Yes: “diet.” I’m calling it that. It’s a word that, for the past couple decades, has been a dirty one. It was only ever whispered, while good feminists like myself were loudly rallying for body positivity. But I am at peace with admitting I want to lose a few pounds, possibly using a prescription drug.
I am more torn when I think past myself, to the larger question of what Ozempic (and similar drugs such as Wegovy and Mounjaro) mean for body positivity. If most people can lose weight with an injection or pill, is there a place for this movement any more? Will there be any body-positive icons left at all in Hollywood? Or does the rapid rise and acceptance of Ozempic show that the body positivity movement wasn’t ever as powerful as we had hoped it was?
In the 1960s, there was a fat liberation movement inspired by the radical politics of the Black Power and queer communities and women’s liberation. The idea that fat people could just exist without having to strive to change their bodies was a very progressive notion in the decade that also gave us Weight Watchers. Inspired by the countercultural be-ins of the era, in 1967, 500 activists held a “fat-in” in Central Park, eating bread and butter, burning diet books, and carrying banners with slogans including “Fat Power” and “Buddha Was Fat.” Liberation didn’t always take the form of protests: By the time third-wave feminism came around in the early ‘90s, zines such as Fat!So? were candid and joyous about living in larger bodies.
Dove’s Campaign for Real Beauty, which began in 2004, was one of the most mainstream and early representations of body positivity. The campaign was a sensation just for presenting gray-haired women or women with cellulite or women with a lot of freckles as — gasp! — beautiful. Now, 20 years later, that kind of love-yourself-the-way-you-are messaging seems normal, with upscale brands such as Reformation, Mara Hoffman, and Girlfriend Collective regularly showing models with a more diverse array of body types than the industry standard size 4 and below.
But, at the time, it felt like the beginning of a major cultural shift, paving the way for the plus-size models Ashley Graham and Paloma Elsesser on the cover of Vogue, and another plus-size model, Lauren Chan, as a Sports Illustrated swimsuit model. Beyond just models, we’ve had pop stars of size such as Lizzo and Adele. And in the world of plastic surgery, people were after the round face look of filler and the round rear look of a Brazilian butt lift.
But looking back, I’m not so sure this was ever more than noise. Even the phrase “body positivity” is so much weaker, more anodyne than its origins in fat liberation. The body positive inspiration on Instagram usually consists of relatively thin, light-skinned women somehow against all odds learning to love themselves in a bikini. But these body positive icons were unrealistic too, with perfect waist-to-hips ratios and none of the features of a real fat person, like belly bumps or rolls.
The hourglass-shaped size 16 model Ashley Graham got her own Barbie in 2016. And while it was larger than the average Barbie, it was still Barbie. Meanwhile, Lizzo has launched Yitty, “shapewear reinvented” that is “designed for every single body.” If the bar for body positivity is slightly bigger Barbies or size-inclusive shapewear, was there any real fight in the movement?
Data suggest the answer is no. One 2019 Harvard analysis examined explicit and implicit bias across a number of spectrums — including race, sexuality, disability, and body weight — from 2007 to 2016. During those years, implicit bias against people in these categories fell or stayed the same across the board — with one exception: body weight. Implicit bias against larger people actually rose during the years we think of as peak body-positivity. At the same time, researchers found that over those years, explicit bias was reduced: that is, people knew they just shouldn’t say they prefer thin bodies.
Through it all, Weight Watchers, that other child of the ‘60s, persisted, embracing every conceivable fitness and diet trend (aerobics in the 1980s, low fat in the 1990s, wellness in the beginning of this century). So it says something important about where we are headed that, in its latest move to stay on top of trends, last year Weight Watchers acquired the telehealth company Sequence, which allowed it to come out with WW Clinic. It’s an online portal that facilitates prescriptions for GLP-1 drugs and helps members navigate insurance via telehealth appointments.
This is a big step for Weight Watchers, a company that has historically prized lifestyle change and community as the foundation to diet success. The company never integrated past diet drugs such as fen-phen into its system. The shift is an indication that Weight Watchers thinks the future of dieting and the financial success of its company is tied to this new class of drugs that mimic naturally occurring gut hormones which, when taken in a weekly shot, can activate a feeling of satiety and lessen appetite.
We know there will be appetite for it: On TikTok, videos tagged #ozempic have been viewed 1.3 billion times. We also know that prescriptions have been spiking. In Boston, they were up 79 percent from 2021 to 2022, according to an analysis by Trilliant Health. Elsewhere, the rise was even more dramatic: 130 percent in Atlanta, 351 percent in Seattle, 481 percent in Cleveland. In New York City, the highest concentration of prescriptions is in one of the wealthiest neighborhoods, the Upper East Side — a sign that Ozempic is being used for weight loss, not for the management of type 2 diabetes. Barclays predicts up to a $100 billion global market for the drugs by 2030 and Danish drug maker Novo Nordisk, the pharmaceutical parent company of Ozempic and Wegovy, is now responsible for most of Denmark’s economic growth. It has been battling the French luxury conglomerate LVMH for the spot as Europe’s most valuable company.
