On social identity…the people who surprise you, and the ones who don't
Something changes when your body changes on a GLP-1 medication. Not only in the mirror. It happens in the room. And it’s not just what you hear (or don’t hear). It’s how you feel and see yourself and how others see you.
Weight loss rarely happens in a vacuum. It happens in a family. A marriage. At the office. Amongst friends. On social media. GLP-1s add a new dimension to an already complicated experience.
The impact this has on social identity - how we see ourselves in relation to others - is often the most consequential part of this experience. The most consequential, yet the least discussed.
See how this impact is interwoven into the daily lives of the following five people who are taking GLP-1 medications.
The characters and stories in this article are fictional. They were created to illustrate experiences that research and clinical observations have documented among people navigating GLP-1 therapy. Any resemblance to real individuals is coincidental.
Diane
46 years old. Marketing director.
The first time my sister asked, “why don’t you just eat less?” I let it go. I figured she was genuinely curious and just uninformed. Our relationship was open and close. She was my confidant. But then she kept asking me the same question. Each time with a little less curiosity and a little more judgement. She had watched me struggle with my weight through the years. Doctors’ warnings about heart failure and shortened life span. She cheered me on every time I started a fad diet and consoled me when it didn’t work. I keep trying to explain the biology behind GLP-1 medications. She brushes me off and says, “doesn’t sound healthy”. I say I got it from my doctor. She says, “yeah, but you could have just gotten it online.” Then she hops back on to social media and the conversation is over.
On the flip side, my co-worker can’t get enough of me these days. “Oh, wow. You look amazing,” she says every time I walk past her desk. Every single time. I know she’s being nice, acknowledging that she sees my results. But she doesn’t understand that it’s more complicated than that. At least for me. It’s a reminder of all the times she didn’t think I looked amazing. It also diminishes the work that I put in every day. I’m not doing it for appearance. I’m doing it for my health. That difference matters to me.
Then there’s social media. I don’t post. I never did and don’t want to now. But I do scroll. I know I shouldn’t but I am human. And I’m curious. I’m curious about other people’s experiences. And about other people’s opinions. I know I shouldn’t care. But I do. The discourse is so…complicated. On the one hand, it’s a major breakthrough in obesity medicine. On the other hand, it’s a sign of weakness and laziness. Then there are those who wonder why we can’t just all accept our bodies as they are? Well, because I don’t want a shortened life span. I don’t want to fall over from a heart attack while I’m shopping for pet supplies.
I didn’t realize just how much noise would come with going on a GLP-1 medication. Not just the naysayers, but I’m learning that the enthusiasm from the people on the other side is just as consuming. I didn’t ask to be judged. I didn’t ask to be an example. I asked for better health…for myself.
Glo: Visibility invites opinions. And research has documented that weight stigma doesn't disappear with weight loss. It changes form. The medication itself becomes a new focal point for judgment (Puhl & Heuer, 2009). The noise from outside is real.
Marcus
53 years old. Married 22 years.
Married 22 years, but together since college. We’re like one of those couples who can finish each other’s sentences. At least up until recently.
When I started GLP-1 therapy, she was really supportive. We went to pick up the prescription together and stopped by the grocery store on the way home. She wanted to stock up on a few things, she said, in case I felt sick. She set her alarm for my weekly injections. I felt so seen and was motivated to put in the work.
And then something happened. I’m still not sure what it was, but she started distancing herself. Not necessarily from me - at least not at first - but I started seeing take out boxes in the backseat of her car. Her alarms went quiet. Then she went quiet. It didn’t happen overnight, but I started to notice. So I asked her. She said she wasn’t sure, and I believed her.
When I look back on it now, she started changing when I started to change. I was spending more time at the gym. I bought new clothes. I started eating differently, not because I had to but because I preferred it. I started making new friends.
We tried talking about it. She said she didn’t recognize me anymore. Thirty-one years together, and she felt like she was sleeping with a stranger. She wanted the guy she married back. The guy I’ve worked so hard to change.
We’re trying to figure it out. Together…for now.
Glo: When one partner changes, the relationship is asked to reorganize. Research suggests this friction is common even in stable relationships, and that naming it out loud is what makes it navigable (Gorin et al., 2008).
Renee
39 years old. Comfortable in her own skin.
The body positivity movement? I could have been the poster child for that. Not because I wanted permission to feel good about myself. I really did feel good about myself. Ever since I was young, my family never made me self conscious about my weight. They wanted only one thing for me…and that was to be happy.
So, I never cared about the number on the scale. When I looked in the mirror, I saw someone who was happy. I wasn’t just comfortable in my body. I was confident. I would walk into a room and revel in the attention that I got. I had a lot of friends, and many of them looked to me when they were struggling with their own weight.
Then my doctor decided to put me on a GLP-1 medication. He said my A1C was way too high. The conversation wasn’t about losing weight, it was about better managing my type 2 diabetes diagnosis. I picked up the prescription on my way home.
Six months in, and my A1C is down. And so is my weight. Forty-five pounds. I had to buy new clothes. I still get attention when I walk in a room, but it feels different. Before, people noticed me because I took up space…a lot of it. Now I think they notice me because I'm what society considers “more attractive”. And I'm thrown by the fact that that feels good. Not just physically, but mentally. I like being this smaller version of me. But at the same time, it feels like a betrayal. A betrayal to my confidence and to the friends who turned to me as the example.
There’s a layer of sadness on top of my happiness. But what am I sad about? That I lost the version of me who was so beyond all that? Or maybe I’m sad that that person was actually a fraud.
Glo: When a characteristic you’ve built your identity around changes - even for the better - reorganization is required, and it can be genuinely disorienting. The relief and the guilt about that relief can exist at the same time. Both are real (Tajfel & Turner, 1979).
James
44 years old. Friends have come…and gone.
Yes, I lost friends after starting my GLP-1 medication. Two, actually. Lost them completely.
One was a college buddy. We were inseparable. And the foundation on which our friendship was built was food. We loved to eat. Big meals. Comfort foods. Late night snacks. After graduation, our bond grew even stronger. We both had jobs and added stress. Eating out was our reward for working hard or therapy for feeling out of control. So when I finally pulled the trigger and started GLP-1 therapy, everything changed. Our friendship fell apart. Not overnight. At first, we just tried to laugh it off. He would just finish eating what I couldn’t. “More for me,” he would say. After a while, it wasn’t funny anymore. And then, he just kind of stopped calling.
The other was my girlfriend. I’ll admit, that one really caught me off guard. I thought she would be happy for me. I was losing weight, getting fit. I started dressing better and being more active. I wanted to travel together. Go out to bars. Things I didn’t like doing before when I was too busy eating and hiding. So when she started wanting to stay in more, then going home early and then eventually canceling dates, I knew something was off. I tried to talk to her, but she just brushed me off. She said we had drifted apart, but later told me that she felt like I had left her behind. We didn’t last much longer after that.
In both relationships, once the thing that held us together was gone, so were they. It was a tough time. But, then something happened. I started meeting new people and letting them into my life. They knew where I had started and where I was hoping to go, and they were supportive. I was talking to my brother about it. He told me it seemed like I had more room for different people now. And you know what? It’s true. I can see it too.
Glo: Relationships built primarily around shared habits often weaken when those habits change. Connections with more durable foundations tend to deepen. The ones that didn’t survive were real. So is what came after (Bramming et al., 2021).