Skinny jabs. Weight loss injections. The new miracle drugs to “tackle the ob*sity crisis” once and for all. Drugs like Ozempic and Wegovy are being hailed as wonder drugs. Oprah raves about weight loss drugs and says “ob*sity is a disease” so it’s not about willpower. This apparently can help get rid of weight stigma…by reinforcing weight loss and thin ideals? This doesn’t make much sense to me.

“Ob*sity” is not a disease, nor a behaviour or an eating disorder. It’s a body size measure and there is wide range of people of varying degrees of health within that bracket. It’s not something that needs fixing. However, I understand that many people feel unhappy in themselves and want to make changes, though sadly this often becomes about making themselves smaller using any means possible.

I’m not against people who choose to take weight loss intentions, in the same way that I’m not anti people who diet. When I use the term “anti-diet” I mean I stand against diet culture, the thin ideal and weight stigma/biases in our society as these are harmful to so many people. It’s important to make an informed choice, and how can we really do that when we are swimming in diet culture narratives? The decision to take weight loss drugs needs to be based on reliable information, and should you choose to go ahead, it needs to be done safely, through the correct channels and with plenty of support before and after. Having counselling before can help you explore your relationship with food and your body, as it may be that you’re experiencing disordered eating or negative body image thoughts. If this is the case, taking weight loss injections will not help – it will likely only drive the thoughts and feelings that underpin your relationship with food and make things worse.
 
Weight loss injections: what are they and how do they work? 
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Weight injections are for people in higher BMI (Body Mass Index) categories, and in the UK they are usually available through a referral to a weight management service. It’s meant to be more of a last resort, like weight loss surgeries, and only available for those who “really need it” i.e. higher weights. I don’t mention specific weights as this can be triggering and further reinforces weight stigma. BMI itself is very outdated and not fit for purpose – you can learn more about that in this article by Aubrey Gordon aka Your Fat Friend.

Weight loss injections work by making people feel full for longer. The idea is, if you’re less hungry, you’ll eat less and that means you’ll lose weight. This may work in the short term whilst you’re on the medication, but when you come off it you will gain it back. However, eating less doesn’t necessarily equal thinness – lots of people in larger bodies have likely tried eating less, perhaps having tried every diet under the sun, and are not thin (if diets “worked” wouldn’t everyone be thin, right?) Even if people do lose weight they may not be thin, as for many people thinness is not just possible. Our weight is decided by many factors and genetics is a big part of that. If people can be “naturally slim” then people can also be “naturally fat”. Your body will work hard to keep you at a “set point range”, your body’s comfortable weight range, in a similar way to how our bodies regulate our temperature and our need to go to the toilet. Our bodies are clever and we should trust them but due to diet culture, many of us have lost that trust sadly.

Do weight loss injections "work"?

The long-term “success” of weight loss injections is not yet known as research has not been going long enough to be able to adequately tell. Whilst some diets and weight loss interventions can result in weight loss in the short-term weight is often gained back in the long run. In the UK, weight loss injections are only prescribed on the NHS for a maximum of 2 years, and one study has shown that people regain two-thirds of the lost weight within two years of stopping. Short-term side effects include headaches, nausea, sickness, diarrhoea, acid reflux, constipation and more. Long-term side effects of staying on weight loss injections for many years aren’t yet known, and due to fears of weight regain it is concerning how many people may try to stay on them for life.

These drugs were first intended for people with diabetes, so there have been shortages recently since its growing popularity for weight loss. Celebrities, and thinner people generally, are using it to “drop those last few pounds”, many of whom can afford to pay for it privately. Purchasing weight loss injections can be expensive plus there are risks of purchasing them online.
 
The risks of buying weight loss injections 

In the documentary, “The truth about skinny jabs” with Anna Richardson, she visits some private clinics in London where they were happy to prescribe weight loss injections, without even taking any health markers, and despite her not being fat. They did so with a hefty bill of course. Anna also experiments with buying weight loss injections online, which she does with alarming ease. The risks of this are many; you can’t trust what’s in them, you might get ripped off or scammed, and anyone young or vulnerable could potentially buy them including those with eating disorders. This is a very dangerous way of accessing these drugs, you really don’t know what you’re getting. People on social media also target people for sales and these are often scammers. If you decide to take weight loss injections please do so through the proper medical channels, and if you do not meet the criteria for them, do not take them.
 
