TW: Mentions of disordered eating
“Serena Williams just called me fat,” is a text I recently sent to my friends. I typed these words in jest. Of course, the former star tennis player did not utter such a phrase (and she obviously has no idea who I am). But this is the sentiment I took away from seeing her as the new spokesperson for Ro, a company that specializes in direct-to-consumer pharmaceutical and telehealth services. Ro advertises various treatments for birth control, mental health, and hair loss, but they have since gained notoriety for their offers of GLP-1 weight loss medications like Ozempic, Wegovy, and Zepbound. Despite never engaging with or searching for this company or its products, these advertisements have come to dominate my feed.
In her ad, Williams divulges that after giving birth, she was not happy with her body, and she does not talk about having a health condition like diabetes or mention obesity. However, she clearly and confidently proclaims that this is the medicine her body “needed.”
With a big smile, she proclaims that she lost 31 pounds and closes out by saying, “This is healthcare. This is Ro.” (“This feels like an episode of Black Mirror,” I thought to myself.)
To be clear: I am not a medical professional and I do not know the specifics of Williams’ health. I also believe everyone should have full bodily autonomy and that we should not stigmatize individuals taking medications that are appropriate for their health needs. What I do find concerning, however, is the continued valorization of the “skinny ideal” coupled with direct-to-consumer pharmaceutical ads that insinuate that GLP-1 agonists are needed.
For some individuals, particularly those with conditions like diabetes, a GLP-1 agonist could do wonders for their health. But this is a conversation that should be taking place in a doctor’s office, not in a YouTube ad. The U.S. is one of the two countries in the entire world that permits direct-to-consumer pharmaceutical ads—a practice I find deeply concerning and toxic—but Williams’ Ro ad and others like it disturb me on a deeper level.
(Also, William’s husband is on the board of Ro and is a major investor in the company. This poses another ethical concern, one that is the classic case of “follow the money.”)
This Ro advertisement and others like it are pushing GLP-1 medications to consumers in a way that prioritizes aesthetics, not health.
Mentions of Ozempic and its sister medications have dominated headlines in recent years. To make matters worse, droves of celebrities and influencers have touted the efficacy—or denied their assumed usage—of these substances.
A twisted game of “Guess Who?” has emerged as people put on their weight-loss detective hats to speculate on the pharmaceutical intake of their parasocial fixations. But now this game, popularized by mass advertising campaigns and the proliferation of these medications, has left many pondering, “Should I be next?”
One in eight adults in the U.S. has taken a GLP-1 agonist, according to a 2024 KFF Poll. Of these individuals, four in 10 reported that their primary motivation for doing so was to lose weight, not to address a chronic condition like diabetes or heart disease.
The flourishing of these substances begs the question: What does a GLP-1 agonist do?
Colloquially referred to as GLP-1s, a GLP-1 agonist is the abbreviation for glucagon-like peptide-1 receptor agonists. These drugs mimic the naturally occurring GLP-1 hormone that is released in the gastrointestinal tract after eating, which triggers the release of insulin, thus allowing glucose (i.e., sugar) to move out of the bloodstream and into the cells, where it can be converted into energy.
This medication is something of a miracle drug for individuals with type 2 diabetes and polycystic ovary syndrome (PCOS), conditions where the body has become resistant to or does not produce enough insulin. However, more and more individuals without diabetes are using these drugs. According to a study from the University of Pennsylvania and Cedars-Sinai Medical Center, between 2019 and 2023, there was a 700% increase in patients—all without diabetes—taking GLP-1 agonists.
But how do GLP-1s induce weight loss? Put simply, GLP-1s are injectable medications that lower blood sugar levels, slow stomach emptying (meaning you feel fuller for longer), and increase satiety (the “full” feeling after you eat). These effects lead to a decreased appetite, reduced food intake, and—of course—weight loss.
Additionally, “food noise,” a concept sometimes considered to mean intrusive thoughts around food, is quieted when taking GLP-1s. While some practitioners view this as a positive, others fear this side effect—which essentially leads people to ignore their natural hunger cues—can contribute to disordered eating.
Importantly, Williams makes no mention of the menagerie of side effects these drugs can have. Nausea, vomiting, and diarrhea are the most common gastrointestinal issues that arise from GLP-1 medications. However, more serious conditions, such as pancreatitis (inflammation of the pancreas) and gastroparesis (when the movement of food from the stomach is slowed or stopped), have also been reported. Ozempic’s manufacturer, Novo Nordisk, is currently facing a multi-billion-dollar lawsuit for failing to adequately disclose these risks associated with the drug.
The rise of these medications also poses a cultural risk as they can exacerbate weight stigma and contribute to the idea that bigger bodies must be “fixed” through weight loss. The valorization of thin bodies is nothing new. The impact of the “heroin chic” ideal of the 90s and “thinspo” content of the early 2000s continues to reverberate into our modern culture.
It is also well understood that social media has a deleterious effect on mental health, and there is a growing body of research, such as this study published in a 2022 edition of the scientific journal Current Opinion in Psychology, that explores the negative impact that social media has on body image. A 2023 study published in Eating Behaviors, a peer reviewed research publication, also found that exposure to weight loss-related content on social media is associated not only with poorer body image but also with disordered eating behaviors. The same study found that consuming content with body-positive messaging did not meaningfully protect against the deleterious side effects of the weight loss content.
Research published in 2023 by the American Psychological Association found that reducing social media use greatly improved body image in teens and young adults. But the pervasive pull of social media is often too strong to ignore.
It is not only the content that we subscribe to or the people we follow that can leave us susceptible to the negative mental health impacts of social media. Advertisements pose a threat that is perhaps even more insidious. I never subscribed to receive messaging valorizing GLP-1 medications, but the ads continue to infiltrate my feed nonetheless.
My frustration with Williams becoming the face of Ro is that she is an incredibly strong, talented, and successful woman whose happiness and self-satisfaction are now being portrayed as something she achieved through weight loss.
The mass advertising campaigns for GLP-1s, which are marketed for the specific outcome of losing weight, are toxic and reinforce our culture’s obsession with and idealization of slim bodies, particularly for women.
When Williams, a record-breaking athlete and incredibly fit person, tells me how great GLP-1s are for the specific purpose of losing weight, how much better she feels because she lost weight, and that this is healthcare, she sends the message that maybe I need that drug to be “healthy” too. A glaring problem with this line of thought is that “health” is now equated with achieving a smaller, skinnier body. That is not healthcare, that is the reiteration of our culture’s beauty standards—this time packaged as a pharmaceutical product.