The Complicated Reality of Being a Weight-Inclusive Provider in the Era of GLP-1s

Being a weight-inclusive provider has always meant standing in contrast to dominant narratives about body size and health. But in the wake of the rapid rise of GLP-1 medications like Wegovy, Ozempic, and Mounjaro, that work has become even more layered, even more emotional, and—honestly—even more complicated.

These medications are being hailed as revolutionary: a way to “treat” larger bodies, to suppress appetite, to finally gain control. They’re being promoted not just by doctors, but by celebrities, media outlets, and influencers. They’re reshaping the conversation around body size in real time, and for weight-inclusive practitioners, this presents a new challenge: how do we hold space for our clients while staying grounded in our values?

Weight-Inclusive Care in a Culture Obsessed with Shrinking

At the heart of weight-inclusive care is the belief that health is not determined by body size, and that all bodies deserve respectful, evidence-based care. That approach already runs counter to a medical system that often equates thinness with virtue and health with weight loss.

Now add GLP-1s to the mix: medications that deliberately flatten or erase hunger signals, marketed under the banner of health and wellness. The pressure on clients to pursue weight loss—whether subtly encouraged by providers or openly demanded by insurers—is stronger than ever. And many people are taking these medications not because they’re excited about them, but because they feel like they have no other choice.

For some clients, GLP-1s offer relief from relentless body-based shame, or they represent a way to feel safe in a healthcare system that has long denied them appropriate care. Others may be experiencing complicated grief around the side effects—nausea, fatigue, food aversions—as they wrestle with the impact on their social lives, energy, and sense of self. And many are caught in a tangle of guilt, fear, and ambivalence.

As weight-inclusive providers, our role is not to dictate choices—but to contextualize them.

The Personal Meets the Political

Our relationship with our bodies is always personal—but in a society that systematically marginalizes fat people, it’s never just personal. The decisions people make about their bodies exist within a larger cultural framework that punishes fatness, rewards thinness, and pathologizes natural body diversity.

This makes body autonomy deeply complex. When a client chooses to use a GLP-1, it may be about survival. It may be about trying to feel safe in public spaces, in intimate relationships, or in a medical office. It may be about reclaiming a sense of control in a world that relentlessly undermines it.

As providers, we need to remember that people don’t make these choices in a vacuum. Body size is not neutral in our culture. So when someone is seeking to change their body, that desire can carry layers of trauma, social pressure, and longing for belonging.

We can honor the personal while still naming the political.

Sitting with the Discomfort

Clients are showing up in our offices asking: Is it okay to be on this medication and still want body liberation? Can I take this and still say I believe in size inclusivity? Am I betraying myself or this movement?

These are not hypothetical questions—they’re real, emotional, and deeply human.

Our job is to hold space for the nuance. To validate that it makes sense for people to want safety and comfort in their bodies. To acknowledge the real harm of weight stigma while gently questioning the narratives that make thinness seem like the only escape. To offer care that doesn’t hinge on weight loss, even if a client is actively losing weight.

It’s not easy. But it’s honest.

Navigating a New Terrain

Being a weight-inclusive provider in this era means:

• Staying curious, not judgmental when clients share their experiences with GLP-1s.

• Recognizing the systemic forces at play, from healthcare discrimination to insurance incentives to media hype.

• Supporting clients in reconnecting to body cues, even if those cues have changed or dulled due to medication.

• Helping people hold conflicting truths—that they can want weight loss and still deserve to be free from stigma. That they can use medication and still question the system that glorifies it. That they can feel relief and grief.

This isn’t about being the “food police” or the “body police.” It’s about offering care rooted in respect, compassion, and consent.

Why This Work Still Matters

GLP-1s may be changing the surface of the conversation, but the underlying issues remain: we live in a culture that moralizes weight, pathologizes hunger, and sees fatness as a disease to be cured.

Weight-inclusive providers are here to challenge that narrative. Not by policing choices, but by offering a radically different framework—one that centers dignity, honors body diversity, and refuses to reduce health to a number on a scale.

This moment is hard. But it also affirms how needed this work really is.

Even in the era of appetite suppressants and medically-endorsed shrinking, people still deserve care that trusts their bodies, honors their humanity, and helps them feel safe—not just smaller.

Let’s keep offering that care.

To work with Robin, email robin@bodypositiveacupuncture.com