Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Behavior, Psychology and Sociology

The effect of GLP-1 receptor agonist use on negative evaluations of women with higher and lower body weight

International Journal of Obesity (2024)Cite this article

Subjects

Abstract

Background

GLP-1 receptor agonists (GLP-1 RAs) have dramatically altered obesity treatment. Media reports suggest that GLP-1 RAs users often report feeling judged for taking a “shortcut” to lose weight, which may be related to negative stereotypes toward people with larger bodies. Media reports also describe negative attitudes about lean people who take GLP-1 RAs to enhance their appearance. The present research used a 2 × 2 experimental design to test the effects of GLP-1 RA use and body size on attitudes and egocentric impressions.

Subjects/Methods

A sample of 357 U.S. adults (Mage = 37.8, SD = 13) were randomly assigned to read about a woman, who either was lean or had obesity, and who lost 15% of her body weight either with diet/exercise or a GLP-1 RA. Participants answered questions measuring endorsement of negative weight-related stereotypes and egocentric attitudes toward the woman, as well as beliefs that she took a shortcut to lose weight and beliefs that biogenetic factors caused her baseline weight.

Results

Negative evaluations and egocentric impressions were stronger toward a woman who lost weight with a GLP-1 RA compared to diet/exercise. Losing weight with a GLP-1 RA led to stronger negative evaluations through higher weight loss shortcut beliefs irrespective of body size. Losing weight with a GLP-1 RA also led to higher egocentric impressions through higher shortcut beliefs, and this effect was stronger for a lean woman. Finally, losing weight with a GLP-1 RA led to more negative evaluations through stronger endorsement of biogenetic causal beliefs for a lean woman only.

Conclusions

This timely study provides evidence that people with larger and smaller bodies alike are at-risk for being judged for using GLP-1 RAs due to beliefs that these medications are a shortcut. Findings also demonstrate novel reactions related to egotism when weight loss is achieved with pharmacological interventions.

Pre-registration and data

osf.io/xme4w.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Moderated mediation model: the effects of weight loss method on negative evaluations through weight loss shortcut beliefs, dependent on body size of target woman.
Fig. 2: Moderated mediation model: the effects of weight loss method on egocentric impressions through weight loss shortcut beliefs, dependent on body size of target woman.
Fig. 3: Moderated mediation model: the effects of weight loss method on negative evaluations through biogenetic causal beliefs about weight, dependent on body size of target woman.

Similar content being viewed by others

Data availability

Full measures, code, and data analyzed for the present study can be found online at osf.io/xme4w.

Notes

  1. The pre-registered study tested a fifth condition in which the woman with obesity lost weight with bariatric surgery. We excluded this condition from the present manuscript because our primary research aim was to compare differences in negative evaluations and egocentric impressions between GLP-1 RA and diet/exercise; however, mean comparisons with the bariatric surgery condition are included in supplemental materials.

References

  1. Prillaman M. The ‘breakthrough’ obesity drugs that have stunned researchers. Nature. 2023;613:16–8.

    Article  CAS  PubMed  Google Scholar 

  2. Bernstein E. On Ozempic, and feeling judged for taking the “easy way out”. The Wall Street Journal. 2023. https://www.wsj.com/articles/ozempic-weight-loss-drugs-strains-relationships-327ab217.

  3. Kolata G. New obesity drugs come with a side effect of shaming. The New York Times. 2023. https://www.nytimes.com/2023/06/14/health/obesity-drugs-wegovy-ozempic.html.

  4. Thompson D. The weight-loss-drug revolution is a miracle—and a menace. The Atlantic. 2023. https://www.theatlantic.com/newsletters/archive/2023/01/the-weight-loss-drug-revolution-is-a-miracle-and-a-menace/672861/.

  5. Nogrady B. “Hollywood skinny jab”: what do we know about anti-obesity drugs such as Ozempic in Australia? The Guardian. 2023. https://www.theguardian.com/society/2023/apr/08/theres-a-real-bias-what-do-we-know-about-anti-obesity-drugs-in-australia.

  6. Prunty A, Clark MK, Hahn A, Edmonds S, O’Shea A. Enacted weight stigma and weight self stigma prevalence among 3821 adults. Obes Res Clin Pract. 2020;14:421–7.

