I'm Coming Out: the Stigma Around GLP-1s, and the Role of Data in Health Choices

Weight loss has been a journey for me—a long and, at times, exhausting one. Like many others, I’ve worked hard through “traditional” methods, losing over 100 pounds twice in my adult life. But while I could lose the weight, keeping it off was a different story. Weight loss required intense, almost obsessive dedication, taking over my thoughts and daily routines. Both times it was accompanied by huge numbers of hours in the gym. A little over 3 weeks ago: I began taking ZepBound, a GLP-1 receptor agonist designed to aid in weight loss.

For years, I’ve been aware of ZepBound, weighing its potential benefits and risks and the fact that I just needed to make the decision to lose weight again and I didn’t need a drug. Well, no matter how many times I started that diet I’d get derailed. I finally decided it was worth a try, and for me that required I pay $65 to an online provider to onboard, another $25 for them to call in a prescription, and $550 a month because I qualified for the discount code. BEFORE I even know if this will work, I'm in it for the price of a new upgraded m4 Mac Mini.

This isn’t a small financial commitment, and there are people paying $1200 for just the drug every 4 weeks because they don’t qualify.

Thank God, after spending that much within days, my relationship with food transformed. I quickly realized that choosing this path came with unexpected judgments from others. Many people still view GLP-1 medications as “cheating” or taking the “easy way out.” This stigma around weight loss medications is a real barrier to open discussion and acceptance, even though medications like ZepBound have been food relationship changing for people like me.

In sharing my experience, I want to break down some of these stigmas and illustrate how data and biomedical informatics can help people make informed, personalized health decisions.

How ZepBound Changed My Life and My Relationship with Food

On the second day of taking ZepBound, I felt a shift that surprised me. I went from eating around 4,500 calories daily to closer to 1,500 or 2,000, without trying to diet. For the first time in years, I found myself not finishing my meals, almost as if my brain was rewiring its relationship with food. This wasn’t about sheer willpower; something fundamental had changed. My constant thoughts about food, a phenomenon many people on GLP-1s call “food noise,” began to quiet.

That “food noise” had always been part of my daily life, dictating my thoughts, my cravings, and often my plans. On ZepBound, I walk out the door without snacks or walk past the fridge without a second thought. For the first time in my life I understood why the serving size was set at its benchmark, I’ve never even at my lightest found myself sated by a serving size until now. The freedom this gave me is invaluable, its a stressful time of my life and I’m not overeating!

The Stigmas Surrounding GLP-1 Weight Loss Medications

As incredible as this shift was for me, I soon learned that there’s a stigma around using weight loss medications like ZepBound. People don’t want to say they are using it. Here’s a closer look at the misconceptions and biases that people face and why we need to rethink them:

1. “The Easy Way Out” Mentality: There’s a widespread belief that using medication to lose weight is “cheating” or somehow invalidates the effort. This perspective oversimplifies the complexity of obesity, reducing it to a problem of self-discipline. I was shocked at how a hormone could impact my relationship with food in such a profound way. I can still eat all the food I want, my body is geared up to handle 4500 calories in a day, but I want to lose weight so I’m eating to where my body is happy and right now that’s 1500-2000 calories. I’m a very large guy.
2. Lack of Understanding About Obesity: Many people see obesity as simply the result of overeating and lack of exercise, which doesn’t capture the whole picture. Obesity is a complex, chronic condition influenced by genetic, metabolic, and psychological factors.
3. Concerns About Safety and Side Effects: Because GLP-1 medications are perceived as new, people have questions about their long-term effects. Its been used on diabetics for years before it was approved for weight loss. The data shows that it leads to better weight loss than it did in diabetics probably because people want to use it for weight loss rather than insulin controls. While these concerns are valid, they often manifest as judgment rather than curiosity, leading to negative perceptions about people who choose this path. Users of GLP-1s have carefully considered their options, weighing the risks and benefits based on available data.
4. Body Stereotypes and Biases: Society tends to value certain body types over others and holds biases against people who don’t fit these ideals. This bias extends to those who seek medical assistance for weight loss, with people often questioning the “authenticity” of their results. Our famous celebrities don’t reveal their cosmetic surgery to look young for a reason. The reality is that health doesn’t look the same for everyone, and weight loss medications are just one of many tools available to achieve it.
5. Media Influence and Misinformation: Media coverage of GLP-1s often focuses on sensational angles, discussing risks and controversies more than the life-changing potential these medications offer. This shapes public perception and reinforces stigma around those using them.
6. Financial Accessibility: The cost of medications like ZepBound can be high, and many insurance plans don’t cover them. (If your plan does cover it and you’re over 30 BMI, its $25) This can lead to the perception that these medications are for the privileged few. The solution isn’t to stigmatize those who can access them but to advocate for broader access and support.

