Kassaundra Ferm
6 December 2025
I cannot scroll through social media without being confronted by the relentless normalization of thinness, a trend aggressively amplified by celebrities and influencers who showcase extremely slender bodies. This cultural shift, primarily driven by the rise of new GLP-1 medications like Ozempic, has blurred the lines between wellness and disorder.
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| Constant Comparison |
As someone passionate about nutrition, I have been on a personal journey since my time in Thailand two years ago, when I first began exploring the importance of nourishing foods. I’ve sought to understand holistic approaches to healing from the inside out, emphasizing high-fiber, whole foods, and the vibrant colors of a rainbow diet.
However, my history with anorexia nervosa complicates this journey. Three years ago, I was hospitalized for an eating disorder and faced a traumatic experience at a clinic where I regained weight but did not fully address the underlying mental challenges. My desire to be smaller, coupled with a pursuit of perfection and an ideal level of thinness, has persisted for years. During that time, I was told I was extremely skinny, which initially made me happy. Since then, my weight has fluctuated as I’ve battled between nourishing my body and the urge to maintain a very slim figure through calorie deficits.
This ongoing struggle with body image affects me deeply. I avoid taking pictures because I worry about how I might be perceived, and I steer clear of mirrors to prevent nitpicking my body. Last summer was particularly difficult, as constant thoughts about my family members’ opinions—about my body, weight, and eating habits—kept circling in my mind. This internal conflict between wanting to eat healthily and a desire to stay as thin as possible continues to influence my life.
Scrolling through social media, I often find myself down a rabbit hole filled with influencers and celebrities who are extremely thin. I recently came across a critique by a nutritionist working within the eating disorder field, warning against the normalization of skinny bodies by celebrities. This normalization can harm those of us who wish to achieve a super thin physique, making it harder for us to improve because we are constantly exposed to images of bodies achieved through GLP-1 drugs and strict diets—bodies we are striving for and have worked hard to heal and improve. Comparing ourselves to these celebrities can be deeply damaging.
This prompts me to explore the psychological impact of GLP-1 usage among celebrities, family members, and social media users, particularly how it influences eating disorders. I also want to assess whether these drugs are truly beneficial or if they are being misused by people who don’t need them, due to the widespread acceptance of being extremely thin.
What steps can we take to promote healthier body standards rather than celebrating extreme thinness? Are too many individuals using these drugs without medical necessity? Could this trend be creating a negative societal cycle, where the focus is on treating symptoms of overweight rather than addressing the root causes—metabolic health and mental well-being holistically?
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| Harm From Body Checking |
Let's investigate these questions.
The widespread popularity of GLP-1 drugs like Ozempic and Wegovy didn’t happen by chance. It reflects a deep, long-standing shame around body size that has grown over decades. Society has long promoted a narrow ideal—slim for women and muscular for men—that most bodies cannot naturally match. Although the body positivity movement aimed to challenge this, it swung too far, and encouraging healthier choices for metabolic health was sometimes labeled as "fatphobic." As a result, society still has not fully embraced normal body acceptance. For many of us who struggle with body image, there is a constant, tiring voice suggesting our issues stem from mere lack of willpower. We tend to blame weight on personal choices like diet and exercise, but these are only part of a bigger picture that includes genetics, stress, sleep, and our environment. Our bodies also seem to follow a set point—an idea that our brain is hardwired to maintain a certain weight range and will resist weight changes fiercely. That makes dieting and weight loss feel like an ongoing battle between our brain and body.