    Article  PubMed  Google Scholar 

  7. Brochu PM, Esses VM. What’s in a name? The effects of the labels “Fat” versus “Overweight” on weight bias1. J Appl Soc Psychol. 2011;41:1981–2008.

    Article  Google Scholar 

  8. Wu Y, Berry DC. Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: a systematic review. J Adv Nurs. 2018;74:1030–42.

    Article  PubMed  Google Scholar 

  9. Hoyt CL, Burnette JL, Auster-Gussman L, Blodorn A, Major B. The obesity stigma asymmetry model: the indirect and divergent effects of blame and changeability beliefs on antifat prejudice. Stigma Health. 2017;2:53–65.

    Article  Google Scholar 

  10. Crandall CS. Prejudice against fat people: ideology and self-interest. J Personal Soc Psychol. 1994;66:882–94.

    Article  CAS  Google Scholar 

  11. Martingano AJ, Telaak SH, Schopp EM, Fortney C, Dolwick AP, Carnell S, et al. Using educational videos and perspective-taking to communicate gene-by-environment interaction concepts about eating behavior: effects on empathy and weight stigma. J Nutr Educ Behav. 2023;55:55–67.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Persky S, Eccleston CP. Impact of genetic causal information on medical students’ clinical encounters with an obese virtual patient: health promotion and social stigma. Ann Behav Med. 2011;41:363–72.

    Article  PubMed  Google Scholar 

  13. Columbia University Irving Medical Center. Popularity of weight loss drugs soars, but weight stigma persists. 2023. https://www.cuimc.columbia.edu/news/popularity-weight-loss-drugs-soars-weight-stigma-persists.

  14. Xing S, Sharp LK, Touchette DR. Weight loss drugs and lifestyle modification: perceptions among a diverse adult sample. Patient Educ Couns. 2017;100:592–7.

    Article  CAS  PubMed  Google Scholar 

  15. Fardouly J, Vartanian LR. Changes in weight bias following weight loss: the impact of weight-loss method. Int J Obes. 2012;36:314–9.

    Article  CAS  Google Scholar 

  16. Mattingly BA, Stambush MA, Hill AE. Shedding the pounds but not the stigma: negative attributions as a function of a target’s method of weight loss. J Appl Biobehav Res. 2009;14:128–44.

    Article  Google Scholar 

  17. Vartanian LR, Fardouly J. The stigma of obesity surgery: negative evaluations based on weight loss history. Obes Surg. 2013;23:1545–50.

    Article  PubMed  Google Scholar 

  18. Tchang BG, Aras M, Kumar RB, Aronne LJ. Pharmacologic treatment of overweight and obesity in adults. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000. http://www.ncbi.nlm.nih.gov/books/NBK279038/.

  19. Tolentino J. Will the Ozempic era change how we think about being fat and being thin? The New Yorker. 2023. https://www.newyorker.com/magazine/2023/03/27/will-the-ozempic-era-change-how-we-think-about-being-fat-and-being-thin.

  20. Valdesolo F. What you need to know about Ozempic: the diabetes drug fueling Hollywood’s harmful weight-loss obsession. Vogue. 2023. https://www.vogue.com/article/what-is-ozempic-hollywood-weight-loss-drug.

  21. Kolata G. The doctor prescribed an obesity drug. Her insurer called it ‘Vanity.’ The New York Times. 2022. https://www.nytimes.com/2022/05/31/health/obesity-drugs-insurance.html.

  22. Cha A. Their child’s obesity drug was working. Then their plan refused to pay. The Washington Post. 2023. https://www.washingtonpost.com/health/2023/03/26/ozempic-insurance-coverage-children/.

  23. Bonell S, Barlow FK, Griffiths S. The cosmetic surgery paradox: toward a contemporary understanding of cosmetic surgery popularisation and attitudes. Body Image. 2021;38:230–40.

    Article  PubMed  Google Scholar 

  24. American Psychological Association. APA dictionary of psychology: egocentrism. American Psychological Association; 2023. https://dictionary.apa.org/egocentrism.

  25. Elboim-Gabyzon M, Attar K, Peleg S. Weight stigmatization among physical therapy students and registered physical therapists. Obes Facts. 2020;13:104–16.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Flint SW, Hudson J, Lavallee D. UK adults’ implicit and explicit attitudes towards obesity: a cross-sectional study. BMC Obes. 2015;2:31.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Puhl RM, Latner JD, O’Brien K, Luedicke J, Danielsdottir S, Forhan M. A multinational examination of weight bias: predictors of anti-fat attitudes across four countries. Int J Obes. 2015;39:1166–73.

