You don’t know anyone an explanation. 

It’s that time of year again. You are sitting at the holiday dinner table, and an aunt leans over with that look on her face. "You look different! What are you doing?" Before you can answer, your uncle chimes in with his opinion about weight loss medications he saw on the news. Your cousin starts talking about how she lost weight the "natural way." Suddenly your medical decisions have become the main course conversation, and everyone seems to think they deserve a detailed explanation of your healthcare choices.

The holidays bring family gatherings, which often means facing relatives you have not seen in months. They notice changes. They ask questions. They offer unsolicited opinions. And when it comes to weight loss and GLP-1 medications, everyone suddenly becomes a medical expert with thoughts about what you should or should not be doing with your body.

Here is the truth: you do not owe anyone an explanation for your medical treatments. Your healthcare decisions are between you and your provider. What medication you take, why you take it, and how it is working are your private information to share or keep to yourself. This article explains why stigma around GLP-1 medications exists, why it is wrong, and how to handle people who think your body and healthcare choices are up for public debate during the holidays or any other time.

Where the Stigma Comes From

Weight as a Moral Issue

Our culture treats body weight like a character test. Thin equals disciplined and virtuous. Higher weight equals lazy and lacking control. These ideas are so ingrained that people apply them without even realizing it.

This means losing weight through "hard work" (diet and exercise) is seen as admirable, while losing weight through medication is seen as cheating. The assumption is that you need to suffer enough to earn your results. If you are not struggling, you do not deserve success.

Think about how absurd this is. Nobody tells people with high blood pressure they need to suffer more before they deserve medication. Nobody accuses people taking statins for cholesterol of taking shortcuts. We only apply this "earn it through suffering" standard to weight loss. The stigma seems less about health but some form of moral judgement. 

The "Just Eat Less" Myth

People believe weight management is simple. Eat less, move more, problem solved. If it were that easy, then needing medication must mean personal failure. This belief ignores decades of research showing that obesity is a complex disease involving genetics, metabolism, hormones, brain chemistry, and a multitude of factors competing together. 

Your body actively fights against weight loss. Metabolism slows down. Hunger hormones increase. These biological changes make sustained weight loss extremely difficult for most people through lifestyle changes alone. This has nothing to do with discipline or trying hard enough.

GLP-1 medications work by addressing these biological mechanisms. They modify hunger signals, affect satiety, and help normalize the metabolic changes that make weight maintenance so hard. Using medication to address biological mechanisms is not cheating. It is treating a chronic disease with appropriate medical care. 

Social Media Amplifies Everything

Social media makes everyone's body feel like public property. Celebrities taking GLP-1 medications face intense criticism. This filters down to regular people who find their personal medical decisions becoming topics of conversation and judgment among people who barely know them.

Weight loss is visible in ways that improvements in cholesterol or blood pressure are not. People taking GLP-1 medications cannot avoid questions about how they lost weight. The assumption that visible body changes require explanation puts people in impossible situations where they either have to disclose private medical information or face speculation and judgment.

GLP-1 Medications Are Legitimate Medical Treatment

Let's be clear about the medical reality.

Obesity Is a Chronic Disease

The American Medical Association, the Obesity Medicine Association, the World Health Organization, and virtually every major medical organization recognize obesity as a chronic disease. This is not controversial within medicine. It reflects understanding that obesity involves complex biological mechanisms including genetic predisposition, metabolic dysfunction, hormonal issues, and brain chemistry affecting appetite.

The disease framework matters because it establishes that medication is legitimate medical intervention for a medical condition. Your provider prescribes GLP-1 medications because they treat a chronic disease. That is sufficient justification. No additional explanation required.

GLP-1s are Proven

GLP-1 medications underwent extensive clinical trials before FDA approval for weight management. Semaglutide trials showed average weight loss of 15 to 17 percent of body weight with significant improvements in cardiovascular health, blood sugar control, and quality of life. Tirzepatide trials demonstrated even better results with average weight loss of 20 to 22 percent.

These medications are not experimental. They are evidence-based treatments backed by rigorous research and approved by regulatory agencies specifically for weight management. Taking FDA-approved medication as prescribed by your provider is about as mainstream as healthcare gets.

The characterization of these medications as risky or inappropriate generally comes from people unfamiliar with actual evidence or motivated by bias. You would not accept random medical advice about your thyroid medication. There is no reason to accept uninformed opinions about your weight management medication either.

