- Ozempic and other anti-obesity medications can improve health and aid with significant weight loss.
- With significant weight loss may come anxiety about people’s reactions and views of you.
- Experts share ways to cope with the newfound attention.
While losing weight with anti-obesity medications like Ozempic, Wegovy, or Mounjaro can improve a person’s health and well-being, the newfound weight loss they experience can bring about feelings of social anxiety and confusion about self-identify and self-worth.
Dr. Sethu Reddy, president of the American Association of Clinical Endocrinology, said many patients he treats with anti-obesity medications share this sentiment with him.
“People might go to their workplace or out and when they were overweight, people wouldn’t talk to them, they would ignore them, and now that they lost weight people start coming up to them and saying, ‘hello how are you?’ and so they’re not used to that social interaction, so they get nervous from getting attention that they hadn’t had before,” Reddy told Healthline.
The most powerful comment that a patient told Robyn Pashby, PhD, licensed clinical health psychologist and founder of DC Health Psychology was, “I am both invisible and highly visible at the same time.”
Pashby said this reflects the duality that is often faced by people living with obesity.
When a person has obesity, she said they may be exposed to negative comments, accusing glares, or physical harm due to their weight or body size.
“Unlike other less outwardly obvious struggles such as some addictions, mental health concerns, cancers, etc., obesity can be seen by others, making it a highly visible condition,” she told Healthline. “Society is quick to judge and make accusations and assumptions about that person solely based on weight and size, rendering a person’s true substance (thoughts, feelings, opinions, beliefs, needs, wants, etc.,) invisible.”
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Once a person loses a significant amount of weight, Pashby said the way they are treated by others may change.
“Weight stigma is woven into the fabric of our society, unfortunately, and there are few social or legal constructs to protect people living with obesity from discriminations both big and small,” she said.
When on an anti-obesity medication, she encourages people to consider and anticipate that their way of interacting in the world might feel different with significant weight loss.
“Sometimes bringing awareness can reduce the surprise a person experiences,” Pashby said.
When it comes to coping with newfound attention from weight loss, she pointed out that while they may have experienced being the “center of attention” in their life, they might have less experience with the type of attention they receive.
“When attention shifts from negative attention (jeers, dirty looks, rude comments, being ignored) to positive attention (compliments, flirting, offering connection or support, etc.,), it may feel like unfamiliar territory,” she said.
Pashby said many people with obesity have learned to develop coping strategies for navigating negative attention like the following safety-seeking behaviors:
- Avoidance or staying away from social settings
- Distraction or diversion by being smart or using self-deprecating humor
Disordered eating
While the coping tools technically work in the short run, she said they may not help the person live the way they wish to live.
“[Our] goal in therapy is often to lean less on these safety seeking behaviors and more on new coping skills that provide space for them to engage in their lives in meaningful ways,” Pashby said. “[This] shift in coping styles is a good goal whether the person loses weight or not.”
Some ways to cope include:
- Advocacy
- Exercise
- Therapy
- Meditation
- Self-talk and self-compassion
Social anxiety occurs when social interactions cause persistent, irrational anxiety due to a person’s fear that they will be judged, embarrassed, or humiliated.
For many people living with obesity, this type of anxiety is real and valid because they are often judged, embarrassed, or humiliated in social situations, said Pashby.
“[It] is unclear if the level of anxiety is out of proportion. So I tend to think that for many people, social anxiety is a result of weight-related biases, which are experienced by living with obesity,” she said.
While obesity is complex, so is weight loss.
“When weight loss occurs, the type of social anxiety might shift,” said Pashby.
For instance, social anxiety from positive attention after weight loss may initially elicit a desire to avoid social situations.
“When losing weight, it is also normal to have anxiety about a shift in how one is viewed by our society,” said Pashby.
A change in how one is perceived and treated can cause mood changes, noted Dr. Rekha B. Kumar, associate professor of medicine at Cornell and Chief Medical Officer at Found.
She stressed that it is important for people to understand that their weight history is part of their health history and that they don’t have to explain anything to anyone about their weight loss.
If people do want to respond to compliments or questions about how they lost weight, she said it’s good to think about what they want to share.
“People might want to decide how to respond by having a set response that shares an amount of information they feel comfortable with,” Kumar told Healthline.
For instance, with the popularity of medications like Ozempic and Wegvoy, a person should determine whether they want to tell people that’s how they lost weight if asked.
She also recommended that people lean into social circles where they feel supported rather than judged to help ease anxiety.
Pashby teaches her patients to focus on acknowledgment of why they feel more anxious or upset and helps them work through how weight bias plays a part.
“A person’s body weight isn’t the problem. Our society’s bias, against larger bodies, against anyone deemed ‘less than,’ is the problem. I try to work with my patients to learn to cope in the context of unfair biases,” she said.
If you’ve lost weight on Ozempic or another GLP-1 receptor agonist and feel anxious from the attention you are getting, Kumar said talk to the doctor who prescribed the medication.
“It is a topic that they can discuss in regards to getting some strategies on how to respond,” she said. “[Your doctor] may also suggest counseling or support groups with others who have dealt with the same situation.”
While anti-obesity medications like Ozempic can cause weight loss and improve health for those living with obesity and overweight, the newfound attention weight loss brings may cause anxiety and struggles with self-identity and self-worth.
Talk with the doctor who prescribed the medication to help you find ways to cope.