Abstract
Background
GLP-1 receptor agonists (GLP-1 RAs) have dramatically altered obesity treatment. Media reports suggest that GLP-1 RAs users often report feeling judged for taking a “shortcut” to lose weight, which may be related to negative stereotypes toward people with larger bodies. Media reports also describe negative attitudes about lean people who take GLP-1 RAs to enhance their appearance. The present research used a 2 × 2 experimental design to test the effects of GLP-1 RA use and body size on attitudes and egocentric impressions.
Subjects/Methods
A sample of 357 U.S. adults (Mage = 37.8, SD = 13) were randomly assigned to read about a woman, who either was lean or had obesity, and who lost 15% of her body weight either with diet/exercise or a GLP-1 RA. Participants answered questions measuring endorsement of negative weight-related stereotypes and egocentric attitudes toward the woman, as well as beliefs that she took a shortcut to lose weight and beliefs that biogenetic factors caused her baseline weight.
Results
Negative evaluations and egocentric impressions were stronger toward a woman who lost weight with a GLP-1 RA compared to diet/exercise. Losing weight with a GLP-1 RA led to stronger negative evaluations through higher weight loss shortcut beliefs irrespective of body size. Losing weight with a GLP-1 RA also led to higher egocentric impressions through higher shortcut beliefs, and this effect was stronger for a lean woman. Finally, losing weight with a GLP-1 RA led to more negative evaluations through stronger endorsement of biogenetic causal beliefs for a lean woman only.
Conclusions
This timely study provides evidence that people with larger and smaller bodies alike are at-risk for being judged for using GLP-1 RAs due to beliefs that these medications are a shortcut. Findings also demonstrate novel reactions related to egotism when weight loss is achieved with pharmacological interventions.
Pre-registration and data
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Data availability
Full measures, code, and data analyzed for the present study can be found online at osf.io/xme4w.
Notes
The pre-registered study tested a fifth condition in which the woman with obesity lost weight with bariatric surgery. We excluded this condition from the present manuscript because our primary research aim was to compare differences in negative evaluations and egocentric impressions between GLP-1 RA and diet/exercise; however, mean comparisons with the bariatric surgery condition are included in supplemental materials.
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Acknowledgements
This study was supported by the Intramural Research Program of the National Human Genome Research Institute. We would like to thank Junhan Chen, Crystal Peterson, and Kaylee Foor for assistance with data collection preparation, and Christopher Fortney for assistance with experimental stimuli preparation. Thank you to Rebecca Hoffman for providing input on the study design.
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SMP was responsible for study conceptualization, writing the protocol, data collection, formal data analysis, writing and editing the manuscript, creating the Results tables and figures, and compiling reference lists. SP was responsible for study conceptualization, providing feedback and editing the protocol, writing and editing the manuscript, and overall supervision.
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Post, S.M., Persky, S. The effect of GLP-1 receptor agonist use on negative evaluations of women with higher and lower body weight. Int J Obes 48, 1019–1026 (2024). https://doi.org/10.1038/s41366-024-01516-4
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DOI: https://doi.org/10.1038/s41366-024-01516-4