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On Ozempic for Weight Loss and Feeling Judged? The Guilt Ends Here

If you are taking Ozempic—or any GLP-1 inhibitor medication—to lose unhealthy weight, you may be feeling judged by those around you or on social media. These acts of judgement from others stem from the misunderstanding and stigma that surround obesity and overweight. Let’s see how scientific research disproves outdated attitudes about weight loss.

Why are people against using GLP-1 inhibitors like Ozempic for weight loss?

fallacy /’faləsē/ [noun]: a mistaken belief, especially one based on unsound argument

1. The “You’re so vain” fallacy

When people say “you’re just losing weight to look better,” they fail to understand that unhealthy weight is linked to an increased risk of developing several diseases and medical conditions, including type 2 diabetes, heart disease, high blood pressure, sleep apnea, some cancers, depression, and more. 

Diseases aside, carrying excess unhealthy weight can create barriers that prevent people from doing the activities they enjoy, and this can have social and psychological effects. The desire to improve your ability to live the life you want is not a cosmetic goal.

2. The “Your disease isn’t serious” fallacy

Let’s break this one down by first understanding what a disease is: a disorder of structure or function with a known cause and a distinctive group of symptoms or signs. Obesity has a known cause—or to be exact, many known contributing causes, including genetic, psychological, physical, metabolic, neurological, and hormonal impairments. It also has distinct symptoms—and beyond the physical changes, these can include negative effects on relationships with other people.

Here are a few more reasons to believe that obesity is a serious disease that should be given the same attention as any condition that is affecting millions of people around the world:

  • The National Institutes of Health (NIH) confirms that extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease.
  • The National Cancer Institute states that, compared with people of healthy weight, those with overweight or obesity are at greater risk for at least 13 types of cancer.
  • According to the Obesity Action Coalition’s fact sheet, obesity—and specifically, excess fatty tissue leading to inflammation—can increase the risk of stroke. 
  • Recent research published in Cell stresses that decreasing body fat mass can normalize a metabolism that has been impaired by obesity and can even help people achieve diabetes remission.

3. The “Eat less, do more” fallacy

When people say “to lose weight, all anyone needs are diet and exercise,” they fail to understand how complex obesity is.

Unhealthy weight gain can be caused by a variety of factors—even the type of bacteria that live in your gut can play a role. On top of this, our environment and what we’ve been taught is a “balanced diet” have set us up for failure when it comes to staying healthy. What’s more, the way the human body has evolved over thousands of years to process food doesn’t fit well with the carbohydrate-dense diet and less active lifestyle that modern living has afforded us.

Eating the right combination of foods and staying active are great recommendations for everyone. But when diet and exercise are not enough to overcome all the additional barriers to weight loss and lower your risk for weight-related health conditions, it’s encouraged that you take the next step to achieve it. This next step could be finding a fitness partner, joining a support group, starting therapy, exploring surgical options, or trying medication. 

It’s your prerogative to find the right solution for you. And it’s also your right to define what success looks like for you—without feeling judged.

4. The “Treatment trumps prevention” fallacy

This is a widespread belief in our society—not just about obesity, but all diseases and unhealthy conditions. We are much more likely to visit our doctor when something is wrong rather than take steps to keep ourselves in a state of good health. Medical care is the same way, tending to focus on reactive treatment rather than proactive prevention.

This is a big reason why experts in the diabetes field made a push for recognizing prediabetes as a formal diagnosis. They knew that by identifying an earlier stage of unhealthy blood sugar levels (instead of waiting for clinical diabetes to take hold), early diabetes treatment—including an improved diet—would gain traction and save more lives. 

Looking at obesity specifically, researchers at Washington University confirm that taking early action to reverse insulin resistance (which can be caused by too much body fat) can also prevent heart disease, kidney disease, and nerve damage.

You could take prevention a step further and say that it would be better to prevent obesity and excess weight rather than treat it with GLP-1 inhibitors like Ozempic. This is true, and many dollars and hours of effort have been put toward obesity prevention, but barriers to healthy lifestyle are woven into the fabric of our society, so breaking them down will require major shifts in social norms—and deep, sweeping changes that don’t happen quickly.

Is semaglutide a diabetes drug or a weight loss drug?

Semaglutide treats diabetes, but it also helps prevent diabetes by treating obesity. You can think of Ozempic as a diabetes drug that helps you lose weight and Wegovy as a weight loss drug that helps treat diabetes—but they both contain the same active medication: semaglutide.

Is having excess weight a legitimate reason to take Ozempic—or am I stealing from people with diabetes?

An attitude of “GLP-1 inhibitors are for people with diabetes, not for those with obesity or overweight” fails to acknowledge that efforts to treat type 2 diabetes and efforts to curb obesity aren’t at odds—they are intimately connected. 

GLP-1 meds are effective in helping people with type 2 diabetes and people who would like to lose unhealthy body fat (many of whom have prediabetes, diabetes, or are at risk of developing diabetes). Neither group should be made to feel judged for putting their health first.

What about people who have diabetes but don’t have excess weight?

While having a BMI of 25 or higher is considered the leading risk factor for type 2 diabetes, 1 in 10 people with type 2 diabetes have a BMI under 25. One possible reason that people of healthy weight get diabetes is that they carry excess visceral fat in their abdomens, located in and around certain organs.

One study followed a group of people who all had type 2 diabetes and a BMI of 26 or below. These participants ate a low-calorie diet for 2-4 weeks then ate a diet with a normal caloric intake for 4-6 weeks. This low-calorie/normal-calorie cycle was repeated by each participant until they lost at least 10% of their body weight. In addition to weight, researchers measured the amount of fat in their pancreas and liver. The study concluded that people with type 2 diabetes who have a lower BMI can still benefit from a low-calorie diet because it helps them lose harmful fat in their organs.

What about people who have excess weight but are metabolically healthy?

It is true that while obesity and excess weight are risk factors for type 2 diabetes, not all obese people are at a higher risk of getting type 2 diabetes or heart disease. But remember that there are other complications that excess weight has been tied to.

The main takeaway is this: If a person views their excess body fat as a possible risk to their health and they need some help losing that excess fat, they shouldn’t feel judged, just as someone with diabetes or complications of diabetes shouldn’t feel judged.

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External Sources Referenced:

Boye KS, et al. Obesity and glycemic control among people with type 2 diabetes in the United States: a retrospective cohort study using insurance claims data. J Diabetes Complications. 2021 Sep 1;35(9):107975. doi: 10.1016/j.jdiacomp.2021.107975

Centers for Disease Control and Prevention. Prediabetes risk test. 2022.

Chobot A, et al. Obesity and diabetes—Not only a simple link between two epidemics. Diabetes Metab Res Rev. 2018 Oct;34(7):e3042. doi: 10.1002/dmrr.3042

Diabetes UK. retune study shows type 2 remission possible for people with lower body weight. 2022.

Dryden J. Study reveals obesity-related trigger that can lead to diabetes. 11 January 2023.

Klein S, et al. Why does obesity cause diabetes?. Cell Metab. 2022 Jan 4;34(1):11-20. doi: 10.1016/j.cmet.2021.12.012

Latif W, et al. Compare and contrast the glucagon-like peptide-1 receptor agonists (Glp1ras). 27 March 2023.

National Cancer Institute. Obesity and cancer.

National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of diabetes.

Obesity Action Coalition. Obesity and Stroke Fact Sheet.

Obesity Medicine Association. Why obesity is a disease. 30 December 2023.


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