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When Virgie Tovar got an email asking her to promote <a href="https://www.washingtonpost.com/business/2023/08/08/what-you-need-to-know-about-drugs-like-ozempic-being-used-for-weight-loss/6666c470-3605-11ee-ac4e-e707870e43db_story.html" target="_blank">injectable weight-loss medications</a> on her social media, she thought it was spam.

As an activist, she had spent the last 13 years espousing body positivity and fat acceptance. Why would she promote drugs like Ozempic on her Instagram account?

But the offers to promote companies proffering drugs like Wegovy and Ozempic kept coming in.

And then she saw fellow fat activists posting screenshots of similar emails they had received. They came from a variety of marketing agencies and “med spas” (medical spas) with names like Valhalla Vitality, Toma Skin Therapies and The Hills Beauty Experience, promoting injectable drugs for weight loss.

“That was when it started to register that this might be something that is very widespread — that’s strategic,” she said.

Tovar was right. The emails she received were part of an industry-wide strategy to market injectable weight-loss medication via plus-size influencers. Tovar and other activists have started spreading the word on social media and speaking to the <a href="https://www.yahoo.com/lifestyle/plus-size-influencers-receiving-paid-225720883.html" target="_blank">press</a>.

As <a href="https://www.washingtonpost.com/business/2024/01/31/novo-nordisk-wegovy-supply-earnings/" target=_blank>profits explode</a> from sales of its drugs Wegovy and Ozempic, Novo Nordisk has created marketing campaigns that address body-positive communities. WeightWatchers is hyping its new WeightWatchers Clinic, focused on injectable weight-loss drugs, via paid promotions with social media influencers.

This push from the weight-loss industry is creating ideological rifts in body-positivity communities.

Jessie Diaz-Herrera, who is a plus-size certified fitness instructor, <a href="https://www.instagram.com/reel/C2SGp5IL1A7/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==" target=_blank>posted an Instagram video </a>saying that if she received another partnership offer from a company selling medical injectables she would throw her computer.

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“If some of your favorite fat influencers start doing paid campaigns for this stuff, it’s because they sold themselves into diet culture, period,” she said in the video, using an expletive.

The new marketing campaigns have raised existential questions for plus-size internet personalities about what constitutes medical autonomy, self-love and self-acceptance.

“There’s a bit of a wasp’s nest going on in the body positivity community online where people have been flooded with invitations to partner with weight loss drug companies,” said Kara Richardson Whitely, the CEO of the GORGEous Agency.

Part of the GORGEous Agency’s business is connecting companies to body-positive influencers. Richardson Whitely said the uptick in partnership opportunities from injectable weight-loss companies has raised red flags for some clients.

“It’s an affront for people who have worked so hard to come to a place of body acceptance or body appreciation and debunk diet culture,” she said.

In April, WeightWatchers acquired the telehealth company Sequence, allowing it to more easily connect its users with the class of drugs known as semaglutides or GLP-1 drugs, Ozempic and Wegovy, as well as tirzepatides, such as Mounjaro and Zepbound.

Since then, the company has been partnering with influencers to promote its new initiative, WW Clinic, which connects users to injectable drugs for weight loss.

In early January, WeightWatchers flew a cadre of influencers to a hotel in Los Angeles for an event it called the “GLP-1 House.” It featured gift boxes, lectures, an appearance by RuPaul’s Drag Race contestant Kim Chi and ample opportunity for photos, videos and collaborative content creation.

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Jake Beaven-Parshall and Kiki Monique were two influencers who participated in GLP-1 House. Both had already been documenting their use of GLP-1 drugs for weight loss on their Instagram accounts before WeightWatchers approached them.

According to Beaven-Parshall and Monique, they were paid to create content from the GLP-1 House. WeightWatchers also covered their travel and accommodations and waived their WeightWatchers membership fees for three months. In both cases, they were already receiving their GLP-1 drugs through their own insurance.

