In the Ozempic era, not all pounds lost are met with praise.
New research suggests that people may face more judgment for slimming down with the help of a GLP-1 drug than if they hadn’t lost weight at all.
“We expected there might be some stigma around using a GLP-1,” Erin Standen, assistant professor of psychological sciences at Rice University and the lead author of the study, said in a press release. “But what surprised us was the extent of it.”
In the study, Standen and her colleagues asked more than 600 participants to evaluate a fictional person based on their weight history.
The person was described as a 38-year-old college graduate with no specified gender who had been living with obesity since adolescence and recently weighed around 220 pounds.
The participants were told that the person had either slimmed down using a GLP-1 drug like Ozempic or Wegovy, shed pounds through diet and exercise, or hadn’t lost weight at all.
After reviewing the profile, the participants rated the person on a series of positive and negative personality traits, from “friendly” and “intelligent” to “lazy” and “sloppy.” They were also asked whether they’d want to spend time with them.
“The GLP-1 users were socially penalized not just compared to someone who lost weight through diet and exercise,” Standen said. “They were also rated more harshly than someone who didn’t lose weight in the first place.”
The findings come as GLP-1 use for weight loss has skyrocketed in recent years, climbing from 5.8% of US adults in February 2024 to 12.4% in October, according to a Gallup poll.
Originally developed to treat diabetes, the drugs work by mimicking hormones released in the gut after eating, helping regulate blood sugar, appetite and cravings.
They’ve quickly reshaped modern weight-loss care, with studies showing people typically shed between 15% and 25% of their body weight after a year of consistent use.
That shift is now starting to show up in national data.
Last year, the US adult obesity rate fell to 37%, down from a peak of 39.9% in 2022, Gallup data shows. That amounts to an estimated 7.6 million fewer obese adults nationwide compared with three years earlier.
But while GLP-1s have proven to be highly effective tools, many people stop taking them because of the cost, side effects or reluctance to stay on the drugs long-term.
In fact, more than three-quarters quit within two years, and when they do, the results often unravel quickly.
One study found that people returned to their pre-treatment weight within about a year and a half of stopping the medication. Another showed weight is regained roughly four times faster after discontinuing GLP-1s than after ending diet or exercise programs.
Curious how people would react to weight regain, Standen and her colleagues conducted a second experiment involving more than 700 participants.
This time, the fictional person was described as having regained weight after stopping a GLP-1 drug, regained weight after abandoning a diet and exercise plan, never attempted to slim down at all, or successfully shed pounds and kept them off.
The participants viewed people who regained weight more negatively than those who maintained their slimmer size, regardless of whether the initial weight loss came from medication or lifestyle changes.
“There’s a lot of stigma tied to weight regain in general,” Standen said. “And that doesn’t seem to depend much on how the weight was lost in the first place.”
It’s not the first time researchers have found that the public doesn’t always view GLP-1 drugs favorably.
A study released last year found that people, particularly women, who achieve significant weight loss with the drugs are met with more negative attitudes, suspicion and less admiration than those who slim down through diet and exercise.
The “right way” to lose weight is often thought of as exercising willpower, being more physically active and eating less. GLP-1 users, meanwhile, are often perceived as taking a shortcut or cheating.
That perception may help explain why a significant number of people are taking the drugs in secret despite their massive popularity, keeping it hidden from their spouses, partners, friends and family.
“There’s a narrative that using these medications is ‘taking the easy way out,’” Standen said. “And that belief seems to shape how people are judged.”
The ripple effects are wide.
Research has consistently linked weight stigma to poorer mental and physical health outcomes, including stress, delayed medical care and unhealthy coping strategies.
“If people feel judged for the choices they’re making about their health, that can influence what they’re willing to do,” Standen said. “It can affect whether they seek care, whether they talk openly with providers and how they manage their health overall.”