Body shame is big money 

The idea that being thinner equals happier, healthier and more respectable is the entire basis of diet culture. Companies thrive off the body shame people experience when they think they’re not thin enough (even if they’re not fat). A common myth is that people at higher weights are so because they eat too much. This idea is way too simplistic, it is not as basic as “calories in, calories out”. When it is seen as individual responsibility and just an easy “choice” to lose weight, it’s putting more blame and shame on people. Even if two people of different sizes ate exactly the same they could be completely different sizes. The idea that everyone has the ability to be thin, and that thinner is better, causes so much harm in our society and is a major driver for disordered eating.

“The best-known environmental contributor to the development of eating disorders is the sociocultural idealization of thinness.” - NEDA
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Using weight loss injections only reinforces the thin ideal and the fear of weight gain and increases the harmful experiences of fatphobia and weight stigma. These drugs do not help people with their health behaviours, or other aspects associated with better health like reducing stress and better sleep. Weight loss injections offer the same enticing dieting promise that thinner equals happier and healthier, which is simply just not true. Ultimately, in the same way that every other new diet culture fad says they are “the one” that finally makes everyone thin, they’re not. There are lots of fat people in the world and we will always still be here.
 
Eating disorders 

There are sadly too many people who are overlooked for having an eating disorder due to their body size. Many people may not recognise that their eating is “disordered” as diet culture has normalised restrictive eating, over-exercise and the pursuit of thinness “no matter what”. Due to myths and stereotypes about eating disorders, people often assume you need to be thin to have one, when in fact most people with eating disorders are not underweight.

With disordered eating labels such as Atypical Anorexia (Anorexia but not at a low weight) and Orthorexia (a preoccupation with “healthy” or “clean” eating), the lines between eating disorders, dieting and “healthy eating” are becoming increasingly blurred. This, coupled with weight stigma, means that people are often prescribed/recommended weight loss interventions when this will likely only drive the disordered eating. A person who has struggled for a long time with dieting or disordered eating is not going to be helped by yet another thing that attempts to make them thin.

The diet cycle thrives off shame, and every time an intervention fails, people blame themselves or their lack of willpower, when it’s not their fault at all. Diets are made to keep you coming back, diet companies wouldn’t make any money otherwise. Weight loss drugs, manufactured by big pharmaceutical companies, are also made so you stay on them, potentially costing you a fortune and taking on the unknown long-term risks as well as short-term side effects.

Diet companies and big pharma do not care about your health. It’s all about money and they profit big time off your body shame.

In conclusion…

If you’re concerned about your health or have fears and anxieties about your weight, please consider exploring your relationship with food and yourself before any kind of weight loss attempts or drugs. Counselling can help, as well as learning more about disordered eating, diet culture, and body acceptance and intuitive eating. Eating and body image issues can have deeper food causes and influences which will not be helped with weight loss attempts, this just keeps the cycle going. To break the cycle and make lasting changes, a deeper exploration is needed.

I offer counselling sessions online, please check out my counselling page for more info.

I also offer workshops on disordered eating, body image and weight stigma, please check out my workshops page for more information.
 

Body image problems affect lots of different people. We live in an appearance-centred society, but it’s not just about vanity or being shallow. Body image issues aren’t something “silly” experienced by teenage girls, nor are they something we can just “get over”. Body image is partly about how we see ourselves and perceive our bodies, but this is influenced by wider issues such as societal views, diet culture, inequalities, power dynamics and discrimination.

​I struggled for many years, most of my life, with body image problems. For me this centred on weight but I’m aware that other people have body image issues that have nothing to do with weight or size. My work with individuals and in workshops however does sway toward weight because it is such a big factor for so many people. Weight stigma is so prevalent in our society; it can affect people of various sizes, though people at higher weights face discrimination and many more challenges in daily life. Hating our bodies, being unkind to ourselves and trying to change the way we look isn’t the solution. Punishing ourselves only makes it worse.
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As a counsellor and trainer with lived experience of body image problems, I am passionate about helping others understand body image on a deeper level, to enable them to challenge their perceptions, assumptions and internalised fatphobia. I personally found that learning about wider societal expectations and inequalities, as well as past experiences and trauma, can help build an understanding of why we struggle with body image. Knowing all of this can help us be more compassionate to ourselves, and others.