Research shows that the appeal of the "magic shot" is primarily psychological, rooted in deep-seated insecurities. One study revealed that people most attracted to GLP-1 medications tend to have lower self-esteem and higher body image anxiety, clearly illustrating the link between psychological distress and the desire for quick weight loss solutions (Markey et al., 2025). When individuals see their bodies as "broken" because of their size, their desire to be thin isn’t just about appearance; it’s about feeling accepted and gaining a sense of control. The immense pressure to conform to a certain body ideal can come from family, friends, or the pervasive influence of online media. No public figure exemplifies this scrutiny more than Oprah Winfrey, who has openly shared her lifelong struggles with weight and body image. In her special, she expressed deep internalized judgment, viewing her body as a "moral failing" and a sign of a lack of willpower (Williams & Monier, 2024). Many of us share this struggle, highlighting how deeply our culture associates body size with personal character, success, and respect. The promise of GLP-1s is therefore a false hope—an idea that we can finally shed lifelong shame without the "fight" involved. By "fight," I mean both mental battles—such as obsessing over food and negative self-talk—and physical challenges —such as relentless hunger signals and metabolic resistance from set-point theory. It also involves social struggles, such as constant scrutiny of weight and stigma.
This cultural moment is particularly fraught because, for those prone to disordered eating, any quick and easily accessible method for altering body shape—such as laxatives, purging, excessive exercise, or now, GLP-1 drugs—can quickly become a tool of harm. When a potent drug designed to suppress appetite enters a culture already obsessed with thinness, the risk of misuse is immediate and serious. Clinical case reports have begun to highlight this danger. One study described a concerning case of a patient diagnosed with Atypical Anorexia Nervosa (AN) who started using semaglutide for cosmetic weight loss (Guerdjikova et al., 2024). This case is significant because the drug’s powerful appetite-suppressing mechanism subdued the patient's "food noise," which had made dieting and starvation both mentally and physically challenging. For someone with a restrictive eating disorder, the drug acts as an addictive aid, making it easier to sustain harmful behaviors and easing the psychological burden of starvation (Guerdjikova et al., 2024).
The drug's ability to suppress hunger and diminish food noise in individuals with body image issues suggests that it merely accommodates underlying psychological pain rather than addressing it. As a result, the medication has become a psychological "crutch," echoing a cycle often seen in online "pro-ana" communities. These support networks, which thrive on social media platforms, have historically facilitated the maintenance of eating disorders by sharing tips and protocols for misusing pills, laxatives, and appetite suppressants to sustain restrictive behaviors (Fox, Ward, & O’Rourke, 2005). GLP-1s now present a medical and high-tech alternative to extreme restriction, yet they are increasingly being used for self-destructive purposes. Currently, there appears to be no widespread requirement to pair GLP-1 prescriptions with mandatory psychological screening and support. The absence of such measures creates a risk, where the desire to simply "be thin," often rooted in deep psychological pain, is prioritized over the patient’s overall well-being. Vulnerable individuals prone to eating disorders are thus exposed to a powerful new tool that can exacerbate their illness.
Ozempic TikTok and the Glamorization of Restriction
A critical review of the existing global literature on youth, body image, and social media reveals that this environment leads to body image concerns and eating disorder pathology via three key pathways identified by researchers: social comparison, thin/fit ideal internalisation, and self-objectification (Dane & Bhatia, 2023). Social comparison is a major concern because we instinctively compare ourselves to the highly edited and performative images of thinness and success we encounter online. This often leads to dissatisfaction with ourselves. Subsequently, internalizing the thin and fit ideals means adopting these unrealistic standards as personal goals, fostering the belief that our worth depends on meeting them. Additionally, self-objectification occurs when individuals internalize an outsider's perspective, constantly monitoring and judging their own bodies based on appearance. These three processes create a vicious cycle of risk, where each scroll reinforces damaging reference points that ultimately normalize illness by framing dangerous restriction as a coveted body ideal.
The current online narrative has become a harmful echo chamber, often glamorizing the restrictive side effects of the medication. Many users frequently discuss how the drug causes extreme appetite suppression, nausea, and early satiety, often framing the resulting tiny meals or days without hunger as benefits and effortless dieting strategies. For those seeking to be thin, this can seem like exactly what they want to buy and use. However, a qualitative study analyzing TikTok content about Ozempic revealed a disturbing reality: 52% of videos and 8% of all comments showed eating behaviors that matched the criteria for Anorexia Nervosa (AN) (Omar, 2025). The comments were especially revealing, with users sharing direct restrictive advice and linking the drug to AN behaviors, such as one stating, "if starving is how it works, then I don't need to give myself a shot" (Omar, 2025).
