Licensed psychologist Rachel L. Goldman shares strategies for addressing and coping with the stigma attached to these weight loss medications.
A variety of medications are now available that provide powerful weight loss support for people living with obesity and represent an exciting advancement for helping people address weight-based health concerns.
But weight loss is not only a health issue — it’s also a
As certain weight loss medications, such as GLP-1 receptor agonists like semaglutide (Ozempic®, or Wegovy®), receive more media attention, it may feel like the stigma surrounding these agents is inescapable at times.
To better understand how people taking these medications can cope with the judgment they may feel, we spoke with Rachel L Goldman, PhD, FTOS, FASMBS-IH, a licensed psychologist and cognitive behavioral therapy (CBT) expert in New York City. Here, she discusses strategies for addressing this stigma and learning to embrace all steps of your weight loss journey.
This interview has been edited for brevity, length, and clarity.
Unfortunately, people experience shame and judgment whether they decide to seek treatment or not. It’s one of those no-win situations, as everyone has an opinion — and a strong one at that. Unlike other medical conditions, where maybe other people don’t know you have it or are struggling, you can’t hide your weight.
For years, the messages we’ve been hearing are “just eat less and move more,” and so the general public still doesn’t fully understand obesity. As a result, many people who take medications get comments or hear things like “you are taking the easy way out” or “why can’t you just do it the ‘normal’ way?”
These comments are hurtful. They also show that those individuals don’t have a real understanding of obesity. It’s a chronic, recurring disease, and it has an impact on so many body systems, increasing the risk of several other diseases and health problems.
I believe that it needs to start within oneself. If you’re questioning yourself, your decisions, or even judging yourself for taking weight loss medications, then it’s going to be significantly more difficult to tune out the opinions of others.
You need to be your own health advocate — do your research, educate yourself, and then make educated decisions with the information that you have to do what is right for you.
Once you’ve made the decision to try weight loss medication, you have a few choices.
You can ignore outside opinions, and when you hear them, use self-talk to remind yourself of why you’ve made this choice. Or maybe you remind yourself that you have a medical condition that needs to be treated or that you have a family history of heart disease, obesity, or diabetes. I also recommend that you focus on the positive changes you’re experiencing like improved energy or better sleep.
You can also become an advocate and try to increase other people’s knowledge on the fact that these medications work.
But at the end of the day, it’s important that you focus on yourself and remember why you’ve made the decision to take these medications.
When you hear messages that aren’t aligned with what you are doing or what you believe, it can feel really overwhelming in the moment, and you tend to jump to being a bit more defensive. Having some “scripts” prepared can take some of those overwhelming feelings away.
I really think the exact responses depend on the relationship you have with the individual. Since this is a sensitive topic, it can also be a very emotionally charged one. I like to recommend that you think about what you hope to achieve from this conversation. Is it something that you need to explain fully, or can you give a quick “thank you” and move on?
I think another simple short answer can be, “I consulted with my healthcare professional, and we decided this was the best option for me.” The focus should be keeping it about you, as it’s a personal decision. I like to even tell people you can add something like, “Maybe it’s not for you, and that’s OK.”
I also want to emphasize that if you feel shamed or judged by anyone on your healthcare team that you can switch doctors. There are doctors that are properly trained in this area, and you can find them by using resources like the Obesity Action Coalition website or by searching for obesity medicine specialists.
Unfortunately, not all doctors are trained in obesity, and some are not as sensitive and mindful as others. Be your own advocate and don’t be afraid to speak up!
Self-talk is extremely powerful. You believe and internalize the words you hear. I often say, be mindful of your self-talk as you are listening!
I recommend that you surround yourself with the messages and reminders that you need. Listen to podcasts and shows talking about how obesity is not a willpower issue, and it is not your fault. Surround yourself with people who will support you on this journey and lift you up.
Create a circle for yourself — both in person and online — that’s supportive and that makes you feel good. These are things you do have control over, and I always recommend that you focus on what is in your control.
Also, be mindful of where you are consuming information from and be mindful of the who the information is coming from. Are they experts, or are they social media influencers?
Take the time to acknowledge your wins and successes along the way. I’m not just talking about the number on the scale.
Take time to reflect and identify the changes you are noticing. Maybe you can walk up the stairs without getting winded, or maybe you are finding that you have more energy to play with your children. Perhaps your sleep has improved, or maybe your cholesterol or blood pressure is lower.
All these reminders help build confidence and can help rewire your brain. Chances are, your brain was told messages about weight for years — probably not-so-helpful messages that made you feel bad about yourself. It takes time to retrain your brain, but just like things are learned, you can unlearn those things and learn new things.
Further, I strongly recommend therapy and finding a therapist who is familiar with obesity and can really help guide you through these emotional changes and challenges of treatment. I realize therapy is not always easily accessible, but if you can, it can be extremely helpful.
One of the best things someone can do is to surround themselves with supportive and like-minded people. Another is to remind yourself of what you are doing and why you are doing it.
Although, honestly, it’s no one else’s business how you choose to lose weight, treat a disease, or improve your health. This is a choice that is yours to make, and it’s up to you, ideally in combination with your healthcare team that knows your medical history.
Rachel L Goldman, PhD, FTOS, FASMBS-IH (aka Dr. Rachel), is a clinical assistant professor in the department of psychology at NYU Grossman School of Medicine and a nationally recognized clinical psychologist, speaker, and consultant specializing in the mind-body connection. Recognized as a Top 100 Mental Health Influencer and a Top 40 CBT Influencer of 2025, she is passionate about helping people build their own mental health toolbox. Her upcoming book will be released in 2026.