How did GLP-1 medications like Ozempic affect the body positivity movement and fat activism?

GLP-1 medications like Ozempic and Wegovy entered popular culture at a moment when the body positivity movement had already created meaningful headway against diet culture’s dominant messaging. Body positivity, rooted in its parent movement of fat activism (which began in the United States in the late 1960s), had begun to normalize a wider range of bodies in media, fashion, and health contexts. According to weight stigma expert and activist Virgie Tovar, this success represented a genuine financial threat to the diet industry, which responded by investing unprecedented marketing budgets into GLP-1 medications. From a business perspective, GLP-1s are best understood as diet culture’s counter-attack.

The effect on body positivity has been both psychological and cultural. A decade of body positive messaging had helped make the emotional work of self-acceptance slightly more accessible for many people. The sudden dominance of GLP-1 marketing, often dressed in the language of health and medical necessity, reversed much of that psychological scaffolding. Virgie Tovar notes that fat activism itself, the more politically grounded predecessor to body positivity, has not fundamentally changed in its mission. But the marketing landscape shift has made its work harder and made the fence-sitting population more likely to return to weight-loss interventions.

A key distinction that matters in this conversation is the difference between body positivity and fat activism. Body positivity shifted over time toward a focus on individual feeling, “how do I feel better about my body,” while fat activism has remained rooted in systemic change: equal wages, access to healthcare without stigma, media representation, and policy reform. GLP-1 marketing has largely exploited the body autonomy framing of body positivity to position weight-loss medication as a personal health choice, while obscuring the collective consequences of widespread adoption, including what Virgie Tovar calls “lab coat washing,” the creation of a veneer of medical legitimacy around what is fundamentally a marketing campaign.

Non-diet practitioners and weight-neutral health professionals have noted significant mental health disruption in clients who had been practicing weight neutrality before the GLP-1 era. Clients report questioning years of work, experiencing grief and confusion as figures they followed publicly pivoted to GLP-1 use while invoking body autonomy, and returning to diet-culture frameworks they had spent years dismantling. Understanding the distinction between body positivity, fat activism, and body autonomy as a political concept (rather than a personal pass) gives practitioners the language and framework to hold these conversations without pathologizing their clients or dismissing the cultural forces at work.

Transcript 

[00:00:01] Stephanie: Welcome to It’s Beyond the Food Podcast. I’m your host, Stephanie Dodier, non-diet nutritionist, and founder of the Non-Diet Coaching Certification. This is Beyond GLP-1, the expert series. I created this series of podcast episodes because informed consent requires the full picture, not just the press release.

[00:00:21] So over the next several episodes, I’m bringing in experts to cover every angle: science, marketing, side effects, impact on body image, nutrition, health counseling, and what all of this means for you and your clients. Whether you are a health professional navigating these conversations in your practice, or someone personally researching your decision, this series is for you.

[00:00:45] Ready? Let’s do this.

[00:00:50] Stephanie: Welcome to the show. How are you doing?

[00:00:55] Virgie: Doing really well. Happy to be here.

[00:00:58] Stephanie: I’m excited to have you. We’ve been navigating the same circle, but we’ve never been in a digital room together. Before we get started, I want to give you a few minutes to introduce yourself and your work, and then we’ll get right into talking to your zone of genius.

[00:01:15] Virgie: I mostly identify as a weight stigma expert. I’ve been in the field since about 2010. So it’s coming up on almost two decades of really being interested in how weight stigma affects people and affects culture. And it’s a very deep question that I think keeps changing as the landscape changes. I’ve written a few books on the topic, like my 2018 book “You Have the Right to Remain Fat.” I’ve written a book called “Body Positive Journal,” which is through Ulysses Press. That’s my most recent book. And I have a book for kids called “Self-Love Revolution.” I’m a contributor to Rahr, and I’ve written for them for many years on the intersections of weight stigma and fat culture. I have a podcast now called “Y’all Are Full of Hysteria,” which came from the fact that I found there was a lack of critical reporting on this space. There was only one side represented, and there was a need for the other side. My aim has been to help as a journalist, bringing a cultural journalistic lens to this side of the conversation. I work in a lot of different spaces, from people experiencing weight stigma to big tech companies working on safety for people with larger bodies. I recently worked with a department called Look Development in San Francisco, working on reevaluating their programming toward weight neutrality.

[00:03:40] Stephanie: I’m really glad to meet you. The journalistic perspective you bring is something I had never thought about until now, but it is the absolute landscape right now. There is one perspective and one point of view, and the other side is not there. Even for practitioners looking for resources to guide these conversations, there’s almost nothing. Which is why I created this series, aimed at weight-neutral practitioners. I invited you for two reasons: the Truth Serum podcast, which was amazing, and also an article you wrote for Forbes about body positivity. I’d like you to take us through the shift, or the observation you are seeing in the body positivity movement with the rise of GLP-1.

