Ozempic does not cure self-esteem

At the end of August, tennis star Serena Williams advertised a new weight-loss drug. The slogan, in Williams’s voice, was: “They say GLP-1—a drug that mimics a hormone that regulates blood sugar, appetite, and slows digestion—is a shortcut to weight loss, but it’s not. It’s science.” Interestingly, Serena Williams’s husband is an investor and member of the board of Ro, the healthcare company that offers it.

A large number of actresses, singers, models, and influencers have spoken about using Ozempic—the commercial version of GLP-1—for weight loss. In most cases, the narrative has been one of improved health through slimming down.

Talk has spread seeking to dignify its consumption. However, are we doing it for health reasons? Are the interests of a pharmaceutical company driven by promoting healthy habits or simply generating fear around obesity? We are faced with a complex phenomenon where economic interests, health concerns, and aesthetic pressures converge: the recourse to slimming drugs by people with normal blood tests who are simply looking to lose a few pounds to conform to a standard of thinness.

The main debate about the potential harmful effects of GLP-1 use has focused on physical side effects—gastrointestinal problems, fatigue, dizziness, hypoglycemia— and on psychological ones—changes in eating behavior, dependence, mood swings. But what impact does the normalization of its use have from a sociocultural standpoint?

In this sense, one of the consequences is the increase in social pressure regarding one’s body image. For years, Serena Williams has been considered a symbol of body diversity and an example of how a large, strong, athletic body can be synonymous with health and success, even when that body size doesn’t fit the beauty ideal of thinness. This isn’t about questioning her decision to use GLP-1, but rather pointing out that, to the extent that an athlete who has symbolized a non-normative physique advertises this drug in the name of science, there is a loss of representation of body diversity. And this loss implies a message: “If you don’t have a thin body, it’s because you don’t want to,” which promotes a vision of diversity as something that people should want to modify and eliminates some of the scenarios through which many Black women managed to project themselves by inhabiting large, healthy bodies.

On the other hand, by becoming popular as a medically prescribed solution, it reinforces the narrative—endorsed by the World Health Organization—that obesity is a disease and that overweight bodies are pathological. Many critics insist that a person’s health cannot be simplified to a physicality or a body mass index (BMI). Back in 2018, Tomiyama and some collaborators published research in BMC Medicine demonstrating that pathologizing bodies causes stigma, shame, and reduces motivation to take care of ourselves. The authors proposed that people with obesity should be treated only if they have markers of poor health rather than a high body mass index. Although the number of studies pointing in this direction has grown since then, the success of the Ozempic study brings back a culture that denies the existence of a diversity of healthy bodies and perpetuates the pathologization of those that fall outside this aesthetic ideal.

Furthermore, as the drug’s aesthetic use is validated, the population interested in consuming it multiplies exponentially. It’s no longer just a drug for a population with pathologies; it’s also desired by those who suffer the consequences of aesthetic violence and body dissatisfaction, normalizing the use of drugs to interfere with our body’s appearance in order to achieve the desired beauty and social validation. What are we finding in psychological consultations? That drug use doesn’t heal body image distress. It may provide short-term satisfaction and a sense of control, but it doesn’t encourage us to work on emotional wounds, personal history, body self-esteem, or the development of sustainable habits, which are undoubtedly fundamental aspects to cushion the impact that aesthetic violence has on us.

We also cannot forget that the increased demand for GLP-1 drives the interests of the pharmaceutical industry and increases the cost of treatment. This creates an economic gap in countries like the United States, where the most vulnerable populations lack access to the drug. This year, the massive consumption of Ozempic has even led to shortages, leaving patients with diabetes without an essential medication for their health.

Is the rise of this treatment a response to a society that is more health-conscious, or just more concerned with aesthetics? The phenomenon isn’t occurring in a vacuum. It’s happening at a time of a return to the aesthetics of the early 2000s, as relevant fashion media outlets are already pointing out, which was marked by extreme thinness—“heroin chic,” skinny silhouettes...—. Meanwhile, the talk in favor of body diversity is being weakened and challenged, directly affecting those who found support and sustenance in these movements.

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