Ozempic, Saxenda and GLP-1 medication

Most of the clients I work with who are on a fat loss journey are doing so because they want to improve their health and/or improve their self-image. 

Both of these things can be achieved through fat loss, but they can also be achieved separately from fat loss, and fat loss on its own doesn’t guarantee that you will achieve them.

My approach with clients who wish to lose body fat is to do so in a way that is also health-promoting. That includes knowing when not to pursue fat loss. We can work on our health and body image outside of a fat loss phase and take time off from pursuing fat loss without feelings of guilt or shame.

Unfortunately, in recent times, it seems like this nuance is being lost. 

Thin is once again, ‘in’, and though it always kind of has been, for a short while at least it felt as though we were campaigning for ‘strong over skinny’ and we were ‘all about that bass, no treble’. 

What we’re currently seeing is the effort to rewrite the narrative of what health and body confidence could look like crumble under the wrecking ball of resurfacing diet culture rhetoric online.

It runs along the lines of,

Why should I be criticised for not wanting to eat junk food and sit on the couch all day?

Some people prefer their hair a certain colour, I prefer my body to be thinner, how is that any different?

Body positivity is just an excuse to be lazy and let yourself go while calling it ‘empowerment’

The rise of GLP-1 receptor agonists (Ozempic/Saxenda) is a big part of it. These drugs are certainly a breakthrough in medicine that are truly life-changing for people who would benefit from weight loss but have difficulty doing so with diet and exercise alone. 

However, as pointed out in an episode of Polyester Podcast titled Society Has Never Hated Fat People As Much As We Do Right Now, the accessibility of this medication means that we now have a reason to pathologise ‘fatness’ as a medical condition, regardless of whether there are actual health concerns present or not. Shortly, it will be assumed that if you are in a larger body, it’s only because you can’t afford the jab, not because you’re actually happy the way that you are (god forbid).

This reinstates the internalised fat-phobia which many of us have been conditioned to hold.

Making it ‘ok’ to want to be thin again is not about health or body image. 

It’s about justifying a beauty standard that pushes women (because it is mostly targeted at women) to be smaller, more malleable, and more frail. And though there are, of course, women who naturally exist in smaller body types, it is unfair to expect everyone else to deprive themselves for endless periods just to feel worthy.

It’s a complex subject because on the one hand, these medications are life-changing. Losing weight can make a big difference to our health and quality of life, and if you’ve struggled to do so on your own, there should be no shame in needing medication.

But on the other hand, it’s about knowing how far is too far. Many people chase weight loss instead of working on building their self-worth outside of their appearance, or building a life that is both fulfilling and enjoyable. Many people go on diets to distract themselves from unpleasant realities in their lives. We might associate health and happiness solely with having less body fat, and not with consistency of healthy habits or with how we feel on a day-to-day basis. 

My main concern about weight loss medication is its potential to push the thin beauty standard even further, something that becomes normal to take even for those who aren’t in larger bodies, marginalising larger bodies even more. 

In an ideal world, we’d be able to recognise that we can all exist in different body types and be healthy, and beauty standards wouldn’t be determined by how adherent we are to a shrinking ideal. There shouldn’t be a stigma around taking weight loss medication, but there shouldn’t be a pressure to take it either, especially if we genuinely ask ourselves, Is weight loss truly the answer to what I’m seeking?

Like most things in the nutrition world, there really is no black and white answer (sadly).