    Article  CAS  Google Scholar 

  28. Cobanoglu C, Cavusoglu M, Turktarhan G. A beginner’s guide and best practices for using crowdsourcing platforms for survey research: the case of Amazon Mechanical Turk (MTurk). JGBI. 2021;6:92–7.

    Article  Google Scholar 

  29. Pearl RL, Lebowitz MS. Beyond personal responsibility: effects of causal attributions for overweight and obesity on weight-related beliefs, stigma, and policy support. Psychol Health. 2014;29:1176–91.

    Article  PubMed  Google Scholar 

  30. Bacon J, Scheltema K, Robinson B. Fat phobia scale revisited: the short form. Int J Obes. 2001;25:252–7.

    Article  CAS  Google Scholar 

  31. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.

  32. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford; 2017.

  33. Puhl RM, Liu S. A national survey of public views about the classification of obesity as a disease. Obesity 2015;23:1288–95.

    Article  PubMed  Google Scholar 

  34. Aronson E, Mills J. The effect of severity of initiation on liking for a group. J Abnorm Soc Psychol. 1959;59:177–81.

    Article  Google Scholar 

  35. Festinger L. A theory of cognitive dissonance. Stanford: Stanford University Press; 1957.

  36. Kruger J, Wirtz D, Van Boven L, Altermatt TW. The effort heuristic. J Exp Soc Psychol. 2004;40:91–8.

    Article  Google Scholar 

  37. Beames JR, Black MJ, Vartanian LR. Prejudice toward individuals with obesity: evidence for a pro-effort bias. J Exp Psychol Appl. 2016;22:184–95.

    Article  PubMed  Google Scholar 

  38. Throsby K. The war on obesity as a moral project: weight loss drugs, obesity surgery and negotiating failure. Sci Cult. 2009;18:201–16.

    Article  Google Scholar 

  39. Ringel MM, Ditto PH. The moralization of obesity. Soc Sci Med. 2019;237:112399.

    Article  PubMed  Google Scholar 

  40. Hofmann B. Stuck in the middle: the many moral challenges with bariatric surgery. Am J Bioeth. 2010;10:3–11.

    Article  PubMed  Google Scholar 

  41. APA. What Americans Think of Willpower. APA; 2011. https://www.apa.org/topics/stress/willpower.pdf.

  42. Fikkan JL, Rothblum ED. Is fat a feminist issue? Exploring the gendered nature of weight bias. Sex Roles. 2012;66:575–92.

    Article  Google Scholar 

  43. Himmelstein MS, Puhl RM, Quinn DM. Intersectionality: an understudied framework for addressing weight stigma. Am J Prev Med. 2017;53:421–31.

    Article  PubMed  Google Scholar 

  44. Jackson SE, Beeken RJ, Wardle J. Obesity, perceived weight discrimination, and psychological well-being in older adults in England: obesity, discrimination, and well-being. Obesity. 2015;23:1105–11.

    Article  PubMed  Google Scholar 

  45. Puhl RM, Himmelstein MS, Pearl RL, Wojtanowski AC, Foster GD. Weight stigma among sexual minority adults: findings from a matched sample of adults engaged in weight management. Obesity. 2019;27:1906–15.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by the Intramural Research Program of the National Human Genome Research Institute. We would like to thank Junhan Chen, Crystal Peterson, and Kaylee Foor for assistance with data collection preparation, and Christopher Fortney for assistance with experimental stimuli preparation. Thank you to Rebecca Hoffman for providing input on the study design.

Author information

Authors and Affiliations

  1. The George Washington University, Washington, DC, USA

    Stacy M. Post

  2. Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA

    Susan Persky

Authors
  1. Stacy M. Post
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan Persky
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SMP was responsible for study conceptualization, writing the protocol, data collection, formal data analysis, writing and editing the manuscript, creating the Results tables and figures, and compiling reference lists. SP was responsible for study conceptualization, providing feedback and editing the protocol, writing and editing the manuscript, and overall supervision.

Corresponding author

Correspondence to Stacy M. Post.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Post, S.M., Persky, S. The effect of GLP-1 receptor agonist use on negative evaluations of women with higher and lower body weight. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01516-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41366-024-01516-4

Search

Advanced search

Quick links