Comparing the Impact of GLP-1 Agonists vs. Lifestyle Interventions and Weight Controllability Information on Stigma and Weight-Related Cognitions.

Abstract

Background: Individuals with obesity who use glucagon-like peptide 1 receptor agonists (GLP-1s) for weight loss are often judged for taking a "shortcut" rather than using "optimal" methods (i.e., diet/exercise). This is linked with beliefs that weight is highly controllable, which predict both anti-fat attitudes and maladaptive weight-related behaviors. This study tested how exposure to a woman whose weight was framed as highly controllable or largely uncontrollable and who was described as losing weight with a GLP-1 vs. diet/exercise affected weight stigma attitudes and maladaptive weight-related cognitions through social comparison processes.

Method: Women with overweight and obesity (N = 163) were exposed to a woman with obesity who varied by described weight controllability and weight loss method. Participants reported the extent to which they engaged in global downward social comparison and weight and body size comparisons to the woman, as well as weight stigma attitudes and maladaptive weight-related cognitions (likelihood of engaging in binge eating, restrictive eating, and exercising hard to control weight).

Results: When the woman lost weight with a GLP-1 (vs. diet/exercise) she was judged more negatively due, in part, to higher global downward social comparison. Reading about weight loss with diet/exercise (vs. GLP-1) led to more maladaptive weight-related cognitions through higher weight and body size comparisons. Emphasizing that weight is less controllable did not reduce stigmatizing attitudes towards a GLP-1 user and had a limited effect on weight-related cognitions.

Conclusion: Further research is necessary to identify interventions to reduce weight stigma towards GLP-1 users and maladaptive weight-related cognitions.