Navigating Fatness Online and in the Doctor’s Office in the Age of Ozempic

Sitting on an airplane, I hear the flight attendant gush to his co-worker that he has lost weight by using Ozempic. He gets the medication online, he says, from a service that delivers the medication right to his door. All he needed to do was answer a few questions; it was so easy! 

Right now, it seems like everyone has something to say about GLP-1 drugs like Ozempic, Munjaro, and Zepbound. A huge faction of people have taken to the internet to, like my flight attendant, rave about how GLP-1’s have changed their lives for the better. There’s also a sizable faction that shame people who use the drug, either saying that they should lean into body positivity or body neutrality, or calling people lazy for “taking the easy way out”. There is seemingly no way to avoid the craze; the digital landscape has made it virtually impossible to ignore weight loss that is aided by GLP-1 drugs like Ozempic. Advertisements for companies that sell GLP-1’s online have proliferated, and I myself have been bombarded with advertisements like this one on my personal social media accounts. 

Risks with Accessing GLP-1 Drugs Online 

Some of these advertisements are disturbing and have little to do with promoting health and wellbeing. A particular ad I came across on Instagram described people “before Rocky” as “breaking scales on the regular”, “struggling to see results”, and “feeling judged” (I wonder if this might have anything to do with comments about fat people breaking scales!). The column beside the “before Rocky” statements is titled “after Rocky”, wherein taking a GLP-1 like Ozempic from Rocky ostensibly leads to “your ex texting you ‘U Up?’”, “steady progress made simple”, and “confidence restored”. The line below the two columns states “get those cravings out of the way and reach…”. 

These companies know which buttons to push, and the pressure they’re applying to take GLP-1’s is working. In May 2024, a health tracking survey found that 1 in 8 adults in the United States of America had taken a GLP-1 (Montero et al, 2024). These drugs are incredibly popular, but they are not a miracle drug. 

One of the reasons that GLP-1 agonists aid in weight loss is that they cause delayed gastric emptying, leaving food in the stomach for longer, in turn helping a person stay full for a greater period of time which causes them to ingest less calories. This delayed gastric emptying also means that patients who take the drug have a greater chance of aspirating when going under general anesthesia (Jones et al, 2023). This is not a catastrophic issue if healthcare providers know that a patient is taking a GLP-1 and can prepare patients for surgery accordingly. Risks can be mitigated by having a patient go off the medication for a period of time beforehand and/or fast for a longer period of time prior to surgery. 

Obtaining GLP-1 drugs online becomes an issue when someone's healthcare team is unaware that they are taking the drugs. If, for example, someone taking Ozempic through a digital service requires surgery because of an emergency and is unable to stop taking the medication and fast appropriately pre-surgery, they might be at a higher risk of complications. 

Taking any pharmaceutical comes with risks, and not taking pharmaceuticals can also come with risks. The risks and/or benefits of taking a GLP-1 medication like Ozempic is not the point of this blog post. Rather, I urge people to consider the impact that advertisements like this one from Rocky may have on fat people and people at a higher weight who are struggling. Might they feel pressured to take a GLP-1 by loved ones, or be convinced through the promise of more successful romantic relationships made in this advertisement? Is it possible that they may feel shame for taking a GLP-1 using an online service and withhold that information from their primary care provider, if they have one at all? 

Being Fat at the Doctor

Just like these advertisements, I am unable to provide medical advice. However, if this conversation is hitting close to home, know that you deserve a thoughtful healthcare provider such as a medical doctor, nurse practitioner, or pharmacist who can go through your personal medical history to help you make the decision on whether or not taking GLP-1’s is the right thing for you. In addition, it is helpful to ensure that your primary healthcare provider and loved ones know what medications you are taking. 

It is understandable that fat people might look to online services for healthcare rather than pursue traditional care. Fat people frequently avoid going to scheduled healthcare appointments due to concerns of experiencing weight stigma (Alegria Drury & Louis, 2002; Ellis-Orday, 2021; Crompvoets et al., 2023). However, you deserve quality healthcare at any weight. Diagnostic overshadowing describes when a healthcare provider refuses to provide a diagnosis for your concerns until you lose weight, or focuses your entire appointment on weight loss instead of treating your concerns. You deserve better than this. In appointments, consider using statements like “if you are unwilling to order tests or take my concerns seriously, I would like that written in my chart and a referral to a different doctor who will” or “I am uninterested in intentional weight loss, I would like to focus my appointment on the concerns that I came to this appointment with”. You have the right to find a healthcare provider who will work with you to find the correct diagnosis and treatment, whether you pursue intentional weight loss or not. 

There are fantastic activists like the people at the Association for Weight and Size Inclusive Health, Asher Larmie a.k.a. the Fat Doctor, Regan Chastain on her substack ‘Weight and Healthcare’, the Association for Size Diversity and Health, and the National Association to Advance Fat Acceptance who host events, share resources, and give tips for navigating medical encounters as a fat person or someone at a higher weight. 

About the author: Elizebeth is a second year master's student in the Joint Communication and Culture program at York University and Toronto Metropolitan University. They are interested in the experiences of fat people within the healthcare system and ground their work in trauma-informed, feminist, queer, fat and anti-oppressive theories.

Insights & Ideas is a ComCult blog series showcasing the research and expertise of ComCult students. Designed to engage a broad audience, the series features op-ed-style posts that connect academic insights to real-world issues, making complex ideas accessible and relevant. Each entry highlights the unique perspectives and innovative thinking within the ComCult program. We invite you to explore more stories that amplify research and inspire ideas! (News and Events Archives)

References: 

Alegria Drury, C. A., & Louis, M. (2002). Exploring the Association Between Body Weight, Stigma of Obesity, and Health Care Avoidance. Journal of the American Academy of Nurse Practitioners, 14(12), 554–561. https://doi.org/10.1111/j.1745-7599.2002.tb00089.x (external link) 

Crompvoets, P. I., Nieboer, A. P., Rossum, E. F. C., & Cramm, J. M. (2024). Perceived weight stigma in healthcare settings among adults living with obesity: A cross‐sectional investigation of the relationship with patient characteristics and person‐centred care. Health Expectations, 27(1), e13954-n/a. https://doi.org/10.1111/hex.13954 (external link) 

Ellis-Ordway, N. (2021). Why would I want to come back?: Weight stigma and noncompliance. In Weight Bias in Health Education (1st ed., Vol. 1, pp. 72–80). Routledge. https://doi.org/10.4324/9781003057000-8 (external link) 

Jones, P. M., Hobai, I. A., & Murphy, P. M. (2023). Anesthesia and glucagon-like peptide-1 receptor agonists: proceed with caution! [Anesthésie et agonistes des récepteurs du peptide-1 de type glucagon : la prudence est de mise!] Canadian Journal of Anesthesia, 70(8), 1281-1286. https://doi.org/10.1007/s12630-023-02550-y (external link) 

Montero et al. (2024). KFF Health Tracking Poll May 2024: The Public’s Use and Views of GLP-1 Drugs. KFF. https://www.kff.org/health-costs/kff-health-tracking-poll-may-2024-the-publics-use-and-views-of-glp-1-drugs/ (external link)