I find that "body positivity" can be too fluffy. As much as it can be helpful for some people, it can just be yet another pressure; the pressure to “love yourself”, which is a big jump if you’ve hated your body for years. For me, it just seemed unrealistic to jiggle around in a bikini like the people I saw on Instagram when I couldn't even wear a swimming costume without a big baggy t-shirt over it for many years. "Body positivity" has unfortunately been capitalised on by companies who have noticed its popularity, and by influencers and thin (often white) attractive people online who want to promote themselves. Unfortunately, this has taken the movement away from the very people who need it the moment the most; fat, black, queer, disabled people and others who have faced discrimination and oppression.

My body image approach involves taking a "big picture" view, understanding the societal and cultural issues surrounding how we see our bodies, including class, gender, disability, race, and more. Accepting our bodies can feel like a radical act in our society where capitalism needs us to be ashamed of our bodies in order to make money. Accepting living in a larger body can be incredibly difficult for people, given the weight stigma and fatphobia they may face.
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Self-worth is so often tied up in body image. For me, healing came from understanding experiences in childhood which impacted my confidence and self-esteem. Trauma, bad experiences, bullying and attachment difficulties can all play a part in how you view yourself and your body. Gender expectations also play a big part, and how comfortable you feel in your identity. Neurodivergence, such as autism and ADHD, can also impact how you view your body, and how your body feels. I’ve heard many people talk about not fitting in and feeling like they don’t belong, which in itself is a very difficult way to grow up and can result in anxiety and social isolation. Race, culture, disability, chronic health conditions, visible “differences” and much more affect body image. When the dominant beauty standard (here in the UK) is thin, white, young, able-bodied and “normal”, anyone outside of that can be deemed “different”. We could speculate that in fact, all those “different” people would make a majority, though this is more about power held by dominant groups in our society and the “othering” which maintains that power.
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If you’re struggling with body image, you don’t have to “love” your body right now, but you could start to explore what makes you feel the way you do about your body. Having counselling may help – if you’re interested in finding out more about my counselling service click here.

For professionals, looking at the whole person and intersecting identities, and the context of their life, is so important to understand body image. But the starting point is looking at your own relationship with your own body, and the influences on how you see others’ bodies too. If you’re interested in finding out more about my training on disordered eating, body image and weight stigma, click here.

I recently saw “Your Fat Friend”, a documentary about Aubrey Gordon made by Jeanie Finlay. I’m a big fan of Aubrey’s work, her books, blogs and podcast - Maintenance Phase, and she’s been a huge influence on me both personally and professionally. I am a counsellor and trainer working with people struggling with eating, body image and the impact of weight stigma. I’m passionate about highlighting the importance of helping those in larger bodies with eating disorders, and training other counsellors in understanding disordered eating and weight stigma, and this film just lit even more of a fire in me.

In the film, Aubrey talks about having an eating disorder and the barriers for fat people trying to access help, she says eating disorder treatment/support for fat people literally doesn’t exist. This broke my heart to hear, even though I’ve heard so many stories like this from people who have been judged, dismissed and turned away. I’ve worked for eating disorder charities in different roles for over 7 years now and it’s always disheartening to hear stories of being turned away from NHS services for not being “thin enough” and the assumptions made about fat people. As Aubrey says in the film, if a fat person has an eating disorder it is assumed that must be binge eating. This is absolutely not the case; people in smaller bodies can struggle with binge eating, and fat people can struggle with restrictive eating. Binge eating can often include restriction anyway (eating less than your body requires), it’s part of what keeps the cycle going – restrict, binge, feel guilty/ashamed, and double-down on restriction again. It’s called a binge cycle and can also be applied to dieting – diet, “fail” at the diet, shame, back to dieting. This is how diet companies make money (sometimes now not using the word diet, but “wellness” or some other fluff), because it’s never the diet’s fault, right? It’s ours for lacking willpower, being lazy/not good enough etc. This is why dieting does not “work”, it’s just creating more shame, more anxiety, more self-blame, and ultimately creating more eating disorders.
 
