Layla Cameron is an academic, writer and documentary filmmaker.
I don’t know a single fat person who has not fantasized about losing weight at some point in their life.
For many of us, these fantasies involve violent acts, such as slicing the fat off our stomachs with a magical knife that would otherwise not harm us, or receiving a cancer diagnosis (that we would eventually beat! But not before we lost a ton of weight). While horrifying, it’s completely understandable why so many of us, often as children, entertained these thoughts. The Western world has been very cruel to fat people.
One of the greatest privileges of my life was discovering the fat liberation movement and subsequently building a community with other fat folks. I was introduced to Fat Studies while pursuing my PhD at Simon Fraser University, where I found an entire world of information and activism that changed the trajectory of my life, both personally and professionally. During this time, I made my first short documentary film, Fat Hiking Club, featuring Summer Michaud-Skog, the founder of Fat Girls Hiking, and co-founded the Heavy Hitters, a fats-only fast-pitch softball team in Vancouver. Over the past decade, I have surrounded myself with friends, artists, academics and community organizers who occupy larger bodies and who work incredibly hard to make the world a bit better for fat people.
These spaces and relationships are sacred to me. When I’m among other fat people, I do not have to prove anything about my morality, health status, or other arbitrary measures of worthiness. These communities are a lifeline for all of us who have had to navigate a hostile world that considers our bodies to be a liminal space, and not a permanent home worth caring for.
While fat liberation has decades-old roots, alongside many other identity-based social movements, in the last 10 years it felt like fat positivity was finally having its moment. I think this is largely due to the rise of social media, particularly image-based platforms such as Instagram. Fatness is well-suited for visual media because it is a visible stigma. You cannot hide that you are fat. While this fact has been exploited by legacy media – reality television especially has maintained the freakshow tradition of framing fat people as an abject spectacle to be gawked at – on social media fat people have more control over how they are perceived. The participatory nature of these platforms also means that content is coupled with important conversations in the comment sections.
One of the greatest privileges of my life was discovering the fat liberation movement.Carmin Kõvamees/Supplied
For a moment, this made a big difference in the lived realities of fat people: body-positive and fat-positive content creators provided spaces for fat people to discuss what it was like to exist in a fat body. This discourse appeared to push mainstream industries, such as fashion and health care, to take the needs of fat people seriously. While far from perfect, the world that was created over the last decade or so was vastly different from the one I grew up in. This shift made me excited for the future.
And then slowly over the past few years, these spaces began to transform again. Many fat public figures have drastically lost weight and fat-positive content has started to disappear. In some cases, there was no acknowledgment of this visible change. Others did discuss their weight loss, often to explain why the content on their platform had shifted. Not surprisingly, many of them disclosed that they took a GLP-1 for intentional weight loss purposes.
The GLP-1 era, like other popular weight-loss fads, is a huge threat to the new, fat-positive world that we built for fat people. And as generic GLP-1 medications begin to roll out, the massive marketing efforts and subsequent popularization of these drugs have brought on a resurgence of fatphobia. For fat people, it has been devastating to reckon with the loss of an accepting space in public life that we fought so hard for, to see the slow back-pedalling of Health At Every Size (HAES) and other weight neutrality policies from public health fields, and to navigate the ongoing loss of fat public figures and valued community members – particularly those who led the online charge for body-positivity and fat-positivity. This phenomenon sparked by GLP-1 medications feels like a tidal wave that has cast me back onto the shore of an island that I was trying desperately to escape from.
One of the most beautiful things about fat communities is that we hold space for our complex feelings about our bodies in ways that are simply not possible when the room is full of people who have never lived in a fat body, or who believe that our lives would be better if we were not fat. Many people who are not actually fat often lament that they “feel fat,” which is impossible – fat is not a feeling. But there are many conflicting feelings that arise when you are a fat person, and it’s important to be able to talk about some of your deepest fears, worries, or concerns with other fat people who, like you, are still going to be fat once the conversation is over.
Values that underscore fat liberation – such as bodily autonomy and weight neutrality – provide the emotional safety necessary for fat folks to navigate sticky feelings and difficult topics, such as whether or not chronic stress and inflammation is caused by the size of your body, or the result of living in a world that is not built for you.
Believing in bodily autonomy – that everyone has the right to do what they want with their body – has made reckoning with the GLP-1 era very difficult. It is hard to hold steadfast in that position when what some people want is to no longer be fat – at any cost. A “flab jab” has always been one of those fantasies, like the magical knife, and many of us hoped that one day there would be an inoculation that could “cure” us. And now here it is, a very real carrot dangling in the face of a group of people that I love very much.
We had been working toward a new world that dimmed those fantasies, one where we could exist happily in our bodies as they are. But now, fat people have been placed at a fork in the road with no safe options.
Going down one path are those who are opting out of taking these “miracle” weight-loss drugs. On this path, there are punishments for refusing them. Violent manifestations of fatphobia – both literal, such as medical negligence, and symbolic, including the loss of plus-size clothing retailers – are seemingly intensifying. Choosing to stay fat is confusing to the majority of people who have been raised on fatphobic rhetoric, and so they increasingly judge a fat person for believing that it is okay to be fat. Having to continue defending yourself against people and industries with opposing world views is exhausting and oftentimes futile.
Where does the rise of GLP-1s leave the body positivity movement?
