Two new studies show the complexity of the way these drugs affect their users. The first is a working paper for the National Bureau of Economic Research by the Harvard economist Rebecca Diamond, using data from the University of Southern California’s Understanding America Study. Diamond compared women ages 25 to 61 who started a GLP-1 for weight loss with women who wanted to start a GLP-1 but had not. The base line body mass index of these groups was around 35, which is at the low end of Class 2 obesity.
As Diamond notes, there is already a wealth of economic research that shows “heavier women earn less, work less and are less likely to marry or cohabit,” and her study adds to this literature:
Among women who are single when they start, the probability of being married or living with a partner rises 18 percentage points overall and 29 percentage points after six or more quarters. The gain builds gradually as weight comes off. Women not employed at base line also move into work. Their employment rate rises 13 percentage points overall and 27 percentage points after six or more quarters, and their weekly hours rise by nearly 10 hours at the longer horizon. Much of the employment gain is movement out of unemployment rather than out of retirement or disability.
Interestingly, for women who were already employed or partnered when they started taking a GLP-1, Diamond found that very little changed, suggesting that the “obesity penalty” for women is largely a first-impression prejudice. “The markets that respond are the ones where someone forms a fresh impression of a woman’s body weight: a prospective partner, or an employer considering an applicant who is not employed,” Diamond explains. If weight is just one piece of information balanced with other factors, it has less impact. (Men also face some economic penalties for obesity, but they are smaller than those that women face.)
A research letter recently published in JAMA Psychiatry outlines a study that estimates the prevalence of GLP-1 use among people with eating disorders. Nearly all of the study participants were female. Researchers found that the use and misuse of GLP-1s is higher among people with eating disorders than among the general population, and that some of them may be attempting to maintain their “eating disorder psychopathology through rapid restriction and weight loss.” They found that over 10 percent of participants with anorexia had tried GLP-1s.
Though GLP-1s may be a promising treatment for some kinds of disordered eating, like binge eating disorder, it appears much riskier for women with other kinds of diagnoses. In 2024, Bloomberg’s Madison Muller spoke with several eating disorder specialists who said that they’re “seeing an influx of patients who’ve relapsed after taking drugs like Ozempic. In other cases, people at risk of eating disorders develop what one doctor calls ‘GLP-1 induced’ anorexia after taking shots they never should’ve been prescribed.”
These findings bring me back to Calloway’s piece. She is subject to the same pressure to be thin that many — most — women in our culture feel, but for her, as an influencer, that pressure is undoubtedly ratcheted up to 11. Her livelihood is more dependent on how she looks, and because ultrathin is in, she clearly feels she must adhere to what’s in vogue.
