Beyond weight loss: Examining the social effects of GLP-1 medications
GLP-1 medications are gaining in popularity to help people manage their weight, but new research highlights social trends that are emerging from their massive use. Photo by iStock
Glucagon-like peptide-1 receptor agonists, more commonly known as GLP-1 medications, have become ubiquitous in public discourse, with widespread focus on their weight-loss effects.
But beyond changes on the scale, these drugs are also reshaping social norms and behaviors in significant ways.
“These drugs are a fantastic medical innovation, but with extremely complex — and sometimes very harmful — social and psychological implications,” said Alexandra Brewis, Regents and President’s Professor at Arizona State University's School of Human Evolution and Social Change, who is coordinating an international research effort to understand their human dimensions.
A new essay published in PLOS Global Public Health reveals what they are learning about the broader impact of the rapid rise in GLP-1 weight-loss medication use.
Coordinating with social scientists leading research programs in Brazil, Denmark, Japan, the United States and online communities, Brewis and colleagues were able to identify nine emerging global trends.
These trends highlight how these medications have moved beyond a biomedical innovation and are a “social technology” that is reshaping bodies, identities and health systems, according to the authors.
“As one example we have seen just in the last six months, is a massive shift to pitching these as cosmetic products that help you slim for an event or bikini or use for body-building. This is amplified by startup telehealth companies tapping into underlying weight anxieties that are cultural, psychological and social — not about medical necessity,” Brewis said.
Social implications of GLP-1 medication use extend far beyond cosmetic use. The nine trends they identified are:
- Feeling “normal” in their bodies and in their relationship to food is a powerful emotional benefit for many users.
- Underlying anxiety about weight, often more than weight itself, is driving demand.
- Users are often willing to endure severe side effects and make substantial financial sacrifices to maintain access.
- Many people adjust dosages against recommendations or access the drugs without medical advice or oversight.
- Conversations between patients and doctors around weight have become easier.
- Unregulated use of GLP-1 medications greatly complicates disordered eating.
- Differences in experiences often labeled as “sex differences” are likely not based in biology.
- Social media greatly affects and influences user decision-making.
- Weight stigma — where social value as a human is questioned based on body size — is likely to worsen.
For the last year, ASU’s Center for Global Health has brought together a global team of experts who have been conducting long-term studies on the social contexts of weight loss that pre-date the initial drug introductions. This allowed the researchers to document early, real-world changes as these medications became more widely available.
The nine trends they identified emerged through careful cross-country comparison of findings from 10 nations, including the Czech Republic, the United Kingdom and Australia.
This group also recently published further commentary on off-label use of GLP-1 medications for users without obesity and joined together recently in Vienna for a workshop on the “Human Dimensions of GLP-1RAs.”
As GLP-1 medications continue to rise in popularity, Brewis explains one of many reasons we need to have the social science front and center.
“Major health organizations are now planning release of these drugs in middle- and lower-income countries,” she said. “The motivation is dealing with epidemics of chronic diseases like diabetes that are a struggle for many nations to manage, but the biological, social and ethical implications of that decision are profound and not being discussed.
“For example, we don’t know how the release of an appetite suppressant in places where many people are both food-insecure and weight-conscious — which is much of the world — are likely to yield longer-term and dangerous biological impacts around growth, development and health, including weight regain.
“The time to understand the downsides and devise solutions around the accelerating use of such a major medical innovation is right now.”
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