Beaven-Parshall described his experience at GLP-1 House as “incredible,” estimating that he received more than 20 DMs from his followers curious about the WW Clinic program.

“There’s a lot of stigma around these drugs: it’s the easy way out, the Kardashians [are] doing it, that kind of stuff,” he said. “So I think it’s important to humanize it and help educate people and show people’s actual journeys.”

Monique said that the response to her GLP-1 content was largely positive. One user responded to her video getting ready for the GLP-1 House by commenting “@weightwatchers hire me 🙋🏻‍♀️🙋🏻‍♀️🙋🏻‍♀️🙋🏻‍♀️ 150k on Tik tok!”

Monique also lost some followers and received a few angry comments. The level of vitriol surprised her.

“Body positivity is about being comfortable in your own skin,” she said. “I started this because I wanted to feel good. I don’t care if I stay a size 18 as long as my back doesn’t hurt.”

WeightWatchers’ chief marketing officer Amanda Tolleson wrote in an emailed statement that the company’s intention was to work with influencers to help them and their followers “reclaim their health” by “bringing healthcare into the living room and providing a safe space free of bias, stigma, shame to discuss their medication experiences.”

Ragen Chastain, a fat-positive writer, speaker and researcher, sees danger in this approach. “Influencers aren’t doctors,” Chastain said. “Pharmaceutical companies paying influencers to market their drugs has inherent ethical issues because the influencers cannot be expected to understand the science issues with the drugs. That’s not what they do.”

The fat acceptance movement dates back to at least 1967, when activists <a href="https://timesmachine.nytimes.com/timesmachine/1967/06/05/90353755.html" target=_blank>held a “fat-in” in Central Park</a> at which protesters burned diet books and images of the model Twiggy. Two years later, the NAAFA, now known as the National Association to Advance Fat Acceptance, was founded.

Today, the movement is largely concerned with changing legislation and structures that discriminate against fat people. “Body positivity,” on the other hand, tends to focus on loving one’s own body and expanding beauty standards to include all sizes.

Virgie Tovar

Some of the marketing materials from Novo Nordisk, the company that manufactures Ozempic and Wegovy, can echo talking points from body-positive online communities.

On “It’s Bigger Than Me,” a scripted internet talk show produced by Novo Nordisk, the actor Yvette Nicole Brown guides guests like plus-size influencer Katie Sturino and media personality Ashlee Marie Preston through familiar body-positive territory: lamenting the lack of size inclusion in fashion, encouraging people to stop judging celebrity bodies on red carpets, learning to accept yourself at any size.

But there is also mention of “reverse body-shaming” of people for losing weight and “<a href="https://youtu.be/Qv6Zmw3Hc3o?si=ovYMaz33H3khlHwF&t=260" target=_blank>the limitations of the body-positive movement</a> when it comes to certain health issues.” In one episode, titled “<a href="https://youtu.be/Qv6Zmw3Hc3o?si=GP3gJRVztlvuK8jW" target=_blank>Defending Your Right to Lose Weight</a>,” Preston describes herself as having been “waist-deep in the body-positivity movement” until health issues like acid reflux and sleep apnea led her to consider weight loss.

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Many people in online body-positivity communities have expressed concern about <a href="https://www.washingtonpost.com/health/2023/08/08/weight-loss-drugs-side-effects-wegovy-ozempic/" target=_blank>the safety of injectable drugs</a> used for weight loss, citing <a href="https://www.cnbc.com/2023/10/05/weight-loss-drugs-wegovy-ozempic-may-be-linked-to-stomach-paralysis.html" target=_blank>instances of stomach paralysis</a> and questions of what happens if a patient stops using the drug. Others question the validity of obesity as a medical diagnosis and the assumption that a higher BMI necessarily indicates poor health.

In an emailed statement, a representative from Novo Nordisk said that the content from “It’s Bigger Than Me” can coexist with other body-positivity movement messaging:

“We are not here to denounce body positivity or detract in any way from the strides we, as a community, have made in inclusivity,” a representative wrote. “The reality is that two truths exist — obesity can impact health, but the discrimination, stigma and shame experienced by people living with obesity for their weight is also very real.”