[00:04:29] Virgie: I’d say there’s a real difference between body positivity and its parent movement, which is fat activism. I feel strongly that fat activism is the parent movement, and that history is not always told as it should be. Fundamentally, body positivity became much more about how do I feel better about my body, how do I make room for myself to exist in any body at any size. And body positivity now is largely framed around body autonomy. When you look at GLP-1s and body autonomy together, what becomes clear is that body autonomy is a political idea. It does not operate in a guilt-free, consequence-free way the way people tend to use it. The house of body positivity is built on body autonomy, which is something that is really important but also something that when it comes to GLP-1, you can see where the tension is immediately.

[00:11:35] Virgie: Yeah. And I think those differences have been largely unspoken, right? And now we’ve reached a point where we actually have to discuss them.

[00:11:45] Stephanie: Your article really named the difference between using body positivity from an influencer perspective for individual change, versus someone who is in that work for social and systemic change.

[00:12:48] Stephanie: When we think about body positivity and its link to fat activism, how do you see the future of fat activism in an Ozempic era, as we see it today in 2026?

[00:12:58] Virgie: I think it’s important to name that nothing has changed in terms of the fundamental mission. Obviously Ozempic has come in with an historically unprecedented amount of money in marketing. We have never seen the diet industry spend as much money on marketing as we have now. The marketing language is different, and the psychological landscape has changed. But the fundamental tenets, beliefs, philosophy, and what fat activists are fighting for has not changed. When I look around at the people I would consider fat activist colleagues and friends, they are still having meetings about how to help people. Their beliefs have not shifted. Fat activism started in 1968 and it is still going. I think it is going to keep going. What has changed is the amount of marketing dollars being spent, which does affect the psychological landscape. After almost a decade of body positivity making the work of self-acceptance a little bit easier for many people, now that is being reversed by the weight of GLP-1 marketing. But in terms of the fundamental mission, it has not really changed.

[00:17:03] Stephanie: I heard a New York Times podcast comparing GLP-1 as a pharmaceutical accelerator of body expectations. The prediction is that what we thought was the standard of thinness is going to get even worse. And to me, that is a signal for even more fat activism to be needed.

[00:21:01] Virgie: From a very personal business perspective: body positivity came in and became a major threat to the profits of diet culture. It was never gonna just lay down and lose all that money. It just was never gonna do that. And so from a business perspective, they are going to come down with the fist of fury. They are going to try and take that money, and try and take more money. There is this really almost sinister, agnostic, business side of this, where the diet industry was always going to try and come back and take that money. And I think they have overreached. They have overcompensated. And we are now at a point where people are having a battery of illnesses associated with what is fundamentally anorexia. It is a waiting game. And what is really interesting is that I am slowly watching journalism pick up what they should have started reporting two years ago. There is still a lot of profit motive and marketing budget, so it is challenging to work against. But if you look outside the US, it is being highly regulated in countries similar to ours.

[00:23:00] Virgie: One of the things I find most troubling about the way GLP-1s are being marketed is that they are talking as if the FDA doesn’t matter, and as if the FDA isn’t going to come down and begin to regulate this. They are saying you are going to be on this for life before they even know what the FDA is going to do. To tell someone to get on this for life and to normalize that, and to act as if the FDA doesn’t matter and the future of whatever they decide doesn’t matter, that is not medicine. That is marketing.

[00:25:08] Stephanie: One thing I want to explore with you is this concept of body autonomy from a collective lens perspective. Yes, we do have body autonomy. Everybody can do what they want with their body. And there is also a responsibility, particularly when you are in a position of leadership. What is your thought on the impact of individual choices, like visible public figures choosing GLP-1, on the rest of the collective?

[00:26:01] Virgie: I just wrote a piece for my Substack about this. Body autonomy is an extremely important concept. The whole point of liberation is that we feel we have agency over our bodies, because diet culture has made so many of us feel so disconnected from our bodies. I don’t want to downplay that. But the dream world is body autonomy with transparency. And the reality is that body autonomy does not operate in a neutral environment. It works differently for different people based on what they are doing with it and what body they are in. Body autonomy is being used to end conversations. And that benefit is not extended equally to larger bodies. People in larger bodies never got to say “body autonomy” and have the conversation stop. So I think it is really important to understand that body autonomy in itself is not operating in a neutral environment, and it works differently depending on the structures around you.