The journey down this path is made more difficult by the added layer of grief of losing people from the communities that we had worked for decades to build. When public-facing fat icons, or the fat comrades from your daily life, choose the other path and take these medications, it brings on a complex mixture of anger, resentment, jealousy, sadness, respect and quiet empathy. No matter how much we believe in “your body, your choice” theoretically, it can be hard to hold steadfast to this ethos when others’ choices feel like a comment on your body and your choices.
These contradictory feelings often make those who refrain from taking GLP-1s doubt themselves. While there was significant headway made in the last few years to make the world more accessible for fat people it is still incredibly difficult for us to joyfully move through the world in peace. Structural and systemic barriers serve as a constant reminder that the world would, in fact, be a nicer place to live in if you were thin. It doesn’t matter if there are plus-size travel companies, for instance, if fat tourists cannot fit into seats on airplanes or find adequate gear (such as life jackets, seat belts and higher weight–capacity equipment) so that they can safely participate in activities.
Fat people are constantly put in a position where they must calculate at what point the cost of living in their body becomes too high.
Those who choose the other path and take the medications, most often because the price to stay fat has become unbearable, face other costs and challenges by putting their trust in a medical system that has never cared if they live or die.
As a tool for intentional weight loss, GLP-1s function by reducing one’s ability to acknowledge hunger cues, enforcing disordered and highly restrictive eating habits. As well, these medications need to be taken at a higher dosage than what is typically prescribed for diabetes in order to increase the chance of notable weight loss; doing this increases the risk and severity of side effects such as gastroparesis, chronic malnourishment, and the loss of bone and muscle mass in addition to body fat. These significant health issues have been overshadowed by the marketing efforts of GLP-1s as a “cure” for fatness. To be fair, assuming these risks is not a new phenomenon: research has long shown that, statistically, most people would rather suffer these consequences, or be dead, than be fat.
About three million Canadians, and millions more Americans, now use GLP-1 drugs.Karen Pulfer Focht/Reuters
If someone decides to stop taking their GLP-1, data from Novo Nordisk, the manufacturer of Ozempic and Wegovy, indicates that weight regain will occur. Referred to as weight cycling, this process inflicts immense harm on the body independent of weight, including increased risk of cardiometabolic disease. As Ragen Chastain, a prominent weight stigma researcher, has written, Novo Nordisk’s data also indicate that weight cycling can occur at the 68-week mark by people who continue to take GLP-1s. Considering this, the path for some people taking these drugs seems to be bent like a horseshoe, as they ultimately return to the bodies (and community of people) that they tried to leave. Despite this, these medications are ever popular: Three million Canadians use GLP-1 drugs, and this number is expected to increase as generic options continue to become available.
Those still standing at the fork in the road, weighing two imperfect choices, occupy an incredibly painful and devastating position. We can see the carrot right in front of our eyes and are struggling with whether to reach out and grab the very thing that we have long fantasized about, but which will most likely fail us.
The carrot symbolizes temporary freedom from our traumas and most troubling thoughts – that being fat is bad, that we would be in less physical and emotional pain if we were smaller, that we would have access to all sorts of thin privileges, such as beautiful clothing, fitting comfortably in public spaces, and being treated as human beings by doctors. Holding us back from making that choice is everything we have learned from fat activism and the brief taste of the good life that came our way when some of those privileges edged closer to us without us having to change our bodies.
Dominant attitudes about fatness are highly subjective and have ebbed and flowed throughout time. How we feel about fatness is dependent on the political, economic, and social context of a specific time and place. In many places over the past 2,000 years, fatness has symbolized abundance, success, and even good health. Today, fatness is pathologized as a disease manifested by a lack of self-control and a sedentary lifestyle.
My purpose here is not to debate if being fat is healthy or not. For the record, I think that choosing to be fat is a valid choice and I believe that the potential cause or causes of someone’s fatness are: a) very complex; and b) none of my business. For medical professionals invested in promoting normative public health standards, I think your time would be best spent focusing on research-backed holistic approaches, such as increasing access to leisure time and nourishing foods, or offering the same treatment options to patients regardless of their size.
Today, the influence of the GLP-1 era feels like it is erasing any semblance of fat-positive ideologies from our current cultural imagination – as if society at large is screaming at fat people, “We knew you were wrong all along! How dare you demand basic things, such as dignity and the right to exist in your own body!”
At the same time, as digital spaces are increasingly overrun by fascist propaganda, AI sludge, and the whims of nefarious big-tech overlords, people are fleeing what used to be a gathering place for fat people to come together and demand we be treated with dignity (or at the very least, with less violence). Those who do still visit these sites are bombarded with marketing campaigns for weight-loss medications, and I worry about the vulnerability of fat people who are now less likely to have a robust media diet composed of more complex takes on health, morality, and body size.
Having to weigh your politics, horrifying side effects, and your deepest fears against each other is gut-wrenching. Needing to become a medical expert to decipher what is true and what is not about these medications, and about your health, is a deeply unfair and dangerous position that many fat people consistently find themselves in. As each new carrot is dangled in front of us, we ask ourselves: will this actually help me, or do I just want to be thin at any cost? The emotional labour and mental load required to simply exist as a fat person in this world is so heavy, and yet for a time we alleviated this burden by sharing the load.
I am in no position to tell someone which path they should take. That is a decision to be made by an individual alone, or between that person and a medical team they trust.
The only comforting fact that I remain tethered to at this moment is that, despite countless attempts throughout history to eradicate fat people from the face of the Earth, we are still here. And we will still be here when the next “miracle cure” comes around.