Even I’ve been contemplating the reality of whether I want to admit anything because it may impact my job search negatively.

What can we biomedical informaticians do about this all?

A small silly example, Recent research suggests that Zepbound can enhance sleep quality and eliminate sleep apnea. An example of data we don’t collect routinely as a health system are sleep apnea machine’s nightly data, I happen to use a CPAP machine to manage sleep apnea and I’m interested in using my own data to see how my sleep evolves over time. A microcosm of 1 that we should be evaluating in more systems.

Biomedical informatics gives us the power to analyze this kind of data ourselves, allowing us to make informed decisions and observe trends that might otherwise go unnoticed. By looking at things like sleep duration, the frequency of interruptions, and oxygen levels, I can directly see whether this intervention is benefiting me.

The Role of Biomedical Informatics in Real-World Decision-Making

Biomedical informaticians have a unique role in helping people make data-driven health decisions. Here are some ways that informatics can contribute to more informed choices, particularly when it comes to GLP-1s and other new treatments:

1. Analyzing Personal Health Data for Better Outcomes: Biomedical informaticians can help individuals track and interpret their health data over time, similar to how I plan to analyze my CPAP data. For people on GLP-1s, this could mean tracking changes in weight, blood sugar, and other relevant metrics. By compiling data over weeks or months, we can identify trends and gauge the effectiveness of these treatments more accurately than occasional doctor visits allow. Nobody has been data mining the multitude of public communities for outcomes reporting.
2. Building Tools for Public Understanding: Informatics experts can create accessible tools and visualizations that help the public understand the science behind weight loss medications and obesity treatment. For example, interactive charts or dashboards showing the impact of medications on metrics like hunger, calorie intake, or weight could help people understand why medications like ZepBound are effective.
3. Integrating New Health Technologies with Everyday Life: As health tech expands, informaticians are crucial for integrating it into users’ lives. Tools that analyze data from wearables, medications, or devices like CPAP machines give people real-time insights. This can empower individuals to adjust their habits or treatments based on real-world data, giving them control over their health journey.
4. Supporting Informed Consent and Reducing Stigma through Data: Informatics can help demystify medications like GLP-1s by making data-driven insights more accessible to both patients and the public. If people can see evidence of safety, effectiveness, and the challenges others face, the stigma around these treatments might lessen. Public education tools that translate complex medical data into simple, relatable information can reduce misconceptions about weight loss medications.
5. Helping Physicians and Patients Make Evidence-Based Choices: Biomedical informaticians play a key role in bringing the latest evidence into clinical practice, supporting physicians as they recommend treatments based on real-world data. Informaticians can help ensure that healthcare providers and patients understand the nuances of new treatments, reducing fears and fostering openness about different health strategies.

Ending the Stigma Around GLP-1s and Embracing a Data-Driven Health Approach

My decision to take ZepBound was not about taking the “easy way out.” It was about finding a solution that gave me the freedom I’d been searching for. You can't see dramatic weight loss, I’m early in my journey, I didn’t believe the first weeks were more than psychosomatic, and heck while it still could be, I’m feeling great about it and think this is going to help me get to my goals. If you aren't over a 30 BMI don't use the drugs, its got risk profiles we should talk about if you are thinking about it. We'll find safer alternatives in the upcoming years.

Reducing the stigma around weight loss medications like ZepBound means approaching health as a spectrum with multiple paths, not a single “right” way. Each person’s health journey is unique, and the support of data-driven insights can empower us to make the best decisions for our own lives. Through better understanding and open conversations, we can foster a culture that respects all health journeys and the tools we use along the way.