Behavioral medicine in the GLP-1 era

Abstract

Glucagon-like peptide-1 (GLP-1) agonist medications are receiving high levels of attention because of their dramatic efficacy in causing weight loss. This commentary discusses several ways that those in behavioral medicine and health psychology might think about these medications-whether they should be fully in support of them or whether they pose a risk. The positive aspects of GLP-1s include their great promise in improving health independent of weight loss and the perspective that their efficacy frees individuals from the difficulties of behavioral weight maintenance and the associated stigma of "failing" to lose weight. However, GLP-1 agonist medications also risk medicalizing weight and increasing weight stigma (in addition to those on GLP-1 medications being stigmatized for taking the "easy way out"). From a social identity perspective, GLP-1 medications could even be perceived as a tool to eradicate an entire social group-those that identify as higher weight. In terms of clinical care, a patient-centered, weight-inclusive approach will allow for individuals to receive the treatment that fits with their own social and health context. In terms of research, behavioral medicine should shift away from weight loss interventions simply to lower body mass index, and instead intervene on actual health markers, disease endpoints, or healthy behaviors. Doing so will improve health regardless of a person's weight or whether they are on GLP-1 agonist medications.

Keywords: GLP-1; healthcare; obesity; weight stigma.