framing body size as a disease is stigmatizing in and harmful, but it won’t stop diet culture from doing it.
If your ears (and social media feeds) are buzzing with news of ‘miracle’ weight loss drugs and #thinisinagain messaging – I want to offer you compassion. It’s incredibly difficult to work on healing your relationship with food and body while living in diet culture.
The bad news is that diet culture and its toxic ideals still have a stronghold on our society. The good news is that moments like these will show you that you can still choose to ditch diet culture and enjoy a peaceful relationship with food & body even while everyone else is out burning their time, energy and hard earned money chasing the unrealistic thin ideal (all while doing greater harm to their relationship with food and body).
Stories around the latest ‘miracle’ weight loss drug (a drug that, mind you, was never studied for the purposes of or intended for use of weight loss) have been swirling for a while and have seemed to reach a fever pitch in the last several months. And one of the most disturbing things I’ve been seeing in a lot of the articles has been doctors and researchers promoting this drug as a ‘solution to fatphobia and weight stigma.’ I’m not sure what planet they’re living on, but in no world is an off-label drug intended to treat T2DM but being used for weight loss a solution for fatphobia and weight stigma. Nothing about providing patients with an off-label drug for weight loss tackles the underlying issues of fatphobia and weight stigma – as usual, these solutions attack weight and body size as the ‘problem’ and the only ‘solution’ is weight loss. The age old argument that is not supported in the research with the age old solution that has been failing for years. Actually, I shouldn’t say the ‘age old argument’ – these doctors and researchers actually have wised up to the idea that weight stigma is an issue that needs to be addressed. However, their solution is not to dig deep and do the work of understanding it, their solution is to blame larger body sizes and call them ‘diseased.’ By qualifying larger bodies this way, it absolves them of doing the work to understand the nuances of and change their behavior in order to address fatphobia and weight stigma and allows them instead to simply prescribe medication or surgery to ‘fix’ the ‘disease.’ The problem is – body size is not a disease and referring to it as such is stigmatizing in and of itself.
And sure, people may be seeing short-term ‘success’ [aka weight loss via appetite suppression] on these drugs, but at what cost? Reported GI side effects (nausea, vomiting, diarrhea, constipation) aside, these drugs were studied in the context of Type 2 Diabetes management for a total of one year and 4 months. That purpose and duration tell us pretty much nothing about how this drug might act in individuals without Type 2 Diabetes using it for the purpose of weight loss long-term.
(As an aside, it’s wild to think that other drugs or vaccines out there that were rigorously studied for the express purpose of addressing conditions for which they were studied are rejected by much of the population, but put an off-label drug not studied for weight loss in front of consumers and suddenly there are no qualms. It just goes to show how obsessed our society is with weight and body size).
I’ve also seen a lot of proclamations from both doctors and patients interviewed in these articles that the drug “took away all my food anxieties!” or “I finally feel normal around food!” That sounds great, but completely discounts the fact that weight stigma, fatphobia and diet culture’s food shaming is what causes these anxieties in the first place. So of course when you’re on a drug that suppresses the body’s innate appetite, you’re not going to have much anxiety around food because your biological drive to eat is being suppressed. What happens when you stop taking the drug? Surely with the rate of weight loss it provides you can’t take it forever…so where are you once use is discontinued? This drug is not ‘curing’ anyone’s anxieties around food, it’s allowing them the leeway to eat what they want, in the amount their [suppressed appetite] wants, without the looming fear of weight gain. If that sounds familiar, it’s because it’s essentially the premise of intuitive eating – only with a hefty dose of fatphobia on top.
We have been here before (you might remember the Fen-phen craze in the early 90’s that was later pulled off the market when it was found to cause heart issues) and we will likely be here again. It can be easy to get caught up in the hype of the moment, making you question your decision to leave diet culture behind, accept and respect your body and make peace with food. Diet culture will stop at nothing to pull you back into its grips because its livelihood depends on it. Remind yourself of that in these moments. Remember that body size is not a disease, body diversity is real and everyone deserves to pursue a peaceful relationship with food and body, regardless of their shape.
Editing this post to add that I just saw that Ragen Chastain published a substack on this topic that is definitely worth a read!3