The Complicated Question of Body Image and the New Weight Loss Drugs

Medically reviewed by April Justice, LICSW
Updated June 11, 2024by BetterHelp Editorial Team

At this point, most people have heard of the tide of new weight loss drugs on the market, including  various brand names of semaglutide that were initially developed as type II diabetes medications. While research has found these medications to be safe and effective for most people, there have been some controversies over availability, price, and unpleasant side effects. 

Another equally important question surrounds the “quick fix” aspect of weight loss with this drug. In recent years, the body positivity and body neutrality movements have made headway in the public health arena, encouraging followers to love their bodies no matter what shape. Now there is an extremely popular and “easy” way to lose a great deal of weight, playing into long-held and widespread body image concerns in the social landscape. People who may have been experiencing eating disorders now have a new way to avoid food. 

As with anything related to weight loss, it’s not as simple as either large-scale acceptance or rejection of this medication. In this article, we’ll take a closer look at the problem of body image in the weight loss industry, discuss how semaglutide medications are affecting the landscape, and explore ideas for how to balance its use (or not) with positive body image.  

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A brief history of body image and the weight loss industry

Over the years, the weight loss industry has cashed in on body dissatisfaction, often from a purely aesthetic standpoint, although in recent years linking a thin body to health has been a common refrain. Weight loss is a billion dollar industry, selling supplements, programs, tracking apps, and more. 

Movies, TV, magazines, and social media influencers often inform, reinforce, and encourage chasing “the perfect body.” In the past, advertisements often openly celebrated thinness, with even cigarettes being commonly touted as a weight reducer. 

The advertising changed but remained just as harmful in the seventies and eighties as women were encouraged to limit calories with low-fat drinks, restrictive meals, and dangerous stimulant drugs. The nineties brought in a different look, in which both men and women’s hip bones were prominently displayed in advertising. 

The standard of health for many years (which is being challenged now) has been the body mass index (BMI) scale. Critics claim that this measure was developed with a certain type of white body in mind and that using it as a universal standard of healthy weight is not only incorrect, but impossible for many types of bodies.  

As a result of a cycle of media depictions of the “ideal” body, as well as a constant stream of advertising from weight loss companies, many people have developed a negative relationship with their bodies. In some cases, this may lead to eating disorders, such as anorexia nervosa, bulimia, or binge-eating disorder. 

In the United States, the lifetime prevalence rate of binge eating disorder is approximately 2.8%. Bulimia has a lifetime prevalence of 1%, and anorexia has a lifetime prevalence of 0.6%. 

Food restriction is not uncommon in people experiencing eating disorders, nor is it uncommon in the general population. Many people have restricted food intake for weight loss, one way or another. In the last several years, a tool has come along that offers an easier way to do this. 

The advent of the GLP-1 agonist for weight loss

Semaglutide was developed to manage the symptoms of type II diabetes by prompting the body to produce more insulin. Now also known as a GLP-1 agonist for weight loss, it mimics the hormone that is released in the gut in response to food intake. As a side effect, larger doses of this medication suppress appetite by triggering the part of the brain that signals that the body is full. 

Semaglutide is prescribed by and injected into the body by a healthcare professional. A pilot study of nearly 2,000 individuals followed one group who followed a weight loss plan alone and a corresponding group who supplemented their program with semaglutide injections. The results showed that after 68 weeks, nearly half of the semaglutide users lost 15% of their body weight, while almost one-third lost 20% of their body weight. Those who used lifestyle change alone lost only 2.4% of their body weight. 

Semaglutide has been shown to be an effective tool for weight loss, but studies have also shown that those who stop using it tend to gain the weight back

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Semaglutide can have side effects and may not be right for certain people. Side effects include:

  • Dizziness
  • Gastrointestinal problems, such as nausea, vomiting, constipation, or diarrhea
  • Headache
  • Vision changes
  • Rapid heartbeat

Doctors may recommend that you not take semaglutide if:

  • You have a history of gallbladder disease.
  • You have a history of pancreatitis.
  • You have a history of medullary thyroid cancer.
  • You have multiple endocrine neoplasia syndrome type 2.

Some can use these injections to help decrease hunger as a way to lose weight. For others, it may not be in their best interest. 

The balance of supporting choice while protecting body image

It can be challenging to strike a balance between aiming for weight loss and loving your body. People trying to lose weight can have a positive body image yet still desire weight loss to improve their physical health, appearance, or self-esteem. Others trying to lose weight may experience negative body image concerns and try to conform to an impossible standard for themselves. 

Not everyone receiving weight loss injections has body image concerns, although many may. As with any other weight loss tool, it is only harmful as it relates to a person’s relationship to their body. 

If you are using semaglutide and your body experiences a negative reaction, but you continue to use it because you feel pressure to lose weight, this can be harmful. If a negative body image drives you to change your body shape in a way that is detrimental to mental and physical health, then it can be a sign that you may want to improve body image. 

On the other hand, if you want to use semaglutide to improve your health and/or change your appearance with moderation, you may benefit from taking this medication with a doctor’s approval.

If you have doubts about your own motivations when it comes to weight loss (especially if you have experienced disordered eating in the past), it may be helpful to talk to a mental health professional and shift your negative thoughts and feelings into more positive directions, whether you decide to take medication or not. 

If you have difficulty scheduling and attending in-person therapy appointments, online therapy may be a convenient solution. Research shows that online therapy can be just as effective as in-person therapy. Online therapy platforms like BetterHelp typically offer a flexible schedule and various communication options, including audio, video, and live chat. 

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Getting injections for weight loss doesn’t necessarily mean you experience disordered eating or poor body image. However, if you find that in the course of your weight loss you have a tendency to direct negative thoughts toward your body shape, your progress, or any related areas, it can be a good idea to take a closer look at why you feel that way. 

Takeaway

While new weight loss medications may help some people, there can sometimes be body image concerns that remain unresolved even when someone takes one of these medications. With a doctor’s recommendation, there is nothing wrong with taking such a medication while understanding the risks. Regardless of whether you decide to take a weight loss medication, it may help to speak with a licensed therapist. A therapist may be able to help you resolve questions related to body image, if necessary, and then help you make the best decision. Take the first step toward finding support with body image concerns and contact BetterHelp. 

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