A No-Holds-Barred Talk About GLP-1

By: Rachel Tuchman, LMHC

Everywhere we turn lately, people are talking about going on GLP-1s (Ozempic, Wegovy, Mounjaro, Zepbound) as a form of weight loss. And it’s usually framed as a “health” decision, a step toward “feeling better,” “being healthier,” or “taking care of oneself.” And I understand that. For some people, that may very well be true. There are very legitimate reasons for taking GLP-1s, such as helping people with Type 2 diabetes manage their blood sugar (glucose) levels.

But if we’re being honest, a lot of what’s underneath this sudden surge of prescriptions is much simpler: People want to be thinner. And that’s fine, but let’s be clear: “thinner” and “healthier” are not synonymous.

The reality is there is a “look” that is becoming more and more common lately, and I’m not going to lie, it makes me nervous. People aren’t just getting thinner. A lot of them are starting to look under-weight in a way that feels extreme and even frightening. Hollowed faces. Bones jutting out. Skin that hangs in ways you don’t usually see in young people. Sunken eyes (maybe you don’t need a fat transfer; you might just need to eat). Bodies that look worn down instead of nourished. Mismatched proportions that make it clear the body shouldn’t look that way. You may have seen people who are losing weight and at first, you think they look good, but then it continues to the point they become unrecognizable. It’s concerning, and that’s putting it mildly.

It’s true, some people are naturally thin, but that’s not what I’m talking about here. I’m talking about a very specific look and a drastic change that suggests a body that is being pushed beyond what’s sustainable.

This issue is prominent in Hollywood. We know the entertainment industry is full of those kinds of pressures and demands. How many times have we read about Oprah’s weight loss journey over the years, as if from all of the incredible things she’s done in her career, that’s the most interesting thing about her? But this doesn’t stay in celebrity culture. It very much trickles down to us and we are now seeing this in regular everyday life. The people who live in our communities: neighbors, friends, parents. People we actually know.

Now, I want to be clear about what I’m saying and not saying.

I’m not diagnosing strangers. I don’t know people’s medical histories, what prescriptions they’re taking, or their private struggles. This isn’t about judging individual bodies or turning weight loss into a moral issue. We are free to make choices about our bodies. It’s also not a blanket condemnation of weight-loss medications. I firmly believe these medications have their important uses.

And I know the pushback: “Rachel, we’re not supposed to comment on other people’s bodies.” I agree when it comes to individuals. But ignoring a broader cultural trend because we’re afraid to say anything doesn’t help either. This isn’t about judging people. It’s about paying attention to what we’re starting to accept without question.

I also want to say this clearly: If you are on this medication for a legitimate medical reason and it has improved your health or your quality of life, this is not about you. The concern isn’t about responsible use. It’s about what is happening culturally, and the growing number of people who are starting to look unwell in ways that are not just being overlooked but actually being praised.

Remember, many things can be true at the same time.

We can respect that people have their own circumstances and body autonomy, and also recognize when things start to feel like they’ve gone too far. We can acknowledge when something is shifting culturally that could have very negative effects for our health and well-being. Because, when a noticeable number of people start looking this way, it stops being just about individual bodies and it starts to shape what we think is normal. Even people without significant histories of body issues are reporting having struggles with their bodies because the new “norm” has become so much smaller.

We are living at a time when extreme thinness is being pitched as “prioritizing health.” Appetite suppression, which used to set off alarms for people, is now being shared loud and proud on social media and celebrated in the same comments section your teens are reading. Rapid shrinking, which we once knew was not a good thing with potential for serious side effects, is now applauded as “getting healthy” and self-improvement (so many fire emojis).

Medications like Ozempic are part of this landscape, but they are not the whole story. Even among people who are not taking these medications, the message is clear: Less is better. Eat less. Need less. Take up less space.

Hunger itself is being treated as something to override rather something to listen to. Everything is “food noise” now. Even basic biological hunger cues.

I work with disordered eating and eating disorders, so I’m particularly attuned to what under-fueling can do to one’s mind and body. Not in numbers or diagnoses, but in vitality and energy. I see how the mind and body feel and (don’t) function when they are in a state of serious nutritional deprivation.

