GLP-1 medications have surged in popularity, transforming treatment for obesity and diabetes and showing promise for a growing range of other conditions. According to Gallup, an estimated 11% of US adults are currently taking GLP-1s for weight loss, nearly four times the rate since 2024.

But despite their clinical benefits, people taking GLP-1s can face a double stigma: criticism related to their body size and judgment for using medication to lose weight. These attitudes may influence whether patients disclose their GLP-1 use, how they discuss treatment with others, and even their healthcare decisions.

In a qualitative study published in Health Communication, researchers interviewed 34 adults taking GLP-1 medications to examine how they experienced and managed stigma through communication. Participants described navigating judgments from friends, family members, and broader public discourse, sometimes withholding information about their treatment or emphasizing its medical necessity to defend their decisions.

Medscape Medical News spoke with Braidyn Lazenby, PhD, assistant professor in the School of Communication at Florida State University, Tallahassee, about their findings as well as how clinicians can foster more supportive conversations about GLP-1 medications.

The Many Forms of GLP-1 Stigma

What led you to examine stigma surrounding GLP-1 medications through the lens of communication?

Body size is a common source of stigma in our society, especially in the US. The relatively new applications of GLP-1s for weight loss and other conditions as well as their contested nature made stigma management a natural framework to study how patients communicate about weight and GLP-1s.

As communication scholars, my co-authors and I know that how members of society communicate about a topic shapes our understanding of that concept. In the case of GLP-1s, communication from family, friends, clinicians, and the media shapes individuals’ perceptions of the drug and its usefulness.

I was inspired to study this topic after a conversation with two people taking a GLP-1 medication. I noticed that they were strategically communicating to mitigate stigma they had experienced or perceived.

What were the most common forms of stigma participants experienced, and how did they navigate the double stigma of being judged for their weight and for using medication to lose weight?

Common trends included feeling like GLP-1 users are “cheating” at weight loss or taking a shortcut instead of doing the hard work to lose weight over time.

For women in particular, GLP-1s are often labeled a vanity drug, so many participants felt their friends or family would judge them not only for how they lost weight but, in some cases, also for wanting to lose weight in the first place.

Many participants felt they were judged for being in a larger body and then judged for losing weight “the wrong way” or, in some cases, not being able to lose weight even with GLP-1s.

Participants reflected on being treated differently after losing weight, such as receiving more romantic attention and acts of kindness from strangers. These observations led them to evaluate whether a situation or person was “safe” to discuss their GLP-1 use with.

At times, this led participants to withhold their GLP-1 use from close friends and family members because of how those people had talked about weight, other people’s bodies, and GLP-1s.

What communication strategies did participants use to manage stigma?

Two key trends spring to mind. First, participants often modified whom they disclosed their GLP-1 use to based on how they heard friends, family, co-workers, and dates talk about GLP-1s or other people’s weight.

Most participants either didn’t openly disclose their GLP-1 use or took on the role of educator to change external perceptions.

The other trend was identifying themselves as part of the “in-group” using GLP-1s correctly. Participants often reiterated that GLP-1s are just a tool, but without the hard work of dieting, exercise, and other long-term behavior changes, the medications would not have been effective.

Participants also provided evidence of health outcomes or medical necessity to legitimize their need for a GLP-1, as opposed to others perceived to be in the “out-group” — those taking a GLP-1 medication for the “wrong reason.”

These categorizations essentially reinforce the same kind of stigma. They put people into categories of who has “suffered enough” and who is putting in the “most effort.”

Helping Clinicians Identify and Address Stigma

Why is it important for clinicians to understand the stigma their patients may experience?

Social networks can and do drastically affect attitudes toward healthcare and influence medical decisions.

The stigma associated with GLP-1 medications and the choices made to manage it influence perceptions of GLP-1 use, decisions about whether to take a medication, and self-perceptions. Those perceptions, in turn, shape how people communicate with others and can reinforce stigma. It’s really one big cycle.

Unfortunately, most of the stigma experienced by our participants came from people in their close social networks. Taking a patient-centered approach to healthcare includes considering all the ways patients seek and receive support, especially when discussing stigmatizing medications and experiences.

Could stigma affect how openly patients communicate with clinicians?

Yes, absolutely! We already have emerging evidence from our data suggesting that some patients will refrain from asking about a GLP-1 if they believe people in their social network will not support it.

One way we saw this was in how participants chose to acquire a GLP-1. If participants anticipated stigma from their clinician, they would often intentionally seek out a different clinician who they knew would prescribe a GLP-1, find a telehealth service that did not require an in-person appointment, or seek out a GLP-1 at a medical spa or related facility.

Participants also described increasing or decreasing doses without medical oversight to achieve specific goals and manipulating dosage and frequency to intentionally restrict or binge or be perceived as eating “normally” in front of others.

I also worry that stigma surrounding stereotypical side effects, such as “Ozempic face” or gastrointestinal issues, will make patients less likely to ask about side effects during follow-up appointments.

What should clinicians listen for?

The first step is recognizing that discussing weight or potentially embarrassing side effects is sensitive and can evoke negative emotions. While a clinician may focus on medical outcomes, a patient is often considering many other factors.

It’s important to notice when patients express hesitancy about a new medication or mention preconceived notions. It is completely appropriate to ask why they feel hesitant and where they heard their information.

A great place to start is: “When I brought up GLP-1 use, you seemed to hesitate. What are your thoughts around GLP-1s?”

What tangible steps can clinicians take to reduce stigma and make conversations about GLP-1 treatment more comfortable?

There are a few easy steps. The first is to build rapport with patients in every interaction, whether by asking simple questions about their lives or expressing understanding and empathy during tough conversations. It does not take a long appointment to build a foundation of trust.

Another strategy is to use open-ended questions. Asking “What concerns do you have?” instead of “Do you have any concerns?” is almost always going to get a better answer.

It’s important to talk about medical goals as objectively and clearly as possible. For instance, if a GLP-1 medication is being discussed for weight loss, it’s important not to suggest that the patient has failed in some aspect of weight loss, such as implementing a specific diet or exercise regimen.

You can support the patient by saying, “I know we have discussed weight loss before to help your sleep apnea. It seems like this has been quite challenging, which is very common for patients. A GLP-1 medication might be a good tool to help support this goal.”

Sometimes patients demonstrate the stigma they feel by making jokes or disparaging comments. A clinician can help redirect this by highlighting how a GLP-1 medication may tangibly improve the patient’s health and quality of life.

Lazenby reported no relevant financial relationships.

John Watson is a freelance writer in Philadelphia.