Ethical Questions About the Rapidly Expanding Use of GLP-1 Medications for Weight Loss
A newly published paper in the journal, Fat Studies, raises urgent ethical questions about the rapidly expanding use of GLP-1 medications for weight loss—questions that the fields of eating disorders and weight stigma can no longer afford to ignore.
Drawing on published clinical trials, adverse-event reporting systems, regulatory documents, and conflict-of-interest disclosures, researchers Ragen Chastain, Angela Meadows, and Louise Adams examined whether the overwhelmingly positive public story surrounding GLP-1 drugs reflects the full scientific picture.
Their conclusion is sobering: it does not. The authors argue that pharmaceutical marketing, financially entangled research, and incomplete disclosure practices have created conditions in which patients and clinicians are often unable to make fully informed decisions about risk.
The study contains several troubling findings…
First, reports of adverse events have increased dramatically as GLP-1 use has expanded—and yet even those numbers are likely underestimates. Many people obtain these medications outside traditional healthcare systems—through online services, compounded pharmacies, or informal networks—and may never report complications through official channels.
Second, patients receiving medical supervision may underreport side effects because they fear losing access to medications they feel desperate to continue. In a culture where fatness is framed as a medical emergency and thinness as a moral good, this silence is understandable—but dangerous.
The paper also highlights concerns about research integrity. According to the authors, many of the major clinical trials supporting GLP-1 medications include investigators with financial ties to manufacturers such as Novo Nordisk, while less flattering findings are sometimes relegated to supplementary materials that receive less scrutiny than primary published results. They further note that the number of adverse events and deaths associated with some weight-loss formulations may already rival or exceed medications that were eventually withdrawn from the market for safety concerns.
None of this is unfolding in a cultural vacuum.
To understand the power of these drugs, we must first understand the intensity of weight stigma. Research has found that many people in larger bodies report they would accept profound losses in quality of life—including blindness, deafness, or even substantial risks to survival—rather than remain fat.
That fact alone should stop us in our tracks. Pharmaceutical companies did not create anti-fat bias, but they have undoubtedly learned to profit from it. When a society relentlessly teaches people that larger bodies are failures to be fixed, the promise of a “miracle drug” becomes extraordinarily difficult to resist.
For people with eating disorders—or those vulnerable to developing them—this moment carries particular risks.
Eating disorders thrive in environments of fear, perfectionism, and bodily dissatisfaction. The cultural celebration of appetite suppression and rapid weight loss can intensify restrictive behaviors, obsessive thinking, and shame around food and bodies. Those already struggling may feel pressured to pursue medications without a clear understanding of the risks, while clinicians may underestimate how deeply eating disorder symptoms shape decision-making.
During my last year at Kaiser Permanente, I noticed that our eating disorders clinic intake numbers were dropping. When I raised the issue with a colleague in health education, she pointed out that demand had tripled for the class required for those who wanted to receive GLP-1. That concerned me because we knew that the prevalence of eating disorders was not going down—rather, the pursuit of weight loss superseded the need to address a problematic relationship with food and one’s body.
The central message of the Fat Studies paper is not that GLP-1 medications should never be used. Rather, it is that informed consent requires honest, unbiased information—and that true informed consent may not be possible right now, because of slanted research and aggressive marketing, which continues, as the authors write, “a history of harming higher-weight people in the name of profits.”
Patients deserve transparent data about benefits, harms, and uncertainties. Clinicians deserve research free from undisclosed influence. And vulnerable populations—especially people with eating disorders—deserve stronger protections than a marketplace built on desperation.
REFERENCES
Chastain, R., Meadows, A., & Adams, L. (2026). GLP-1 medications for weight-loss: a triumph of marketing over patient care. Fat Studies, 1–18. https://doi.org/10.1080/21604851.2026.2646492