"We need to challenge the view that it’s acceptable to judge and stigmatise people just because they’re in a larger body. "

Mel Ciavucco, eating disorder therapist, and expert by experience considers the harmful impact of weight stigma, and thin ideals and how this is shaping our response to weight loss injections.

As an eating disorder therapist, I’m inundated with adverts for weight loss injections on social media. I can hide them but if I’m seeing them, so are countless others, many of whom may struggle with their relationship with food and their bodies. As a person in a larger body, I wouldn’t take weight loss injections, though I never judge those who do. I describe myself as anti-diet culture, but not anti-people who diet (or use weight loss injections).

"As somebody who has seen the harms of diet culture and weight stigma, both in private practice and from my own lived experience,  I understand the allure of weight loss interventions in a world that constantly validates thinness."

I’m fortunate to have done considerable work on my relationship with food and mental health, which allows me to now help others. Being a therapist in this field is a privilege and a gift. I had a hard time growing up because of how people treated me due to my weight and appearance. Ever since I can remember, I knew I had to be thinner. When people “teased” me about my weight (a minimising word for bullying and abuse in my opinion), the solution offered was for me to change, for me to lose weight. This astounds me now. Why should the victim change? It’s the bully who needs to stop. It’s the culture that creates the bully that needs to change.

We need to challenge the view that it’s acceptable to judge and stigmatise people just because they’re in a larger body. Weight stigma is harmful; it impacts self-esteem, mental health, and disordered eating. Punishment and shame are rarely motivators for positive change; they just fuel self-criticism.

 "I spent many years unlearning diet culture and appearance ideals, and challenging the idea that I needed to be thin to be worthy of love."

I reframed my relationship with food and exercise to shift away from a focus on weight. To do this, I needed to build my self-worth, which took a long time as I always felt I wasn’t good enough.

Losing weight is often presented as a solution, but it keeps people stuck in cycles of dieting, bingeing, disordered eating and self-hatred. Many people in larger bodies with disordered eating are pushed toward weight loss interventions that only worsen their struggles. Any intervention that reinforces restrictive thinking and the pursuit of thinness only serves to keep people stuck in disordered eating behaviours such as bingeing and purging. Breaking this cycle can involve having to let go of some control and facing fears of weight gain.

In my practice, I see people terrified they’re going to die because they are at a higher weight (often due to fear instilled by weight stigma) but this fear only serves to exacerbate disordered eating. How can people be expected to heal their relationships with food in a society that keeps instilling this fear of fatness?

Many weight loss strategies and diets only work in the short term, with inevitable long-term weight gain. A 2025 research paper on weight loss injections showed that most people regain weight within two years of stopping the drugs. The NHS currently prescribes them for two years only, because the long-term impact is unknown. Many people pay privately but they can be expensive and may not be financially viable in the long run. People buying weight loss injections online may lack support and guidance, e.g. for correct dosages, psychological support, and may use online discussion groups instead which poses further risks.

Some of the online discourse around weight loss injections has been positioned as self-care and health. This is based on the myth that making your body smaller by any means automatically creates better health.

But it’s all part of the same harmful messaging; that thin is good and fat is bad. The pharmaceutical companies selling weight loss injections do not care about our health, they care about making money.

"People can improve their health in many ways that don’t focus on weight, e.g. by improving mental health, sleep and stress, though this may not be possible for many people due to systemic inequalities. The focus on thinness is not about health but more about a society that sees thin bodies as superior, and capitalist systems that profit from body shame."

I’ve seen people online say weight loss jabs “treat binge eating” and that it reduces “food noise”. From my experience, “food noise” often means anxiety about eating, conflicting or critical thoughts, cravings, distress and fear. These can so often be part of disordered eating and require a psychological approach to help.

"Losing weight is not a solution for eating distress, anxiety, or low self-worth, nor should it be a strategy to escape weight stigma. Weight loss injections only mask “food noise”; it will likely return unless underlying factors are addressed. "

These can include: trauma, abuse, self-worth problems, relational issues, or many other factors which may seem to have nothing to do with food but all play a part. Weight loss injections are at high risk of being abused, like diet pills or laxatives. We know that many thin celebrities and influencers advocate for weight loss injections, and their online accessibility means they could be used by vulnerable people, including people with anorexia. We need to think about the message this sends to young people about their bodies not being good enough.

Using weight loss injections is a personal choice, but it’s crucial to understand the influences on that choice, as well as the effects on wider society and the next generations. It’s hard to make an unbiased choice when we’ve all grown up in a world that demonises larger bodies. However, if we continue to collude with the idea that only smaller bodies are healthy, we risk creating even more disordered eating and body image issues. We must prioritise mental health and self-acceptance in ways that don’t rely on appearance ideals, so the younger generations can learn to be kinder to themselves.

About Mel:

Mel Ciavucco is an integrative counsellor, writer and trainer, specialising in eating disorders and body image, and also domestic abuse and sexual violence. She has worked in mental health charities for over a decade, including domestic abuse services and eating disorder charities. Mel writes informative content on her blog about disordered eating, domestic abuse and more: www.melciavucco.com 

This blog is part of our Weight Loss Jabs+Eating Disorders: Harm Waiting to Happen campaign.