The actual danger lies in what researchers call "hermeneutic discrepancy," which occurs when the content's intended meaning is completely lost. For instance, a creator might post a satirical video mocking the drug's tiny meal portions; however, the audience often interprets this as an inspirational endorsement of restrictive eating rather than a joke about side effects (Omar, 2025). This phenomenon is actively reviving the dangerous ideals of the "pro-ana" movement that I described earlier, where the drug has been transformed into an object of fascination that accelerates, rather than mitigates, eating disorder behaviors. The immense popularity and normalization of these thin ideals in Ozempic content create a destructive cultural atmosphere that makes the drug a potent tool for maintaining disordered habits (Omar, 2025).
Furthermore, this cultural moment is actively creating a form of "symbolic annihilation"—the erasure of those who challenge the thin ideal, particularly people who are content with their larger bodies (Williams & Monier, 2024). This is destructive because when the overwhelming media focus is on the "before and after," it sends a harmful message that happiness and success are only available on the "after" side, once the weight is lost. For someone with a history of an eating disorder, this reinforces the dangerous internal voice that argues, "I was happier when I was as thin as I was years ago," even when returning to that low weight would be detrimental to my long-term health. The pressure to conform is so intense that an estimated 97% of individuals with clinical or subclinical eating disorders who use social media report that it hampers recovery by motivating them to maintain dangerous behaviors (Dane & Bhatia, 2023). I often see girls encouraging others to "eat less and walk more" on social media, and it is a battle not to follow their advice instead of focusing on my own healing. By symbolically annihilating the perspective of "fat and happy" people, the cultural narrative powerfully reinforces the initial shame that GLP-1s promise to relieve, which solidifies a cycle where body shame drives drug-seeking, and that drug-seeking is reinforced by a media that only celebrates thinness.
Misuse, Abuse, and Physical Consequences
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| GLP-1 Mechanisms |
The evidence of this disruption is stark and sobering. Studies analyzing insurance claims have confirmed that using GLP-1 medications for weight loss significantly increases the risk of debilitating gastrointestinal issues. Researchers observed a range of severe complications, including biliary disease, pancreatitis, and bowel obstructions, as well as the most alarming—gastroparesis, or stomach paralysis (Reardon, 2025). These are not the manageable "tummy upsets" often dismissed on social media, but conditions that frequently require emergency hospitalization or surgery. The sheer scope of this issue is a cause for significant concern: research has shown gastroparesis occurring at a rate of 10 cases per 1,000 semaglutide users, which means that if just one million people are prescribed the drug, hundreds of thousands could experience dangerous gastrointestinal disturbances (Reardon, 2025). The drive for weight loss is promoting an extreme misuse of the drug, one that carries potentially fatal clinical consequences.
When used without medical necessity, GLP-1s can quickly transition from medication to a form of substance abuse, with research suggesting they are being misused as Image- and Performance-Enhancing Drugs (IPEDs) (Reardon, 2025). The comparison to IPEDs is chilling: just as athletes might misuse steroids to enhance muscle mass, the general public is misusing GLP-1s to improve their appearance by rapidly shedding weight. The analysis of adverse event reports revealed that semaglutide showed higher levels of misuse, abuse, intentional product use issues, and use without a proper prescription compared to other weight loss medications, which underscores its potential for non-approved usage fueled by its significant weight loss effects (Reardon, 2025).
As an aspiring nutritionist, I find the inevitable nutritional risks associated with this trend to be the most terrifying long-term consequence. Dietitians working in the clinical trenches are raising urgent alarms because patients, focused only on the number on the scale, are neglecting the proper nutrients their bodies need. Key among their concerns is the risk of malnutrition and the subsequent loss of lean body mass due to severely suppressed appetite and inadequate protein intake (Despain & Hoffman, 2024). When rapid weight loss is achieved through drug-induced restriction, coupled with insufficient nutrition, the body does not just strip away fat; it strips away muscle mass at a dangerous rate.
