss and recovery. International Journal of Obesity. Toi: 10.1038/s41366-026-02061-y. https://www.nature.com/articles/s41366-026-02061-y