Medication Works With Lifestyle Changes

One common criticism is that people taking GLP-1 medications are not making lifestyle changes and relying solely on pills. This misunderstands how these medications are actually used. Medical guidelines recommend GLP-1 medications as part of comprehensive treatment including nutrition counseling, physical activity, and behavioral support.

Most people taking these medications work with dietitians, track food intake, prioritize protein, increase physical activity, and make substantial lifestyle changes. The medication makes these changes achievable by reducing hunger and addressing biological factors that make behavior change difficult. Medication and lifestyle modification work together.

Even if someone were taking medication without lifestyle changes (which is rare), that would be their healthcare decision with their provider. Whether someone is "doing enough" is not up for public commentary.

The Glaring Double Standard

The most revealing aspect of GLP-1 stigma is how differently we treat medications for weight versus other conditions.

We Don't Question Other Medications

People take medications for blood pressure, cholesterol, depression, anxiety, thyroid problems, diabetes, arthritis, and countless other chronic conditions without facing questions about trying hard enough first. Nobody suggests people with hypertension are taking the easy way out by using medication instead of trying harder with stress management.

The medical logic is identical. High blood pressure is a chronic condition with genetic and environmental components that often requires medication. Obesity is a chronic condition with genetic and environmental components that often requires medication. The only difference is stigma.

The Suffering Standard

The difference is a suffering standard applied only to weight loss. People with other conditions can reduce suffering and improve quality of life through medication without judgment. People pursuing weight loss are expected to suffer through hunger and deprivation, and any attempt to reduce suffering through medication is suspect.

This suffering standard is not based on medical science. It is based on beliefs that weight loss should be hard, that people at higher weights deserve to struggle, and that reducing suffering in this domain is somehow illegitimate.

You do not have to accept this standard. Your suffering matters. Your quality of life matters. Using medical tools to reduce suffering and improve health is just as valid for obesity as for anything else.

Your Medical Information Is Private

Beyond the medical reality, there is a fundamental principle: your medical information is private, and you control what you share. When someone asks what medication you are taking or how you lost weight, they are asking for private medical information. You are under no obligation to provide it. "I am working with my healthcare provider" is a complete answer. So is "I would rather not discuss my medical care." So is changing the subject.

Many people feel uncomfortable setting boundaries around medical information because it might seem rude. This discomfort reflects cultural norms that treat bodies (particularly women's bodies and anyone's body weight) as appropriate subjects for public commentary. These norms are wrong.

Setting boundaries around private information is not rude. It is healthy self-protection. You would not feel obligated to discuss your mental health medication, sexual health, fertility treatments, or digestive issues with casual acquaintances. Your weight management medication deserves the same privacy protection.

Practicing boundary-setting feels awkward initially but becomes easier. Have prepared responses ready. Practice saying "That is between me and my doctor" or "I am not comfortable discussing my medical care" until they feel natural.

Handling Questions and Judgment

Even with clear boundaries, you will encounter questions and judgment. Having strategies helps you navigate these situations with less stress.

Prepared Responses

Having responses ready reduces the burden of deciding how to answer in the moment. Choose approaches that feel comfortable:

Direct but minimal: "I am working with my doctor on my health."

Firm boundary: "I do not discuss my medical care outside my healthcare team."

Redirect: "I appreciate your concern, but I am comfortable with my plan. Let's talk about something else."

Simple refusal: "That is personal."

Humorous deflection: "My doctor and I have it covered, but I will let you know if we need a committee."

Choose responses that match your personality and the relationship. You might be more direct with a pushy relative than with a well-meaning coworker.

Workplace Considerations

Workplace dynamics complicate boundary-setting. Coworkers may feel entitled to comment on visible changes. Workplace culture might normalize invasive questions. Power dynamics make shutting down commentary more difficult.

Your medical information remains private at work. Comments about your body or health questions are inappropriate regardless of how casually they are framed.

For coworkers: "I keep my medical care private. Let's focus on work."

For supervisors: "I am managing my health with my providers. It does not affect my work performance."

If commentary becomes persistent, document interactions and consider discussing with human resources.

Protecting Your Mental Health

Facing judgment about your healthcare takes an emotional toll even when you know the judgment is unjustified. Protecting your mental health requires deliberate strategies.

Watch for Internalized Stigma

External stigma becomes internal when you start believing the judgmental narratives. You might question whether you are taking the easy way out, whether you are trying hard enough, or whether you deserve medication.

Recognizing internalized stigma is the first step to addressing it. Notice when you are harsher with yourself than you would be with a friend. Notice when you apply different standards to your weight management medication than to other treatments.

