Did weight loss drugs kill the body positivity movement?
From the red carpet to my 13-year-old daughter’s wardrobe, all the signs are there. ‘Super skinny’ – that just-slightly-dangerously-thin aesthetic once labelled ‘heroin chic’ – is back in vogue.
On their way out to do some shopping, my daughter and her friend are dressed in the same micro-Ts and low-slung baggy jeans that my own friends and I adopted in the 1990s, inspired by Kate Moss. And even plastic surgery trends suggest that we want to downsize: in the UK, as in the US, breast reduction is growing at a far faster rate than breast augmentation (120% to 60% last year). As more and more celebrities jump on the shrinking bandwagon, calling out who may or may not be on slimming drugs has become an international pastime. Ariana Grande’s appearance at the Wicked premiere last month sparked endless online speculation over whether she’s ill, starving herself or perhaps on weight loss drugs.
In The Spectator, one woman writer marvelled at the implausibility that the character of Colin Bridgerton – ‘handsome, rich’ – might fall for Nicola Coughlan’s character, Penelope Featherington, in Bridgerton. Coughlan, she wrote, is ‘not hot, and there’s no escaping it…she’s fat’.
What happened to the body positivity movement we were all meant to embrace? I ask my daughter’s friends. ‘Body positivity is a nice idea,’ says one, ‘but no one actually believes it – we all have our own insecurities. We can’t idealise them away.’ My friend Ellie, three decades older, put it this way: ‘I fear true body positivity has never really existed, unless you have a flipping amazing body.’
What is ‘body positivity‘ anyway?
The movement that most of us encountered, formed and filtered on Instagram, was actually born in 1960s America as the Fat Acceptance Movement, says Dr Kat Schneider, research fellow at the Centre for Appearance Research at the University of the West of England. It was genuinely radical: ‘Centred around people in the most marginalised bodies in society – people in larger bodies, people of colour, people with disabilities.’
When this ‘fight for true body liberation,’ as Dr Schneider puts it, saw a resurgence in the 2010s, many were hopeful. Stephanie Yeboah, author of Fattily Ever After: A Black Fat Girl’s Guide To Living Life Unapologetically, explained earlier this year just how radical it felt to be seeing plus-size Black women, women who looked like her, on social media: ‘Everything I wore while younger was geared towards hiding my body, or trying to make myself look smaller. And as I’ve entered this journey of self-love and this new-found confidence, all I want to do is show my body off and just really wear pieces that make me feel confident in myself.’
So what went wrong?
In truth, the 2010s revival did lead to some superficial societal shifts – some larger clothing sizes in mainstream shops, for example, and a rise in mid-sized models in adverts and on catwalks. Yet critics say it failed to shift the needle towards true self-acceptance. A Good Housekeeping survey of almost 3,000 women suggests that Gen Z (aged 12 to 27) are now the most likely to embrace body positivity, while the so-called Silent Gen (those aged 79 and over) are the least. The latter is also the generation most likely to say they are bored with body positivity. Across the generations, two-fifths of women favour body positivity, yet an equal number want a more considered approach. Why?
Yeboah and others, including the singer Lizzo, have called out the ‘commercialisation’ of the movement. Mid-sized models, wrote Yeboah, ‘sent a clear message to the masses: it’s okay to have body diversity, as long as the curvy body you have is still seen as “sexy” and feminine to society.’
After all, was it such a stretch for vocal supporters of body positivity – like Jameela Jamil, the British presenter and actor – to shed their body hang-ups and embrace positivity (or neutrality, as Jamil has more recently advocated, as ‘a complete, almost, divorce from my body’)? They already epitomised many conventional ideals of beauty. Rather than championing marginalised bodies, the 2010s revival gave a platform to bodies that, if they challenged the norm at all, did so in soft and commercially viable ways: ‘Think thin women with body rolls when they bend over, or cellulite that’s visible at certain angles or in certain lights,’ says Schneider.
Then there was the question of responsibility. A majority of UK workers believes there is a weight bias at work, and researchers in multiple studies have found that overweight or obese patients are discriminated against by healthcare workers.
Amanda Cooper is chair of the board of directors of the National Association to Advance Fat Acceptance (NAAFA), a non-profit organisation dedicated to improving the quality of life of people living with obesity. As she puts it: ‘Day to day, it matters to fat people that they might not be able to fit in public transportation or a school desk, and are likely getting paid less if they are hired at all.’ Yet rather than challenging these systemic biases, the movement put the responsibility for change squarely on the shoulders of larger people themselves. Love your body more, the message suggested, and all will be fine.
