Glucagonlike peptide-1 (GLP-1) medications have taken over the national conversation around weight loss. From celebrity headlines to everyday conversations, GLP-1 drugs like Ozempic and Wegovy are often framed as breakthroughs and seen as powerful new tools that can help people lose significant weight.
But new research from Rice University suggests the social reality may be more complicated. In some cases, using these medications may come with more judgment than not losing weight at all.
That's the surprising finding behind a new study from Erin Standen, assistant professor of psychological sciences at Rice, published in the International Journal of Obesity with co-authors Sean Phelan, professor of health services research at the Mayo Clinic, and Janet Tomiyama, professor of psychology at the University of California, Los Angeles.
"We expected there might be some stigma around using a GLP-1," Standen said. "But what surprised us was the extent of it."
In the study, participants were asked to evaluate a fictional person based on their weight history. The person either lost weight using a GLP-1 medication, lost weight through diet and exercise or did not lose weight at all. The results revealed a clear pattern. People viewed those who used GLP-1 medications more negatively than those who lost weight through traditional methods.
But the most striking finding went a step further.
Participants also rated the GLP-1 user more negatively than someone who had not lost weight at all.
"The GLP-1 users were socially penalized not just compared to someone who lost weight through diet and exercise," Standen said. "They were also rated more harshly than someone who didn't lose weight in the first place."
The findings highlight a complicated reality. Stigma does not disappear with weight loss. It can simply take a different form.
"There's this idea that if you lose weight, you might escape stigma," Standen said. "But what we're seeing is that people may face judgment at multiple points. They may be judged for their weight and for how they choose to manage it."
That tension is especially relevant now as GLP-1 medications continue to grow in popularity and visibility. Much of the stigma appears tied to perception.
"There's a narrative that using these medications is 'taking the easy way out,'" Standen said. "And that belief seems to shape how people are judged."
What happens when the weight comes back
The study also explored another increasingly common scenario. What happens when someone stops taking a GLP-1 medication? Because of cost, insurance limitations or side effects, many people discontinue use. When that happens, they often regain weight. Standen's research found that this also comes with social consequences.
Participants rated individuals who regained weight, whether after using a GLP-1 or after dieting, more negatively than those who lost weight and kept it off.
"There's a lot of stigma tied to weight regain in general," Standen said. "And that doesn't seem to depend much on how the weight was lost in the first place."
For Standen, the findings point to something deeper than social attitudes.Weight stigma has been consistently linked to negative mental and physical health outcomes. These include stress, avoidance of medical care and unhealthy coping behaviors.
"If people feel judged for the choices they're making about their health, that can influence what they're willing to do," she said. "It can affect whether they seek care, whether they talk openly with providers and how they manage their health overall."
That concern is particularly important as GLP-1 medications become more widely used and more widely discussed.
"This is a moment where these treatments are really entering the mainstream," Standen said. "So understanding the social side of that is critical."
Standen's work fits into a broader research focus on how to promote health without reinforcing stigma. She said er goal is to better understand how people can be supported in making healthy choices without feeling judged in the process.
"There's such a strong cultural script around weight and what a 'healthy' body should look like," she said. "And those messages can get in the way of people doing what's actually best for them."
She said she hopes the research helps shift that narrative.
"Ultimately, any form of stigma related to someone's body or their health choices is not helpful," Standen said. "People should be able to make decisions that are right for them without fear of being judged."
