An experimental investigation of the stigmatization of weight loss and regain from GLP-1 receptor agonist use and cessation

Abstract

Background/Objectives: Glucagon-like peptide-1 receptor agonist medications (GLP-1s) are effective for weight loss, but when people discontinue them, they tend to regain weight. The present work sought to examine the stigma of losing and regaining weight after GLP-1 use and cessation. Subjects/Methods: In two randomized, between-subjects experiments, participants evaluated a fictional target after reading a brief description of the target’s weight-related history, which varied by study condition. Study 1 (N = 607) aimed to understand stigma directed at individuals who lose weight using GLP-1s, so the target was described as either: having lost weight by using a GLP-1, having lost weight via diet and exercise, or not having lost weight. Study 2 (N = 706) examined stigma directed at people who regain weight after discontinuing GLP-1s, and the target was described as either: having regained weight after discontinuing a GLP-1, having regained weight after discontinuing a diet and exercise plan, not having lost weight, or having maintained weight loss. After reading, participants completed measures of weight-related stereotyping and willingness to affiliate with the target. Results: In Study 1, the GLP-1 target was evaluated more negatively than the diet/exercise target and the no weight loss target. Participants’ willingness to affiliate differed significantly across groups (p < 0.001), with the GLP-1 target receiving significantly lower ratings compared to the diet/exercise target (Mean difference = 0.52, 95% CI [0.27, 0.76]) and the no weight loss target (Mean difference = 0.26, 95% CI [0.02, 0.51]). In Study 2, the GLP-1 and diet/exercise targets were evaluated similarly, and both were rated more negatively than the target who maintained weight loss (ps ≤ 0.001). Conclusions: These findings suggest that people may face stigma across the cycle of losing and regaining weight after using a GLP-1, underscoring the need for stigma-reduction efforts in the context of weight management.