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Abstract

As GLP-1 medications become more available and FDA approved in a number of cases, discourses related to their use by individuals for purposes of weight loss and management permeate social life. Prominently, weight management is often positioned in society and researched as a private matter of individual choice, behavior, and responsibility. Relational dialectics theory posits culturally dominant discourses and marginalized discourses to be in constant flux with power as central to meaning construction. Therefore, we examine the competing discourses that animate the weight management experiences of people who have used, have considered using, or are currently using GLP-1 medications to manage their weight through the lens of relational dialectics theory. Through an online, qualitative survey (n = 130) and contrapuntal analysis, we identify four discourses: GLP-1s as a magic bullet and quick fix; deservingness; GLP-1s as freedom and control; and GLP-1s as medically necessary. The interplay of these discourses reveals people using GLP-1 medications for weight management as being doubly stigmatized. As such, they are stigmatized both for their weight and their method of weight management resulting in an inability to escape dominant discourses.

Keywords

relational dialectics theory weight management weight loss glucagon-like peptide 1 GLP-1

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References

Anderson

Cornacchlone

Maloney

E. K.

(2013). Normative beliefs and social support in weight loss communication. Communication Studies and Theatre Faculty, 21. https://openprairie.sdstate.edu/commtheatre_pubs/21

Andreyeva

Puhl

R. M.

Brownell

K. D.

(2012). Changes in perceived weight discrimination among Americans, 1995–1996 through 2004–2006. Obesity, 16(5), 1129–1134. https://doi.org/10.1038/oby.2008.35

Anekwe

C. V.

Jarrell

A. R.

Townsend

M. J.

Gaudier

G. I.

Hiserodt

J. M.

Stanford

F. C.

(2020). Socioeconomics of obesity. Current obesity reports, 9(3), 272–279. https://doi.org/10.1007/s13679-020-00398-7

Bakhtin

M. M.

(1981). Discourse in the novel. In Holquist

(Ed.), The dialogic imagination: Four essays by M. M. Bakhtin (C. Emerson & M. Holquist, Trans.; pp. 259–422). University of Texas Press. (Original work published in 1975).

Ballantine

P. W.

Stephenson

R. J.

(2011). Help me, I’m fat! Social support in online weight loss networks. Journal of Consumer Behaviour, 10(1), 332–337. https://doi.org/10.1002/cb.374

Barnes

(2023, June 29). What doctors think about prescribing Wegovy and Ozempic for weight loss. Keck Medicine of USC. https://internalmedicine.usc.edu/blog/ozempic-for-weight-loss-los-angeles/

Baxter

L. A.

(1988). A dialectical perspective on communication strategies in relationship development. In Duck

(Ed.), Handbook of personal relationships: Theory, research, interventions (pp. 257–273). Wiley.

Baxter

L. A.

(2011). Voicing relationships: A dialogic perspective. Sage.

Baxter

L. A.

Montgomery

B. M.

(1996). Relating: Dialogues and dialectics. The Guilford Press.

10.

Blaine

Williams

(2004). Belief in the controllability of weight and attributions to prejudice among heavyweight women. Sex Roles, 51(1/2), 79–84. https://doi.org/10.1023/B:SERS.0000032315.95890.d9

11.

Brownell

K. D.

(1991). Dieting and the search for the perfect body: Where physiology and culture collide. Behavior Therapy, 22(1), 1–12. https://doi.org/10.1016/S0005-7894(05)80239-4

12.

Callahan

(2013). Obesity: Chasing an elusive epidemic. Hastings Center Report, 43(1), 34–40. https://doi.org/10.1002/hast.114

13.

Campbell

(2023, June 7). Semaglutide shortage prompts FDA warning to patients, providers. HCPLive. https://www.hcplive.com/view/semaglutide-shortage-prompts-fda-warning-to-patients-providers

14.

Carr

Friedman

M. A.

(2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. Journal of Health and Social Behavior, 46(3), 244–259. https://doi.org/10.1177/002214650504600303

15.

