'My body is your worst nightmare': Loving your body in GLP-1 era

Whether you're living in a body that's large or small, the rise of GLP-1 advertising and its use as a weight-loss drug can give rise to big feelings and opinions.Social media is awash with before-and-after weight-loss content and pushy marketing from companies selling the drugs, using advertising tactics labelled "unethical" by some health professionals.At the same time, experts say there are genuine medical reasons to take GLP-1s for weight loss.Weight-bias expert and host of the US podcast, GLP-1 Truth Serum, Virgie Tovar, says for some people there's a cost to coping in the GLP-1 era, which she believes is "aggressively anti-body positivity".Virgie Tovar runs corporate training on weight bias in the United States. (Supplied: Andria Lo)She says a recent weight-loss ad caused her to abandon her weekend plans to spend time at a pool as a distraction."[The ad] really, really, truly upset me," she says. "I just needed something that … was going to completely take me out of my brain."Ms Tovar, who lives in San Francisco, California, is someone who experiences weight bias and also has an eating disorder history."If you have vulnerabilities to this kind of messaging … these are real costs that add up," Ms Tovar says."Even if you're not spending money, like I did on the pool pass, you're spending time, you're spending energy."Weight stigma and diet culture in new packagingEmma Beckett — food and nutrition scientist and self-described "chonky" person from Eora/Sydney — says anecdotally, for larger people, the choice to use GLP-1 drugs can feel like a "lose-lose" situation."People in larger bodies just absolutely cannot win … if we stay fat, we're told that our fatness is the problem. If we lose weight, we're told that our weight loss is the problem," she says.Dr Beckett herself was an early user of Ozempic, which she took to lose weight in order to relieve chronic pain that was preventing her from exercising."I'm trained in biomedical science … and a lot of my research has been on nutrigenetics and nutrigenomics, looking at how genetic differences change the way we interact with food," she says."I always knew that I experienced food differently to other people. I knew that I had different levels of hunger and drives of hunger."Sometimes people who use weight-loss drugs are accused of taking the easy route. (Unsplash)GLP-1 drugs mimic the activity of a natural hormone, slowing digestion and helping people feel full for longer."If biology means we all have a different variance in [the hormones involved in appetite] and a medication can correct that, how is that any different to those exact same differences happening in a blood pressure pathway?" Dr Beckett says.She ultimately chose to stop using Ozempic as she "only wanted to eat bland, white foods" while using it.Emma Beckett has used a GLP-1 drug for weight loss but found it wasn't right for her body. (Supplied: Emma Beckett)While the drug wasn't the right choice for her, she still believes people should be able to use it without judgement.Dr Beckett says the conversation about GLP-1 weight loss drugs and people who use them has gotten a bit silly, and ultimately, weight stigma is to blame."We are over-interested in these medications. No-one has ever asked [me]… 'Do I think it's reasonable that people take blood pressure medications?'" she says."The only reason we are having this conversation is … this particular medication leads to a change in something that you can visibly see."Kaurna country/Adelaide-based clinical psychologist and professor Gemma Sharp, whose research at Adelaide University is centred around body image, eating, and weight disorders, says weight stigma existed long before GLP-1 drugs, and there is strong evidence that it leads to "negative health consequences".Like Dr Beckett, she says GLP-1 weight-loss drugs are not the enemy and is an advocate for their use where medically appropriate and supported by wraparound care.However, she isn't a fan of some of the marketing strategies used to sell them."They rely upon people having poor body image in order to sell products," she says.At the end of the day, "weight stigma is a major social ill" that affects people of all sizes, Ms Tovar says.So how can you hold onto hard-won or developing body positivity, or acceptance, in spite of it?Diet culture a decade ago was very "spandexy", Virgie Tovar says. (Unsplash)Get good at spotting adverts for diet-cultureMs Tovar says diet culture in the era of GLP-1 drugs doesn't look like it did in 2016, when it was "very spandexy" and all about "thin, female bodies packaged in a very particular way"."But the good news is … just like we all became good at spotting it then, we can do that again," she says."Develop a simple phrase like, 'This is an ad, not the truth' … It's like a protective act."Weight is not who you areThere's lots of evidence that weight alone is a not an accurate measure of health and that people living in larger bodies can be fit and healthy."There's nothing wrong with body diversity, we should be advocating for [it]," Ms Tovar says.If appearance is dominating your sense of self, Professor Sharp says it might be time to take a step back and look at all the other things that make up who you are."Because [when] we're just talking about the outer shell, we're not talking about being kind, generous, being a great friend, being a great partner," she says.Gemma Sharp says we are all so much more than our bodies or a number on a scale. (Pexels)"All those facets make up our self-evaluation."She says sometimes investing in other parts of yourself "means that body image facet isn't quite as dominant."Focus on function over formProfessor Sharp says focusing on function over form is one strategy for building a body image that is more resilient to weight stigma."Not just what our body looks like, but what it allows us to do in life: things that we enjoy, being with other people, et cetera," she says."Focusing on those kinds of activities … and thanking our body for what it does for us."We certainly don't thank our bodies enough."Remembering what our bodies allow us to do — such as travel or playing with our kids — can be grounding. (Unsplash)Curate your social feed and set boundariesCurating your social media feed to limit your exposure to diet culture can also help, Professor Sharp says.Gemma Sharp says doing an audit of your social media feed can help if you're seeing to much weight-loss content. (Supplied: Gemma Sharp)"Putting some space between you and that kind of content is a great thing to do," she says.She also suggests setting boundaries "if there's someone who is constantly making comments about your body"."Because we know that weight shaming can occur anywhere: the doctor's office, friends, family, et cetera."Similarly, Ms Tovar says if there's someone in your life who wants to talk about their own weight loss with you and it feels unhelpful, don't be afraid to set boundaries here too."If your boundary is, 'I respect your choice, I don't want to hear about your weight loss' … you have every right for that boundary to be respected."It's OK to have big feelingsMs Tovar says right now, people living in larger bodies are being asked to show significant compassion and respect for the autonomy of people using GLP-1 drugs."And there's no commensurate demand that we understand the GLP-1 environment is … potentially compromising the mental health [and] eating disorder recovery of vulnerable people, [or] that people who choose not to take GLP-1s also are exercising body autonomy and choice," she says.As an example, Ms Tovar says she felt "really hurt" when a person in her life who was once proud to live in a larger body used GLP-1 drugs to lose weight."I couldn't help but go to the place of, 'Wow, my body is your worst nightmare' … Some people say it's an overstatement. [But] I get to have that feeling."If thinking about your body and how looks is starting to take up a lot of your time, Gemma Sharp says speaking with a health professional can help. (Pexels)Reach out for help if you need itYou can have a terrific body image at any weight, and you can have a poor body image at any weight, Professor Sharp says.While it's not uncommon to occasionally feel some fleeting discomfort about your body and how it looks, worrying about it constantly is a problem.Professor Sharp says poor body image can become a mental health issue that requires treatment."It is a psychological issue and should be dealt with appropriately."