GLP-1 Medications: A Weight-Inclusive Perspective on Pros and Cons
Over the past few years, GLP-1 receptor agonists (like semaglutide and liraglutide) have captured public attention as game-changers in the treatment of type 2 diabetes—and more recently, for weight loss. Medications like Ozempic, Wegovy, and Mounjaro are now household names, touted by celebrities and influencers alike.
But while the medical world buzzes about their potential, a weight-inclusive lens challenges us to ask different questions: Are these medications improving health and well-being? Are they accessible and safe long-term? And what does it mean when weight loss is the headline?
Let’s explore the pros and cons of GLP-1s beyond the scale.
What Are GLP-1s?
GLP-1 receptor agonists mimic a hormone that helps regulate blood sugar, slows digestion, reduces appetite, and promotes a feeling of fullness. Initially developed for managing type 2 diabetes, they’ve also been shown to lead to significant weight loss, which has led to their off-label and approved use in people without diabetes.
The Potential Benefits (from a weight inclusive perspective)
1. Improved Blood Sugar Control
GLP-1s are effective at stabilizing blood glucose levels, which can be life-changing for people with type 2 diabetes. From a weight-inclusive view, this is a meaningful outcome independent of weight change.
2. Reduced Risk of Cardiovascular Events
Some GLP-1 medications have shown benefits in reducing the risk of major cardiovascular events. These outcomes matter for long-term health and mortality and should not be overshadowed by aesthetic or weight-loss narratives.
3. Appetite Regulation for Those Who Struggle with Dysregulation with food
Some people report a more peaceful relationship with food while on GLP-1s. This can be a relief for those experiencing “food noise”, binge eating, or other disordered patterns—though it’s not a substitute for addressing the psychological roots. It’s also important to note that binge eating is often a direct result of restrictive eating.
The Complexities and Concerns
1. Weight Loss as the Primary Goal
Much of the public discourse focuses narrowly on weight loss, reinforcing the idea that thinner equals healthier—a view not supported by decades of research. This framing can deepen weight stigma and perpetuate harm, especially to those in larger bodies.
2. Potential for Disordered Eating or Body Dissatisfaction
Rapid weight loss can disrupt a person’s relationship with food and body. There are increasing reports of people feeling disconnected from hunger cues, fearing weight regain, or developing restrictive tendencies.
3. Access, Cost, and Equity
These drugs are often expensive, rarely covered by insurance for weight management alone, and disproportionately marketed to affluent, thin-adjacent people. This creates a two-tiered system where only some can access tools framed as “essential” for health.
4. Side Effects and Unknown Long-Term Risks
Nausea, vomiting, muscle loss, and fatigue are common side effects. There is also limited data on the long-term safety and efficacy of GLP-1s for weight loss, especially in populations without diabetes. There’s also a risk of malnutrition and osteoporosis if adequate nutrition needs are not met.
5. Pressure to Stay on the Drug Indefinitely
Weight typically returns once the medication is stopped. For some, this creates a cycle of reliance, anxiety, or shame—fueling the very stigma these medications claim to solve.
Reframing the Narrative
A weight-inclusive approach doesn’t oppose medical treatment, but it asks deeper questions:
- Are we supporting the whole person—not just shrinking their body?
- Are we addressing social determinants of health—like access to food, stigma, and stress?
- Are we offering informed, compassionate care that honors autonomy and dignity?
Some people may benefit greatly from GLP-1s. Others may find the side effects outweigh the benefits. Both are valid. What’s not valid is a one-size-fits-all narrative that assumes weight loss is inherently good or necessary.
Final Thoughts
GLP-1 medications are a powerful tool—but they’re not a magic bullet. From a weight-inclusive perspective, the goal is not to shame or glorify these drugs, but to center informed consent, body autonomy, and holistic well-being. That means holding space for nuance, listening to lived experiences, and respecting that health looks different for everyone.
Let’s keep the conversation open—and human.