Muscle plays a crucial role in metabolism and overall strength. Its loss not only weakens the body but also makes it easier to regain weight once the drug is discontinued. To counteract this, dietitians stress the importance of adequate protein intake, recommending that patients include protein with every meal (Despain & Hoffman, 2024). Unfortunately, many patients become so focused on losing weight that they neglect necessary dietary adjustments, which can lead to deficiencies in dietary fiber and dehydration risks (Despain & Hoffman, 2024). This narrow focus on specific nutrients weakens our overall ability to function optimally and often prioritizes a fleeting aesthetic over true long-term health and vitality.
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| Counterfeit Weight Loss Drugs |
The most insidious and final danger is the development of a chronic drug dependency. This is a major concern for healthcare professionals: the drug's mechanism for suppressing appetite can actively hinder the development of sustainable lifestyle skills (Carscadden, 2025). Similar to how antidepressants, when not combined with therapy and guidance, can become the sole focus of treatment, GLP-1s, when used alone, create a physiological crutch. When patients are eventually taken off the medication, the overwhelming fear of weight regain—a phenomenon known as the "rebound effect"—often occurs because they never learned the coping skills, nutritional knowledge, and behavioral patterns needed for long-term success. This cycle of losing weight, stopping the medication, and then returning to the original weight—often called "yo-yoing"—can be especially heartbreaking for someone like me with body image issues. It reinforces the damaging belief that my body is fundamentally flawed and requires permanent chemical intervention. Initially, GLP-1 was sought to give a sense of "freedom" from food, but ironically, many end up feeling trapped by a need for ongoing medication. This underscores the danger of seeking an easy fix that bypasses the hard but essential work of developing a healthy relationship with food and one's body.
Embracing Body Neutrality and Holistic Health
For me, adopting this perspective means recognizing that, even if I do not feel positive about my body every day, I can choose to accept it as it is. Body acceptance frees up energy to focus on truly nourishing my well-being by eating whole foods that support my heart and brain, enjoying movement that feels good, prioritizing quality sleep, and strengthening social bonds through healthy habits like walking with family or sharing nutritious meals with new friends. A more holistic approach offers an inspiring path for anyone aiming to lose weight or improve their health, shifting the focus from external appearance to internal well-being.
The most effective and sustainable path to metabolic health involves tapping into our body's innate ability to regulate itself through the production of its own hormones. When given the right inputs, our bodies can self-regulate effectively.
Research shows that we can naturally boost our endogenous GLP-1 production through lifestyle changes—non-pharmacological approaches that empower the body to feel full and manage blood sugar without medication. A nursing-led approach highlights simple, safer, and more robust strategies, such as incorporating adequate protein and fiber into meals. These nutrients stimulate natural GLP-1 release, enhancing satiety and supporting metabolic balance. Evidence suggests that focusing on sustainable methods helps avoid the risks associated with drug dependency and severe gastrointestinal side effects, leading to better long-term health.
Even for patients who genuinely require GLP-1 medication, experts—especially Registered Dietitians and nutritionists—advocate using the drug as part of a comprehensive, multidisciplinary care plan, rather than as a standalone solution. We should aim for a future where obesity and overweight are seen as symptoms of complex and interconnected issues—genetic, environmental, and psychological—that cannot be addressed by medication alone.
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| Personalized Care Matters |
As a future nutritionist, I aim to collaborate with individuals, their doctors, and therapists to promote a care approach that encourages eating wholly—focusing on unprocessed foods that support heart and brain health—and emphasizes long-term well-being by shifting the focus from merely being "thin" to achieving mental and physical health, fostering resilience for our families and society.
