Over the years I’ve gotten countless thoughtful, interesting letters from readers and listeners, sharing their perspectives on wellness and diet culture. Whether they’re expanding on topics we’ve covered, offering new viewpoints for consideration, or describing why a particular edition of the newsletter/podcast resonated with them, these letters always give me something to think about. I’m incredibly grateful for them, and many of them have informed my work.
But I’ve never had a forum to share them more widely—until now.
When I got the letter below, it occurred to me that it would make a perfect “letter to the editor” to publish here (with the writer’s permission, of course). It offers a new take on the nexus of GLP-1s and weight stigma, and although this is one person’s story and not scientific research, I think it’s well worth considering in future studies as well as in doctor-patient conversations.
It's from a reader named Carrie, who writes:
Hi Christy,
I really enjoy the Food Psych and Rethinking Wellness podcasts and the regular emails. Thank you!
I’ve noticed that in all the discussion about GLP-1s, I haven’t seen anyone discuss the problem I’ve observed in my own family. I don’t know if that’s because it’s uncommon, but I suspect that it’s probably more common than people are aware of, and it’s not getting discussed because of anti-fat shaming. I thought you might be interested in hearing about what I’ve seen happen to my husband.
My husband, Ken, is diabetic. He was on a medication regimen that had his blood sugar well-controlled in the target range. He is also, according to BMI charts, “morbidly obese.” He has tried many times to lose weight, and he even had bariatric surgery, but he always regains the weight he loses. In recent years I have been encouraging him to take a weight-neutral approach, and he has been generally maintaining his weight over time.
When Ozempic became popular, all Ken’s doctors started telling him he needed to take it “for his diabetes.” I didn’t like this at all. I kept asking the doctors why he needed new medication when his blood sugar was just where it was supposed to be and he was tolerating all his medications well. Under pressure, they would admit that they just wanted Ken to lose weight. Nobody would accept the idea that Ken didn’t have weight loss as a goal and that we just wanted to treat his actual health conditions. They all believed that his diabetes would not be successfully treated unless he lost weight, despite all the evidence that he would never achieve and maintain a “normal” weight.
After months of pressure, Ken finally agreed to take Ozempic. The side effects were very unpleasant. When he reported this to the doctors, instead of deciding to discontinue the Ozempic, they decided that his medications must be interacting negatively, and they discontinued two of his other medicines. This did help with the side effects, but Ken’s blood sugar numbers got worse! Instead of deciding that Ozempic was unsuccessful, the doctors just increased the dose.
Ken has now been taking Ozempic for about a year. His A1C has risen by about 2 points. He has endured miserable side effects. He hasn’t even lost weight (which doesn’t matter to me, but the doctors cared)! None of the goals of switching him to Ozempic have been achieved. It never seemed to occur to his doctors to return Ken to his previous, successful medication regimen. When I suggested it, they just couldn’t let go of the goal of weight loss.
When anti-diet activists speak about Ozempic, they usually include the caveat that it’s an excellent diabetes medicine. Nobody wants to criticize its use for this purpose. But I wonder how many diabetics are being harmed by anti-fat doctors pushing them into unwise medication choices. I suspect that most patients wouldn’t even try to resist for as long as my husband did. If the doctor tells them that they have to take this medication, whether or not weight loss is the stated goal, the patients will probably know that this is a penalty for being fat. And they won’t say no, because society shames them into accepting the stigma. If they’re fat, they have to at least try to lose weight.
If my husband had been thin, he would have been allowed to stay on his previous blood sugar medications and avoid the health consequences of the switch to Ozempic. This is a blatant example of why fat people have worse health outcomes than thin people. They don’t receive the same treatment for the same conditions.
Although it’s great to have more treatment options for diabetes, and I know that Ozempic is very helpful for some people, it is also harming some diabetics because of anti-fat bias. I would love to see this brought up as part of the GLP-1 conversation.
Thank you for all you do!
Carrie
Thanks, Carrie, for that powerful letter and the important ideas in it. I’m sure many of you listening have similar stories you could share about different aspects of wellness and diet culture—and maybe some of you have even had the same experience with GLP-1 medications. I’d love to hear from you about all of it, either in the comments or in letters of your own.
I’m hoping to make Letters to the Editor an occasional feature going forward, so submit your letters here for a chance to have them included in an upcoming edition!1
It can sometimes feel lonely to think critically about wellness and diet culture when the rest of the world seems to be fully on board with those things. I hope some of the letters you read here will help you feel less alone and more inspired to cut through the diet and wellness hype that increasingly surrounds us in daily life.
This is separate from our regular Q&A feature, for which you can submit questions here. Letters to the Editor are about sharing *your* perspective, not asking about mine.