About a year into the GLP-1 media narrative, we have seen a parade of high-profile people acknowledging losing weight using one of the drugs. “I now use it as I feel I need it, as a tool to manage not yo-yoing,” Weight Watchers’ own investor Oprah Winfrey told People. “The fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for. I’m absolutely done with the shaming from other people and particularly myself.” Elon Musk has mentioned using a weight-loss drug, as have Amy Schumer, Chelsea Handler, Tracy Morgan, and Sharon Osbourne. That doesn’t even begin to cover the array of celebrities (Mindy Kaling, Adele, Jesse Plemons, various Bravo stars) who have become rather svelte in recent months and either denied using Ozempic or stayed quiet.
Speculation has begun happening in my personal life too, and in my own group chats. Some acquaintances, friends, and even relatives of mine have been forthcoming and even matter-of-fact about taking Ozempic, or drugs like it. One woman I know told me it was a “miracle drug” for taking away her lifelong inner dialogue and guilt around food and giving her a sense of peace, even if it came with a bill attached. (A year of out-of-pocket payments for a GLP-1 can be about $10,000.) I speculate about other people, particularly those I have more of a parasocial relationship with: friends of friends and even body-positivity influencers who appear to have dropped several dress sizes. I feel a little bit lurid wondering about who’s taking it. It’s certainly not a very body positive impulse to publicly or privately analyze other people’s (let’s be real — other women’s) bodies. But it does seem like we are losing role models of size, and that feels like a loss.
There is a certain damned if you do, damned if you don’t aspect to all of this. Giving into societal pressure over what’s desirable is a trap. Chasing an ideal can just lead to a lifetime of, well, chasing and never getting to the finish line. I have had dozens of conversations with friends about our baby boomer mothers who are still dieting in their 70s and 80s. At what point do you get to relax and enjoy life?
But, there’s also a rationale to being thin. Strangers will treat you with more courtesy. Your friends and family will likely be less critical of your body. It’s easier to find clothes that fit. You will, on average, make more money. There’s no answer that doesn’t involve feeling like you’re betraying some core principle.
And what about unintended ripple effects? Will doctors pressure patients who are obese to get on drugs as a tool to a normal BMI without a real analysis of their overall health or how the patients feel about their own bodies? Will the drugs be seen as a signifier of class and money for those who can afford them? After all, they are meant to be used indefinitely for optimal effect even though most insurance won’t cover it for weight loss. What about the Met Gala effect — people who aren’t obese or even overweight using the drugs to lose a few pounds before a wedding? (I hate to think about teenagers trying to use them for prom.) These drugs were used on diabetics for a number of years before they were used for weight loss, and doctors say they’re safe. Even if there are, best case, no lasting negative effects on health, there certainly may be for society.
There is also a significant side effect that might make people reluctant to stay on them forever. And not just the more miserable side effects of nausea, diarrhea, and constipation, although any one of those wouldn’t be fun to live with. It’s the elimination of cravings. There is anecdotal research that GLP-1 drugs don’t just dampen the desire for food, but can also come with reduced interest in drinking, smoking, shopping, even sex. There are certainly researchers pinpointing how to target those cravings with new iterations of GLP-1 drugs. But what does life look like flattened of cravings? It’s like a Whac-a-Mole game. If not food, then drinking. If not drinking, then shopping. And if we are able to crush all of our cravings, then what kind of desire do we have left? People go off diets all the time not because living on them is untenable but because it’s boring. Anyone who has done a juice cleanse can tell you that.
Perhaps the normalization of Ozempic will be the end of this era of tepid body positivity, and maybe that’s a good thing. It can signal a return to a more overtly political movement. Or at least one that stands for something. Katie Sturino, a body positivity influencer who has over 800,000 followers on Instagram, recently posted a video of herself talking about Ozempic. Here it comes, I thought, either a decision to reveal that she got a prescription or a screed against people who take it. Instead, what she talked about was different. The body positivity movement, she said, “is not about whether you are gaining or losing weight. It’s about whether you’re at peace with yourself.”
I don’t know what my path to peace is. But I haven’t gotten a prescription yet.
Marisa Meltzer is the author of This Is Big: How the Founder of Weight Watchers Changed the World (and Me) and Glossy: Ambition, Beauty, and the Inside Story of Emily Weiss’s Glossier. Send comments to [email protected].
Rachel Carter is a health and wellness expert dedicated to helping readers lead healthier lives. With a background in nutrition, she offers evidence-based advice on fitness, nutrition, and mental well-being.
