Going fat in the time of Ozempic

And what the New York Times documentary 'Weight of the World' says about the state of diet culture.

Two years ago, I quit diets for good. After a lifetime of pursuing thinness at all costs, it was the most transformative—and terrifying—decision of my life. Transitioning to intuitive eating brought me peace: freedom from food noise (for the first time in my life), obsessive exercising (training for marathons and Olympic weightlifting meets where I intentionally competed in lower weight classes so I’d be forced to lose), calorie counting, and relentless feelings of hatred about myself. But it also brought weight gain—enough that none of my old clothes fit—at a time when the world seemed to believe losing weight was as simple as a weekly injection.

I quit diets in the era of Ozempic, and like a junkie in recovery, I salivated over all the press coverage and hype about these supposed miracle drugs. Could they work for me? Of course, I wondered. But when I quit diets, I quit them for good.

Not because of the damage they had done to me—although that is part of it—but because of the message it would send to my loved ones, two of whom spent years battling and recovering from anorexia. I knew that pursuing intentional weight loss would reinforce the same dangerous message society has fed us for years: that thinness equals value. 

Dieting, ‘health,’ and eating disorders

While the causes of eating disorders are complex, dieting and the pursuit of "health" are often gateways. Eating disorder educator Oona Hanson recently shared that the vast majority of her clients began their struggles with a quest to “eat clean.” 

“I see families almost every day fighting for their child’s life when, just a few months ago, their teen or young adult was simply trying to ‘eat healthier,’” Hanson writes.

We all want to be healthy, but healthiness often isn’t the root of our weight loss motivations. Calling it vanity doesn’t feel entirely accurate either. We all want to be loved, admired and respected. We all want to belong. 

Last week, I spoke with an eating disorder specialist who shared that some of her clients—yes, individuals with eating disorders—are obtaining GLP-1s from med spas for weight loss, creating a potentially dangerous scenario for an already vulnerable population.

I don’t fault anyone for wanting to be thin or for wanting to take these medications for weight loss. If my circumstances were different, I might have already tried them myself—even knowing my own history with prescription diet pills, which led to the fastest rebound weight gain of my life when they stopped being effective. And I’ll admit when I heard GLP-1s were available in med spas, I went down the rabbit hole of wishful thinking once again. Because, let’s face it, there’s never been as much pressure on us as a culture to be thin. 

Those of us who don’t live in naturally thin bodies are certainly feeling it, and those of us who are already thin want to be even more so. Of course, we can’t come out and admit that, though. As America Ferrera’s Gloria poignantly states in her much-heralded “Barbie” monologue: “You have to be thin, but not too thin. And you can never say you want to be thin. You have to say you want to be healthy.”

And this is the crux of the issue. Whether we acknowledge it or not, most of us are engaging in some form of dieting or restrictive eating—but it’s become so normalized, we don’t see it as such. Yet this restriction often triggers a rebound effect, leading to overeating and creating this frustrating and fruitless cycle many of us stay locked in. We know diets don’t work, yet we fail to see how this pattern of restriction sets us up for continued failure in our attempts to lose weight. More often than not, we end up gaining more and then blame ourselves for lacking willpower. 

Sobering takeaways from ‘Weight of the World’

Last week, FX aired a New York Times documentary called “Weight of the World” that followed three people on their journeys taking GLP-1s for weight loss. It’s a sobering state of affairs. While we often claim “health” as our reason for wanting to lose weight, the real motivator is often the shame we feel for living in bodies we believe are too large by society’s standards.

Writer and body diversity activist Virgie Tovar, who appeared in the documentary, summed it up succinctly: “I think there is so much hatred of weight gain and of larger-bodied people, and there’s so much praise to be had for being seen as dieting and losing weight.”

Two of the three documentary’s subjects were portrayed as having active lifestyles—working out and minding what they eat—but, despite their efforts, had been unsuccessful in losing weight. One of them had already undergone bariatric surgery when she started using GLP-1s to help treat lipedema. The third was a 14-year-old girl with polycystic ovary syndrome (PCOS), a chronic condition that often causes weight gain, who was participating in a drug trial for Wegovy.

All three spoke at length about the stigma and discrimination they faced because of their body size. They just wanted to be “normal.” To be treated normally. To feel normal. Isn’t that what we all want?

The man wanted to lose enough weight to go on online dates and eventually fine a wife. The woman who had gastric bypass wanted to lose enough to fit into a beautiful dress. The teenager just wanted strangers to stop calling her fat.