But in some body-positive communities, advocating for weight loss is mutually exclusive with a healthy relationship to one’s body.

“There’s so much value in having a safe space from all the body shame and all the pressure to lose weight, and I know firsthand how important it is, so I am very protective of it,” said Sarah Chiwaya, a plus-size fashion blogger and consultant based in New York City. “I don’t want to see people using this community for their own purposes and then discarding us.”

Calley Means

A few weeks ago in Chiwaya’s hometown, posters advertising WW Clinic began popping up on the walls of downtown city streets that read, “Zero stigma. Expert care.”

Chastain doesn’t think it’s possible to simultaneously reduce weight stigma and promote the eradication of obesity through dieting or weight loss drugs. “That’s not a thing,” she said. “Eradication is stigma.”

Ending weight bias has been a hallmark of the fat acceptance movement from its inception, but Tigress Osborn, the executive director of the National Association for the Advancement of Fat Acceptance, thinks these companies’ focus is misguided.

“They tend to talk about the ways in which weight bias prevents people from showing up for treatment, not the ways in which weight bias prevents people from getting treatment when they have shown up,” Osborn said.

In a clinical trial with a sample size of 122 doctors in Texas, weight bias correlated to <a href="https://pubmed.ncbi.nlm.nih.gov/11477511/" target=_blank>less time spent</a> with larger patients. Another study found weight bias in doctors was linked to a <a href="https://pubmed.ncbi.nlm.nih.gov/8372479/" target=_blank>reluctance to provide certain screenings</a> to larger patients.

Patients’ fear of being judged by doctors for their weight <a href="https://pubmed.ncbi.nlm.nih.gov/29574257/" target=_blank>has been correlated </a>with avoiding preventative medical care, such as mammograms and physicals.

Last year, Novo Nordisk sponsored two documentary projects centered on weight stigma: the feature “Embodied” and the docuseries “Thick Skin.”

“Encouraging people to find a doctor who treats them with humanity and empathy and respect is fine,” said Erin Standen, a research associate at the Mayo Clinic who studies weight bias. “But Novo Nordisk talking about weight stigma and bias makes me ponder what the motive is.”

Rebecca Puhl, a professor at the University of Connecticut, has spent 20 years researching weight bias and advocating strategies to reduce weight stigma.

“I really actually don’t advocate for or against medication,” Puhl said. She also disclosed that she had received funding in the past from Novo Nordisk and Lilly for initiatives and speaking engagements related to weight stigma and weight bias that pre-dated the release of their weight-loss injectable drugs.

Puhl is more concerned with how society accommodates the needs of larger bodies than an individual’s choice to lose weight by using drugs. She mentioned a <a href="https://www.washingtonpost.com/politics/2023/03/22/weight-discrimination-ban/" target=_blank>law passed in New York City</a> in November 2023 banning employment discrimination based on perceived height and weight. Laws like this remain exceptional.

“There’s so much focus on discussing these medications,” Puhl said. “We could be channeling all of that energy to create a more respectful society and community for people of all body sizes.”

Emmy Nomination for "Who, Me? Biased?", 2017

NPPA Best of Photojournalism First Place in Online Video Storytelling for "Voguing Has Always Been Protest", 2021

Society of Publication Designers, Short Video or Video Series Silver Medal for Internetting with Amanda Hess, 2018

Macalester College, BA in English, 2004

Shane O'Neill joined The Post in the Fall of 2023. He previously worked at The New York Times where he produced videos and contributed stories to the Styles and Culture sections. His areas of interest include subcultures, nightlife and L.G.B.T.Q. communities.

Shane O’Neill

Ozempic, weight-loss drugs target body positive influencers for marketing

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Ozempic sidles up to the body positivity movement

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New marketing push by Ozempic and others sparks body-positive backlash