Cassata

(2023, August 8). Insurance providers are halting coverage of Ozempic and other glp-1 drugs. Healthline News. https://www.healthline.com/health-news/insurance-providers-are-halting-coverage-of-ozempic-and-other-glp-1-drugs

16.

Crandall

C. S.

D’Anello

Sakalli

Lazarus

Nejtardt

G. W.

Feather

N. T.

(2001). An attribution-value model of prejudice: Anti-fat attitudes in six nations. Personality and Social Psychology Bulletin, 27(1), 30–37. https://doi.org/10.1177/0146167201271003

17.

Eberly

L. A.

Yang

Essien

U. R.

Eneanya

N. D.

Julien

H. M.

Luo

Nathan

A. S.

Khatana

S. A. M.

Dayoub

E. J.

Fanaroff

A. C.

Giri

Groeneveld

P. W.

Adusumalli

(2021). Racial, ethnic, and socioeconomic inequities in glucagon-like peptide-1 receptor agonist use among patients with diabetes in the US. JAMA Health Forum, 2(12), Article e214182. https://doi.org/10.1001/jamahealthforum.2021.4182

18.

Eberly

L. A.

Shultz

Merino

Brueckner

M. Y.

Benally

Tennison

Biggs

Hardie

Tian

Nathan

A. S.

Khatana

S. A. M.

Shea

J. A.

Lewis

Bukhman

Shin

Groeneveld

P. W.

(2023). Cardiovascular disease burden and outcomes among American Indian and Alaska Native medicare beneficiaries. JAMA Network Open, 6(9), Article e2334923. https://doi.org/10.1001/jamanetworkopen.2023.34923

19.

Fardouly

Vartanian

L. R.

(2012). Changes in weight bias following weight loss: The impact of weight-loss method. International Journal of Obesity, 36(2), 314–319. https://doi.org/10.1038/ijo.2011.26

20.

FDA . (2021, June 4). FDA approves new drug treatment for chronic weight management, first since 2014. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014

21.

Fee

H. R.

Nusbaumer

M. R.

(2012). Social distance and the formerly obese: Does the stigma of obesity linger? Sociological Inquiry, 82(3), 356–377. https://doi.10.1111/j.1475-682X.2012.00420.x

22.

Goodman

(2022, December 28). As the market for new weight loss drugs soars, people with diabetes pay the price. CNN Health. https://www.cnn.com/2022/12/28/health/weight-loss-diabetes-drug-shortages/index.html

23.

Gracia-Arnaiz

(2013). Thou shalt not get fat: Medical representations and self-images of obesity in a Mediterranean society. Health, 05(07), 1180–1189. https://doi.org/10.4236/health.2013.57159

24.

Kwan

(2009a). Competing motivational discourses for weight loss: Means to ends and the nexus of beauty and health. Qualitative Health Research, 19(9), 1223–1233. https://doi.org/10.1177/1049732309343952

25.

Kwan

(2009b). Framing the fat body: Contested meanings between government, activists, and industry. Sociological Inquiry, 79(1), 25–50. https://doi.org/10.1111/j.1475-682X.2008.00271.x

26.

Latner

J. D.

Ebneter

D. S.

O’Brien

K. S.

(2012). Residual obesity stigma: An experimental investigation of bias against obese and lean targets differing in weight-loss history. Obesity, 20(10), 2035–2038. https://doi.org/10.1038.oby.2012.55

27.

Lincoln

Guba

E. G.

(1985). Naturalistic inquiry. Sage.

28.

Martin

C. B.

Herrick

K. A.

Sarafrazi

Ogden

C. L.

(2018). Attempts to lose weight among adults in the United States, 2013-2016. NCHS Data Brief, 313, 1–8. https://www.researchgate.net/profile/Cynthia-Ogden-2/publication/326633259_Attempts_to_Lose_Weight_Among_Adults_in_the_United_States_2013-2016/links/5c07e6bd4585157ac1aaeda3/Attempts-to-Lose-Weight-Among-Adults-in-the-United-States-2013-2016.pdf

29.

