When three leading obesity organizations issued guidance recently on the pharmacologic treatment of obesity, they didn’t stop at saying the recommended medications are safe, effective, and appropriate for long-term use. They called on patients, providers, and policy makers to eliminate the stigma that often surrounds those who have the disease and impedes access to treatment.

“Expanding access, reducing stigma, and ensuring equitable coverage are essential to translating scientific advances into population health gains,” the researchers wrote.

Obesity stigma has long been a problem. More than 40% of people with class II obesity (a BMI of ≥ 35) report discrimination due to their weight.

So, will the new guidance make a difference?

Maybe, but not overnight. That was the consensus when Medscape Medical News polled leading obesity experts, a psychologist who counsels stigmatized people and a person with obesity who has encountered stigma. Their reactions ranged from optimistic to cautiously hopeful that the call out to end stigma would work.

‘Small Step but Good’ 

Calling out obesity stigma in medical guidance “is a small step, but a good step,” said W. Timothy Garvey, MD, MACE, the Charles E. Butterworth Jr, professor and university professor at the University of Alabama at Birmingham.

The new guidance isn’t the first to call out stigma, he said, noting that previous guidelines have also addressed the issue.

While stigma is still a major problem, Garvey said, he also pointed to progress over a relatively short timeline. 

In 2012, the American Association of Clinical Endocrinologists issued a statement that obesity is a disease. In 2013, the American Medical Association also declared obesity a disease. 

“And look how far we’ve come,” Garvey said in a telephone interview. “The more people accept this as a disease process and not the patient’s fault and not a product of lifestyle choice, and a disease where people need help, the more we go that direction, I think it’s going to decrease bias.”

Still, he said, “I think bias is the biggest problem we have.” 

Any chronic disease requires a chronic care plan that involves four elements — the patients, healthcare providers, the healthcare system and the general society, he said. “Bias destroys each of those pillars.”

The guidelines are “one very small step” in reducing bias and stigma, Garvey said. Much bias occurs in social media, and the guidelines don’t get into that. But with time, he said, a reduction in bias is bound to filter down to social media.

A Slow Process 

“I think this statement will go a long way towards reducing stigma for the diagnosis and treatment of obesity as a chronic disease process,” said Sarah Stombaugh, MD, an obesity medicine physician in Charlottesville, Virginia.

“However, the stigma will not go away overnight,” she said in an email interview. “I think we’ll first start to see a shift in the healthcare space, as physicians and other healthcare providers start to recognize how treating obesity as a chronic disease improves other health conditions as well.”

Providers Are the Solution 

It’s not possible to fix obesity stigma in a single report on obesity medications, said Robert Dubin, MD, associate professor at Pennington Biomedical Research Center at Louisiana State University, Baton Rouge. However, “It’s a start. It’s a good start.”

Targeting patients, providers, and policy makers — as the report does — is a good approach to dealing with obesity stigmatization, he said. “Patients are the ones who have to deal with this, health care providers are the ones who are going to be the solution, and policy makers are the ones who are going to make it possible. Without changing policy, none of this is going to happen.”

Treatments for obesity must be available long term, he said, just as they are for other diseases.

The guidance also brings in quality of life, and how obesity medications may improve it, noting that it is as important as initial weight reduction. Dubin agreed. “It is important because we are in a new era of treating this disease and getting beyond BMI,” he said. 

Quality of life won’t factor into the approval process for a new obesity drug, he said. But including quality of life as an important component of obesity care “might provide a new metric, with providers saying, ‘What’s the change in your weight? Comorbidities? And what about quality of life and how you feel?’” 

If the medication use and the resulting weight loss have helped patients get on an airplane, for instance, which Dubin said is a major problem for many, that’s important and likely a boost to their quality of life.

More Research, Less Stigma? 

The guidance about reducing stigma will likely have an impact on scientifically-focused clinicians but not on the public at large, said Jing-Yu Pan, MD, attending physician and obesity specialist at Montefiore Medical Center, Bronx, New York. 

The root of persistent stigma can be partially explained, she said, by the lack of total understanding of obesity’s mechanisms. “We don’t fully understand the biological basis of obesity,” she said. As a result, even some clinicians fall prey to the “move more, eat less” remedy. 

As more is understood about the biological basis of obesity, stigma will hopefully decline, Pan said.

Reframe the Language, Reduce Stigma 

Stigma can be persistent, said Rachel Goldman, PhD, a psychologist and clinical assistant professor of psychiatry at the NYU Grossman School of Medicine, New York. “Stigma often comes from deeply ingrained beliefs about personal responsibility and body size,” Goldman said in an email interview. 

Even with the new guidance stating the obesity medications are safe and effective, “People taking GLP-1 medication may still face judgement.”

To reduce stigma, reframe the medications as medical treatments, not weight-loss drugs, Goldman tells her patients. That puts the focus on health, not weight. Being mindful of language, she said, can change the narrative.

Patient’s View 

The new guidance “has the potential to reduce stigma,” said Shekinah Samaya-Thomas, 61, of Oakland, California, an adult educator and member of the Obesity Action Coalition. “It really depends on the medical providers and their willingness to embrace evidence-based, science-backed understanding of obesity as a disease and not a moral failure.”

Samaya-Thomas had a successful sleeve gastrectomy in 2017 but began regaining weight, so took GLP-1s for about 2 years, with a total accumulated loss of about 190 pounds. But in January, she lost access to the medications when her insurance plan stopped covering them. She is hoping to regain access.

She has many examples of stigma. A year ago, a healthcare provider told her: “You might just need to start practicing more willpower.” When at her heaviest, she said, her “number one fear” was encountering a group of teenage boys. “I can’t tell you how many times I’d hear, ‘Hey, why don’t you go for a walk?’”

Stombaugh is a Zepbound speaker for Eli Lilly and consulted on a Novo Nordisk advisory board in 2025. Dubin and Pan have no disclosures. Garvey has no relevant disclosures. Goldman is an advisor for Ro.