Dietitians highlight that GLP-1s should be considered like "training wheels on a bicycle"—a temporary aid to help patients develop new, healthier habits before discontinuing the medication (Despain & Hoffman, 2024). This metaphor offers a compassionate perspective: if the drug is needed temporarily to quiet the overwhelming "food noise," it can be a positive step toward stability. However, the medication merely supports the transition; it does not replace the effort required.
This comprehensive approach relies on three key elements for cultivating lifelong skills:
- Personalized Nutritional Plans: Moving beyond one-size-fits-all advice to craft sustainable diets tailored to each individual's lifestyle and tolerances, with an ongoing emphasis on sufficient protein and fiber to preserve lean muscle mass (Despain & Hoffman, 2024).
- Psychological Support: Providing counseling to address mental health, body image, and the stigma linked to weight struggles, which ensures that underlying issues are effectively treated.
- Lifelong Skills Development: Encouraging habits such as managing stress, optimizing sleep quality, and practicing intuitive eating—skills that can support lasting health beyond the use of medication.
The process is different for everyone, and we must be wary of how the social media craze, which can be difficult for people like me with a complex weight history, prescribes quick and unhealthy fixes. Instead, we can find contentment in making better choices for ourselves, recognizing that improving our lifestyle can make a more profound, more lasting impact. The real victory is a wellness shift—a movement of individuals, including those in recovery, who are working hard to be their best selves and finding encouragement to appreciate character outside of our bodies. The true path to liberation is not the fastest shot or the smallest size, but the gradual and dedicated work of building a sustainable relationship with your body that values its function, resilience, and inherent worth.
References
Carscadden, T. A. (2025). Optimizing Endogenous GLP-1 Holistically: A nursing led approach to sustainable weight loss without GLP-1 agonist use. https://doi.org/10.33015/dominican.edu/2025.NURS.ST.39.
Dane, A., & Bhatia, K. (2023). The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people. PLOS Global Public Health, 3(3), e0001091. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pgph.0001091&type=printable.
Despain, D., & Hoffman, B. L. (2024). Optimizing nutrition, diet, and lifestyle communication in GLP-1 medication therapy for weight management: A qualitative research study with registered dietitians. Obesity Pillars, 12, 100143. https://www.sciencedirect.com/science/article/pii/S2667368124000457.
Fox, N., Ward, K., & O'rourke, A. (2005). Pro‐anorexia, weight‐loss drugs and the internet: an ‘anti‐recovery’explanatory model of anorexia. Sociology of health & illness, 27(7), 944-971. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-9566.2005.00465.x.
Guerdjikova, A. I., Ward, A., Ontiveros, M., & McElroy, S. L. (2024). Semaglutide misuse in atypical anorexia nervosa—a case report. Journal of Clinical Psychopharmacology, 44(2), 179-180. https://journals.lww.com/psychopharmacology/citation/2024/03000/semaglutide_misuse_in_atypical_anorexia_nervosa_a.15.aspx.
Markey, C. H., August, K. J., Malik, D., & Richeson, A. (2025). Body image and interest in GLP-1 weight loss medications. Body Image, 53, 101890. https://www.sciencedirect.com/science/article/pii/S1740144525000415.
Omar, S. (2025). “Oh, oh, oh, Ozempic!” 1: The Glamorization of Ozempic and Restrictive Eating Disorders. https://papers.ssrn.com/sol3/Delivery.cfm?abstractid=5243583.
Reardon, R. E. (2025). Implications of Ozempic: A Semaglutide with Peptide (GLP)-1 Receptor Agonists Misused for Cosmetic Weight Loss. Undergraduate Research Journal for the Human Sciences, 18(2025), 5. https://newprairiepress.org/cgi/viewcontent.cgi?article=1152&context=urjhs.
Williams, A., & Monier, M. (2024). Oprah and Ozempic: a commentary on Oprah Winfrey’s “shame, blame and the weight loss revolution”. Critical Studies in Media Communication, 41(3), 263-268. https://www.tandfonline.com/doi/pdf/10.1080/15295036.2024.2393755.
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