Challenge internalized stigma by consciously rejecting judgmental narratives. Remind yourself that obesity is a chronic disease, medication is appropriate treatment, your healthcare decisions are between you and your provider, and you are not required to earn health improvements through suffering.

Find Support

Facing stigma is easier with support from people who understand. This might include supportive friends or family, online communities of people taking GLP-1 medications, support groups through healthcare providers, or therapy with a counselor familiar with weight stigma.

Support does not require people who are also taking medication. It requires people who respect your autonomy and trust your judgment. Choose your support network carefully. Share with people who have demonstrated trustworthiness and respect.

When to Get Professional Help

If stigma is significantly affecting your mental health, relationships, or quality of life, professional support can help. Look for therapists who take a weight-neutral approach or have training in working with people managing obesity as a chronic condition.

Therapy can help with developing communication skills for boundary-setting, processing internalized stigma, managing anxiety about judgment, and building self-compassion. You deserve support for the emotional impact of facing judgment about your healthcare.

Finding Care That Respects Your Individual Journey

Everyone's weight loss experience is different. Some people respond better to semaglutide, others to tirzepatide. Some need additional support with medications for nausea or constipation. Others benefit from medications for related conditions like anxiety, sleep issues, or metabolic health. There is no one-size-fits-all approach, and anyone telling you there is a "right way" to lose weight does not understand the complexity of treating a chronic disease.

At Mochi Health, we recognize that your journey is uniquely yours. Our providers offer personalized treatment plans tailored to your specific health needs, goals, and circumstances. Beyond GLP-1 medications, you have access to registered dietitian nutritionists who can help you navigate eating with reduced appetite and ensure you are meeting your nutritional needs. We also offer a comprehensive range of medications to support you through your weight loss journey, from managing side effects to addressing related health concerns that may be affecting your progress.

Your treatment plan should reflect your individual situation, not a cookie-cutter protocol. If you are looking for care that respects your autonomy and provides comprehensive support beyond just prescribing medication, check out the full range of treatment options available at https://joinmochi.com/medications or see if you qualify for personalized care at https://app.joinmochi.com/eligibility.

The Bottom Line

Your medical treatment is your choice in consultation with your healthcare provider. You do not owe explanations or justifications to anyone who questions that choice.

GLP-1 medications are evidence-based, FDA-approved treatments for a chronic disease. Taking them as prescribed is mainstream medical care, not a shameful secret. The stigma reflects cultural biases about weight, not medical reality.

You have the right to privacy about your medical information. You have the right to set boundaries when people ask invasive questions. You have the right to disengage from judgment without defending yourself. You have the right to make healthcare decisions based on your goals, your circumstances, and your provider's expertise rather than others' opinions.

Your treatment is between you and your provider. Your results are your own. Your journey is valid regardless of what tools you use or how closely you conform to anyone's ideas about the right way to manage health. The only explanation you ever owe is the one you give yourself when making informed decisions about your care.

For comprehensive information about weight management and wellness options available through Mochi Health, visit https://joinmochi.com/medications.

References

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Obesity Medicine Association. (2022). Definition of obesity. https://obesitymedicine.org/definition-of-obesity/

Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews, 16(4), 319-326. https://doi.org/10.1111/obr.12266

Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17(5), 941-964. https://doi.org/10.1038/oby.2008.636

Puhl, R. M., Lessard, L. M., Himmelstein, M. S., & Foster, G. D. (2021). The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries. PLOS ONE, 16(6), e0251566. https://doi.org/10.1371/journal.pone.0251566

Rubino, D., Abrahamsson, N., Davies, M., Hesse, D., Greenway, F. L., Jensen, C., Lingvay, I., Mosenzon, O., Rosenstock, J., Rubio, M. A., Rudofsky, G., Tadayon, S., Wadden, T. A., Dicker, D., & STEP 4 Investigators. (2021). Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: The STEP 4 randomized clinical trial. JAMA, 325(14), 1414-1425. https://doi.org/10.1001/jama.2021.3224

Tomiyama, A. J., Carr, D., Granberg, E. M., Major, B., Robinson, E., Sutin, A. R., & Brewis, A. (2018). How and why weight stigma drives the obesity 'epidemic' and harms health. BMC Medicine, 16(1), 123. https://doi.org/10.1186/s12916-018-1116-5

Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002. https://doi.org/10.1056/NEJMoa2032183

This article is for educational purposes only and should not be considered medical advice. Consult with healthcare providers about whether GLP-1 medications are appropriate for your individual health needs and circumstances.