[00:29:00] Virgie: Don’t gaslight us. That is really what I am asking. It is a simple request. What it asks is for the person to engage something that is uncomfortable. And so instead of doing that, it is maybe more intuitive and easier to just gaslight people.

[00:32:11] Virgie: And it is very clear who picks up the tab when influencers go on a weight loss journey and claim body autonomy in an attempt to shut down any kind of conversation. It is very clear who picks up that tab.

[00:32:20] Stephanie: And it’s very clear who it is. That is what I see happening, because I am on the receiving end of people coming to me for support and help, seeing the people they have been looking up to now claiming body autonomy, and years of work being put at jeopardy. I’ve had a couple of people recently who questioned their decision to accept themselves and take a weight-neutral health approach, going through deep anxiety over that.

[00:33:11] Virgie: Yes. I did a survey to gauge how people’s mental health was doing in relation to GLP-1. One hundred people responded. And what I found was more shocking than I expected. A lot of them were reporting things like: I would get dysregulated if I saw GLP-1 marketing or content for weeks. Not only people who were currently on GLP-1s and losing weight, but people who had been practicing weight neutrality, saying this was the right decision before and now questioning it.

[00:34:45] Virgie: Lab coat washing is what I call what they are doing. Creating a veneer of medical respectability or medical acceptability, when in actuality what they are doing is just putting out marketing. It is not a doctor. It is someone with a marketing background bringing in a scientific-sounding paper and doing a 90-day study. And people buy into it.

[00:38:45] Virgie: I am still waiting for people to understand that these are not miracle drugs. They work through starvation states. The marketing has even obscured how they work. The medication does have some mechanism of action outside of food restriction, but fundamentally it relies on extreme food restriction. So it is basically injecting anorexia. The fact that the marketing has obscured the obviousness of how it even works is mind-boggling.

[00:39:30] Virgie: To me, it is very simple. The more I research this, it is very simple. It tunes down your desire to eat, both physiologically and psychologically, and that is what creates that blah personality, the Ozempic personalities, because you cannot selectively turn off the desire just for food.

[00:39:53] Stephanie: You turn off the desire for everything.

[00:39:56] Virgie: Yes.

[00:39:57] Stephanie: But when you do that, you also make people extremely malleable, and then you get people to conform because now they do not have a desire to do anything, to speak out, to fight anything. So you have a population of people you can manipulate in every which way you want, which is exactly how capitalism and systemic power want you to be in this place where you are malleable.

[00:40:32] Stephanie: Before we end, I want to ask: you have interviewed some of the leading experts on your podcast. What are two or three things you learned that surprised you or got you thinking differently?

[00:40:54] Virgie: One thing I am still sitting with: about two months ago I interviewed a friend who is trans-masculine and who has been on a GLP-1 for Type 1 diabetes. One of the things we talked about was what he said to me, which was: as a trans person, I have to jump every imaginable hoop to get hormones that significantly alter my body. But if I want a pill that significantly impacts my weight, I have no hoops at all to jump. And that really made me think about why we have set it up this way, and what that says about our values as a culture.

[00:44:24] Stephanie: He brought up the phrase “starvation state.” And I went and Googled it. And a conservative medical professional, someone without a personal stake in this conversation, confirmed: from a medical perspective, what is happening on GLP-1s is called a starvation state. Consistent state of poor nutrition. That framing from someone with no stake in the fight, to me, has been really powerful. The culture and the medical system are okay with putting people on starvation states. And that is the thing that is even more shocking.

[00:47:35] Stephanie: One of my past experiences in life has been addiction. There is a motto in addiction where people say someone has to hit rock bottom. You cannot force somebody to see what is happening in their life and the damage they are doing to themselves. They have to arrive at “okay, I understand, and it is enough, and I want to change.” And if we think about internalized fatphobia, people have to make the decision to change, and until they can make that decision, all you can do is watch them go down the hill. And that is not okay, but from a patient care perspective, all you can do is keep the door open. When they are ready to do the work, I will be here.

[00:51:17] Stephanie: The moms who are on GLP-1 and whose daughters are watching right now. I lived through the consequences of that for 25 years. Now we are setting up another generation of young women who have seen their mothers do this, and setting up the pathway of intergenerational trauma for decades to come. And in my field of weight-neutral health, our work is not done. We have years of work in front of us.

[00:51:56] Virgie: Yes. 100%. Yes.

[00:51:58] Stephanie: Thank you for being with us. I am going to link to the podcast. Where else can people find your work?

[00:52:06] Virgie: I am really active on Instagram and on Substack. And I am doing a couple of GLP-1 workshops for practitioners. Check the links below for dates.

[00:53:12] Stephanie: Thank you for all the great work.

[00:53:15] Virgie: Of course. Thank you.