The older two had endured so much because of their weight that they were willing to do anything to lose it. Unable to get prescription GLP-1s, they turned to unregulated, compounded or wholesale versions—an added risk subject Jeffrey Luxmore deemed worth it for even temporary weight loss.

“I honestly don’t even care about the long-term effects, and that’s where I’m at today,” Luxmore said. “Okay, let’s say in five years, I have stomach cancer, and it’s bad, like, I had a good run … just being normal for a while—I would take that if it meant a terrible ending.”  

Many living in thinner bodies will judge him for this, but for those who have spent their lives facing scrutiny, shame, and outright discrimination because of their weight, his decision is understandable. 

The New York Times focused primarily on the individuals and the culture conditions driving the demand for these weight loss drugs, which remain expensive (an annual supply costs around $12,000 out of pocket), are uncovered by most insurance, and are therefore inaccessible to the majority of people through regulated sources. They also don’t work for everyone, come with serious side effects, and must be taken indefinitely.

Journalist Ragen Chastain, who has done extensive reporting on these medications and their limitations, said it succinctly in a Rethinking Wellness podcast episode with Christy Harrison, MPH, RD, who was also an expert in the documentary: "Even if people do manage to stay on the drug, there's no guarantee that the weight loss will continue, and there's no guarantee that they'll get health benefits in general.”

We all want to live our lives without shame, stigma, or feeling bad about ourselves. The multi-billion-dollar diet industry thrives by perpetuating this fear and tying weight loss not just to appearances but to health. In this country, being fat isn’t just a condition—it’s a moral failing.

The marketing of these medications has made it so that it is less acceptable to be fat now than ever—because now more than ever, we view fatness as a choice.

“Just eat well and move your body.”

“Burn more calories than you take in.”

Some version of these statements appear over and over again in the comments section of any article covering GLP-1s. 

But for some of us, this isn’t enough. No matter how much we diet or workout, we cannot lose enough weight.

Society tells us it’s our fault, but as New York Times Opinion columnist Tressie McMillan Cottom shared in the documentary: “You can make all the individual changes that you want, but if the environment makes it easier for you to eat more calories and to move less, then it is not an individual problem.”

This shame and blame drives the diet industry, eating disorders, disordered eating, and our so-called “obesity epidemic.” Without them, I don’t think we’d engage in these restrictive, harmful behaviors. We’d define health beyond appearance. 

Yes, some of us would still be bigger than others. Some would be smaller. But it wouldn’t be a moral failing. It would just be how bodies are. 

Relearning to trust myself

Being committed to no longer shrinking myself forced me to address my own complicated feelings around my body. And in a way, it allowed me to see myself clearly for the first time. Even as a child, I was stocky, like my father, with a broader frame and more muscle than other girls. Of course, my young mind wouldn’t have understood this meant I would naturally weigh more.

I remember a day in fifth grade when all the kids were lined up and publicly weighed by the school nurse. My best friend ran up to me after her weigh-in, tears streaming down her flush cheeks, because she weighed more than all the kids who had gone before her. She asked me what I weighed, and when I told her, she burst into laughter, because mine was higher. 

The sting of that moment has long since faded, and I can’t recall if that was the day my lifelong dance with diets began. I already knew my body was different.

I often wonder now how it might look today if I had never dieted—if I had simply been allowed to exist without shame.

The radical act of body acceptance

Relearning to trust my body and listen to its signals has been liberating, but it hasn’t been easy. Decades of dieting taught me to see my body as the enemy, and undoing that conditioning takes time. I believe all those years of restriction and self-punishment made me heavier than I might have been otherwise. And yet, I’m learning to live with that—and, more importantly, to love myself as I am.

This is the message I wish I’d been given as a child: You are enough in the body you have.

Body acceptance isn’t just a personal revelation—it’s a radical act in a society that thrives on our insecurities. Embracing ourselves just as we are—even if we don’t like everything about ourselves—challenges the system that tells us we’re not good enough. It reclaims the humanity that shame and stigma threatens to erase. It’s a declaration: we will no longer live small, shrink ourselves, or allow our worth to be measured by anyone else’s standards.

Now, it’s your turn. Most of us have a complicated relationship with our bodies and self-image. Mine is far from perfect, despite progress. Where are you in this? Have you had similar experiences with dieting and body image? How has diet culture impacted your relationship with food and exercise?