The world outside, however, remained the same. And then weight loss drugs arrived. And, as Schneider notes, the playing field changed. Not because social ideals had been reformed, but because we found a new power to change ourselves in order to meet them.
But can we blame the drugs?
I had dinner with friends not long ago. One, let’s call her Annabel, looked fabulous. She praised the nutritionist a mutual friend had introduced her to. As soon as I got home, I fired off an email: ‘Please share the name of the nutritionist; you look amazing!’ What haunted me, once I read her reply, was that my initial thought was: ‘Good for Annabel! She’s really taken control.’
She had, indeed, taken matters into her own hands. The glow I’d noted might be down to the nutritionist, she said, but it might also be down to the Botox and fillers she’d had to plump up her face following the dramatic weight loss from taking Ozempic (semaglutide). Following a lifetime of poor body image and two pregnancies, Annabel finally had the slender frame she wanted. She is one of quite a few friends I have who have praised the drug semaglutide for allowing them to be the size they want.
Originally developed to treat patients with type 2 diabetes and reduce specific cardiovascular risks, semaglutide was found to make patients feel fuller for longer and reduce hunger pangs.
Semaglutide, marketed as Wegovy, was licensed for weight loss by the US Food and Drug Administration in 2021, and two years later, the UK’s National Institute for Health and Care Excellence (NICE) concluded that Wegovy was a safe, effective and affordable way to treat obesity for the NHS. If you want to get it from them, you must have a BMI of over 35. Go private, however, and you can obtain it for just over £100 a month, with far fewer strings attached. And a lot of people, it turned out, wanted to try the so-called ‘skinny jab’.
By some estimates, one in eight adults in the US have tried Ozempic, or a similiar drug, for weight loss. There are no comprehensive estimates for the UK (where Ozempic is not licensed for weight loss but for type 2 diabetes). Still, diabetes charities have warned that off-label prescriptions for semaglutide to address weight loss have caused shortages of the drug.
Amanda Cooper explains that the vast majority of press inquiries her organisation receives at the moment are about weight loss drugs. ‘From where we sit, a big problem that people trying to live comfortably in their bodies at any size are facing is an onslaught of media content about how weight loss drugs are changing people’s lives and how they feel about their bodies.’
Kerrie Jones, a psychotherapist, and CEO and founder of the Orri eating disorder treatment clinic agrees that the popularity of weight loss drugs as a ‘quick fix’ is ‘troubling’. For weight loss injections to be effective and safe as part of a weight-loss strategy, she stresses, they must be embedded in a multidisciplinary approach. If not, she says: ‘There is a risk that weight loss drugs could be misused or exacerbate existing issues, rather than addressing the root causes of weight and health challenges.’
A drug designed to improve health could be used to worsen it. And perhaps that’s really the point. As much as we may protest to the contrary, we don’t want healthy bodies. We want beautiful ones. And we will go to great lengths to get one.
Thomas Midgley, founding director of The Body Image Treatment Clinic and a CBT and compassion-focused psychotherapist, specialises in eating disorders and has noted a marked shift in his London clinic because of the rise in popularity of weight loss drugs. He is concerned that semaglutide may have a negative impact on body acceptance in the short-term. But he also takes a long view. Throughout history, he says beauty standards and their power have been set according to which shape is the hardest to achieve in that time and context. ‘For example, people wanted to be more voluptuous when there was rationing of food,’ he says.
In fact, Midgley is already seeing a shift in goals. ‘If history is to repeat, we are likely to see the return of “heroin chic”, followed by a shift towards more muscular or curvy figures, once thin is more widespread and too easy to achieve with medication. In our practice, we are already seeing a trend of female clients with a long history of anorexia shifting to powerlifting and bodybuilding.’
And thus, the cycle continues.
Join author and podcaster Bryony Gordon, author Anita Bhagwandas and GH’s MD Liz Moseley to discuss: Is ‘body positivity’ making us sad?
For decades, the body positivity movement – pioneered by courageous women and cleverly embraced by some major beauty brands – has been trying to build a different, more inclusive culture about acceptable female body shapes. But a landmark study by GH of thousands of women from right across the generations has revealed that, regardless of their age, only one in three women are content with their body shape, and a further one in four are embarrassed by it. Perhaps more surprising is that fewer than half agree that ‘it’s important to celebrate every size and shape’. So how can we start to overcome our stubbornly negative self-image?
GH Members can join us at Good Housekeeping’s London HQ at 5:30pm on Tuesday 11 February to take part in the conversation – book your tickets at ghmembers.co.uk. Tickets are also available to join online from wherever you are.
You Might Also Like