Martini

M. C. S.

Assumpção

Barros

M. B. d. A.

Mattei

Barros Filho

A. d. A.

(2023). Prevalence of body weight dissatisfaction among adolescents: A systematic review. Revista Paulista de Pediatria, 41, Article e2021204. https://doi.org/10.1590/1984-0462/2023/41/2021204

30.

Mattingly

B. A.

Stambush

M. A.

Hill

A. E.

(2010). Shedding the pounds but not the stigma: Negative attributions as a function of a target’s method of weight loss. Journal of Applied Biobehavioral Research, 14(3), 128–144. https://doi.org/10.1111/j.1751-9861.2009.00045.x

31.

Montero

Sparks

Kirzinger

Valdes

Hamel

(2023, August 4). KFF health tracking poll July 2023: The public’s view of new prescription weight loss drugs and prescription drug costs. KFF. https://www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-july-2023-the-publics-views-of-new-prescription-weight-loss-drugs-and-prescription-drug-costs/

32.

Numerator (2023, November 30). Consumers using GLP-1 medications for weight loss skew younger and higher income, numerator reports. Numerator. https://www.numerator.com/press/consumers-using-glp-1-medications-for-weight-loss-skew-younger-and-higher-income-numerator-reports/

33.

Ortiz

S. E.

Kawachi

Boyce

A. M.

(2017). The medicalization of obesity, bariatric surgery, and population health. Health, 21(5), 498–518. https://doi.org/10.1177/1363459316660858

34.

Pelc

(2023, November 14). GLP-1 drug Zepbound explained; New obesity treatment approved by FDA. Medical News Today. https://www.medicalnewstoday.com/articles/zepbound-explained-glp-1-weight-loss-drug-fda-approval

35.

Puhl

R. M.

Heuer

C. A.

(2009). The stigma of obesity: A review and update. Obesity, 17(5), 941–964. https://doi.org/10.1038/oby.2008.636

36.

Regina Castro

(2022, June 29). GLP-1 agonists: Diabetes drugs and weight loss. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/byetta/faq-20057955

37.

Romo

L. K.

Dailey

R. M.

(2014). Weighty dynamics: Exploring couples’ perceptions of post-weight-loss interaction. Health Communication, 29(1), 193–204. https://doi.org/10.1080/10410236.2012.736467

38.

Romo

L. K.

(2016). How formerly overweight and obese individuals negotiate disclosure of their weight loss. Health Communication, 31(9), 1145–1154. https://doi.org/10.1080/10410236.2015.1045790

39.

Shmerling

R. H.

(2023, February 21). What happens when a drug goes viral? Social media and celebrities helped trigger a diabetes drug shortage, turning a side effect into a selling point. Harvard Health Publishing. https://www.health.harvard.edu/blog/what-happens-when-a-drug-goes-viral-202302212892

40.

Singh

Krauthamer

Bjalme-Evans

(2022). Wegovy (semaglutide): A new weight loss drug for chronic weight management. Journal of Investigative Medicine, 70(1), 5–13. https://doi.org/10.1136/jim-2021-001952

41.

Sodhi

Rezaeianzadeh

Kezouh

Etminam

(2023). Risk of gastrointestinal adverse events associated with glucagon-like peptide-1 receptor agonists for weight loss. JAMA, 330(18), 1795–1797. https://doi.org/10.1001/jama.2023.19574

42.

Suter

E. A.

Norwood

K. M.

(2017). Critical theorizing in family communication studies: (Re)reading relational dialectics theory 2.0. Communication Theory, 27(3), 290–308. https://doi.org/10.1111/comt.12117

43.

Suter

E. A.

Seurer

L. M.

Webb

Grewe

B. J.

Koenig Kellas

(2015). Motherhood as contested ideological terrain: Essentialist and queer discourses of motherhood at play in female–female co-mothers’ talk. Communication Monographs, 82(4), 458–483. https://doi.org/10.1080/03637751.2015.1024702

Competing Cultural Discourses of GLP-1 Agonists: An Application of Relational Dialectics Theory

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