You see it over time: less energy and less strength. Bodies that look worn down instead of taken care of. We’re also downplaying things that would have raised real concern not long ago. Feeling cold all the time. Hair loss. Dizziness. Gastric issues. Constant headaches. Loss of menstrual cycles. Low energy. Loss of muscle mass. Even a kind of emotional flatness, now known as “Ozempic personality.” These are being waved off as common “side effects” and minimized. But even if they’re common, some of them are serious and can have real long-term consequences.

I’ve seen how complimenting “self-control” and the “you look so good” comments quickly turn into praising not eating enough. And for some people it can spiral into a full-on eating disorder in an effort to keep the weight off.

What feels most worrisome is not any one individual body. It’s the larger shift in what we now treat as a “goal.” Bodies that look unwell are increasingly held up as evidence of beauty, health, and success.

Interestingly, we are often quick to express concern when someone is in a larger body, but when someone loses a significant amount of weight and starts to look unwell, that same concern tends to fade, even though that’s when it may be most needed. Expressing concern for those people is labeled as jealousy or “hating” (I get that often). At the same time, many of the same behaviors we would be concerned about in a thin body are praised when they happen in a larger one. It’s a pretty striking double standard.

And our young people are watching this.

They’re figuring out what a “normal” body looks like based on what they see around them. And right now, what they see is getting narrower and narrower.

Teenagers and young adults, especially young girls, are absorbing these messages long before they have the tools to question them.

They don’t just see it. They internalize it. They are learning what gets attention, praise, and what gets called beautiful. They’re learning that hunger is something to conquer, that shrinking is something to strive for, and that taking up less space is something to feel proud of.

Even if they never go near a weight loss medication, the message still sticks. The cultural permission to eat less, skip meals, and disconnect from their bodies is there. They are learning that thinner is better, no matter the cost. And some of the adults in their lives are reinforcing this.

For some people, Ozempic changed their body. For many others, it changed the atmosphere. It changed what now feels acceptable, even admirable. It lowered the threshold for restriction and made it easier to justify behaviors that, in another time, might have raised serious concerns.

And again, two things can be true.

Medications can be appropriate and even life-changing for some people, and the culture surrounding them can still become extreme in a way that’s not healthy.

Naming that isn’t fear-mongering or judging. It’s responsibility.

Health is not synonymous with shrinking or the absence of an appetite. And a body that looks hollowed out, exhausted, or frail is not necessarily a body that is thriving, no matter how common that look has become.

When I notice how many people now look physically unwell, I don’t feel judgment; I feel concern. Concern about how misguided our definition of health has become, and concern about what happens when an entire generation grows up thinking that disappearing is better than being fully here.

Our bodies are the means by which we live life fully; they are not ornaments to be ogled and objectified according to ever-changing “beauty standards.” Our bodies are meant to be fueled, supported, and lived in. They are supposed to be diverse in shape, size, and ability. That’s not a mistake. People in bigger bodies don’t have a thin person inside them just waiting to get out. Health is about so much more than your physical body.

If we pause long enough to actually reflect on what we are seeing and valuing right now, maybe we can open up the conversation again. Maybe we can move away from control and deprivation, and back toward nourishment, strength, and presence. Toward bodies that look alive and take up space. And toward young people who are given permission to be.

If you’re raising kids in this, talk about it. Don’t assume they’re not noticing. Help them question what they’re seeing and remind them that bodies are not meant to be shrunk into submission. Pay attention to how food, weight, and bodies are being discussed at home, because kids absorb far more than we realize. And most importantly, model a relationship with your own body that is rooted in care, not control. For those struggling personally, this might be a moment to stop and check in with your body rather than overriding it. Hunger, energy, mood, and strength are not problems to fix. They are signals worth listening to. And research from the NIH suggests that a higher appreciation for one’s body may serve as a protective factor against interest in using GLP-1s for weight loss. 

Rachel Tuchman, LMHC, is a licensed therapist in private practice. She not only treats a variety of mental-health concerns, but also shares psychoeducation via her social media platform, public speaking, and online courses. You can learn more about Rachel’s work at RachelTuchman.com and follow her on Instagram @rachel_tuchman_lmhc.