Aubrey also mentions Atypical Anorexia, basically just the same as anorexia but not fitting the low BMI threshold to tick the box of being “sick enough”. This is extremely harmful as it’s stopping so many people from accessing services (though in the UK this is likely largely due to significant underfunding of ED services), and means we have no hope of “early interventions” which the NICE Guidelines state are so important for eating disorders. Being turned away for help, or anticipating not being able to get help, can often just exacerbate the disordered eating, with people feeling there is nowhere to turn. This was very much the sense I got from Aubrey talking about having nowhere to go as a fat person with an eating disorder. It’s so hard to have trust in professionals when they have all grown up in the same fatphobic, diet culture, and have little to no training in this. 

​When I was training to become a counsellor I realised this was very much the case for our industry too – nobody talks about eating, body image, weight stigma or fatphobia, yet it is extremely likely all counsellors will encounter people affected by these issues at some point. This is why I am so passionate about this work and filling this gap – we must make it safer for fat people to access therapy.  Counsellors must know about eating and body issues through an intersectional lens, looking at power, privilege, class and biases. Sadly, in my experience, this is not happening anywhere near enough as the industry is prominently white and middle class, and this is even more so in the eating disorder world. A huge amount of research into eating disorders, and treatment centres and charities, are run by thin, white, middle-class women, focussing on helping thin, white, female clients. There are so many people left out of eating disorder treatment, not only fat people but black people, disabled people, trans and non-binary people, and many more minoritized people. Treatment and therapy isn’t safe enough for so many people. This has to change.
 
In all honesty, the difficulty I find in writing about all these issues is that I don’t want to scare people or put them off trying to find help and support. I want to raise awareness of what’s going wrong so we can work on changing it, but for individuals seeking help, I don’t want this to be another thing that reinforces the idea that there is no help for them. There is help, there are people doing great work out there, and I believe it is possible for fat people to access the help they deserve. As Aubrey says in the film, “you can’t self-love your way out of oppression” which I totally get, but you deserve help to be able to cope, as a bare minimum. There are ways to start healing. It may always be hard navigating the world as fat person but there are ways to build resilience and compassion for yourself, and help create a better relationship with food, if that’s what you would like.

 I’m holding in mind that people reading this may be either looking support for themselves (or individuals who are just interested) or some may be counsellors/therapists or professionals looking for what they can do. So I’ll suggest some ways counsellors/therapists/ED services can help, and if you are looking for support you can perhaps use these as green flags (good things) to look out for!

• Read/listen to everything that Aubrey Gordon has ever done and watch Your Fat Friend!
• Use diverse images, including fat people, on websites/social media
• If working in-person, make sure the room is accessible with larger chairs/no arms on chairs
• Do extra CPD training on weight stigma/fatphobia (I offer this, check out my workshops page)
• Reflect on your own relationship with food, your body, and about fat bodies. We have all grown up in an anti-fat culture so nobody is exempt!
• Reflect on how body size intersects with other aspects of identity eg gender, class etc (this is something I cover in more detail in my training)
• Avoiding using weights, numbers, BMI etc where possible and avoid food diaries and encouraging tracking as this can be very shaming (if working for eating disorders services this may not be possible)
• Throw weight loss out the window – healing should not revolve around weight (again, in ED services this will not be possible). Weight is not a measure of health, and health is not a prerequisite for respect.
• Services and charities can help by elaborating on the popular slogan “eating disorders don’t discriminate” (erm, yeah but people do!) We keep being told that ED’s can come in all genders, bodies, ages etc, so why aren’t we seeing and why aren’t people experiencing that? How can you show that you don’t have discriminatory practices against fat people and minoritized groups?
• Just let fat people be fat, alright?

 
I am proud to work with people in larger bodies (and all kinds of bodies) who are struggling with a range of eating problems and body distress. Sometimes I feel like I’m the only person in their life who doesn’t tell them they need to lose weight or make them feel like their body is not good enough. We need more counsellors, therapists and people working in the eating disorder field to help fat people feel that they are safe, welcome, and cared for. I’m keen to hear other ways we can help fat people access help safely as I know there’s way more needed than just the tiny list above. We need to share ideas, so please let me know!
 
Thanks for reading. If you’re interested in having counselling please head to my counselling page for more info. If you’re interested in my workshops and trainings, I’ll be offering more soon so check out my workshops page and sign up to my mailing list and I’ll let you know when more dates come up. Thanks!

​Your Fat Friend trailer: