Is Ozempic Ruining Friendships?

The rise of weight-loss medications like Ozempic caused a divide in Holly J.'s friendships. When her two best friends began to take weight-loss medication, it put a wedge in her relationships with them.

"I'm at the end of the traditional sizing range but not into plus size, and both of my friends were a very comparable size to me as well," she says. "Once they started taking it, I found that a lot of our [conversations] were centered around appearance and food and weight." Holly found herself constantly trying to change the topic — and her friends noticed. "Our relationship dynamic has changed because of it, and that was really hard."

You've probably heard of Ozempic, a brand name for semaglutide. The medicine treats type 2 diabetes and heart disease in adults and is part of a class of drugs known as GLP-1s. Thanks to its abilities to aid in weight loss, it's become a main character in the cultural zeitgeist and spawned new drugs, such as Wegovy, Zepbound, and Mounjaro, made just for shedding pounds. But these medications don't just change people's bodies — they can also change their friendships.

Weight and size can draw a lot of complicated feelings of competition or resentment between friends and people in close relationships — and in a society that deems thin as "good" and fat as "bad," it's easy to get caught up in size as currency.

Moraya Seeger DeGeare, MA, LMFT, is a therapist and the co-owner of BFF Therapy, which provides culturally competent psychotherapy for youths and adults.

Maddie Friedman, MA, LCSW, is a therapist at Equip, a mental health platform for people experiencing eating disorders.

Nina found herself in the midst of a falling out with two different friends once they learned she was taking Ozempic. She didn't initially tell them because she had seen her friends and family members making fun of Ozempic online, but she decided to open up to one friend. "I told her about taking Ozempic, and she said she was really shocked and disappointed in me," she tells PS. "I really had to hold myself back from saying anything at all, because this friend has suffered from anorexia for almost 20 years, so I just let it go, 'cause I didn't want it to turn that into a fight about our bodies."

Of course, everyone's experience with weight-loss drugs and their friends is different. Some people feel judged, while others can feel a new sense of connection if their friends are going through similar situations. But that's only if someone feels comfortable broaching the topic in the first place. "Most of our body stuff comes with so much shame and embarrassment, so it's really easy to not want to talk about it," says therapist Moraya Seeger DeGeare, MA, LMFT. "When we have shame, it's going to start trickling into all these other aspects of your friendships."

When someone experiences significant weight loss, they're also shedding an older version of themselves, according to DeGeare. "Anytime we're going through big change, we lose friends because our friends have to grieve that old version and they're very used to you being in this body and their life is set up for you in that way. It can be really hard on friendships, and a lot of friendships don't make it through those changes."

Ang Slater has PCOS and says she's been struggling with weight and obesity since she was a teenager. Pre-Ozempic craze she tried phentermine, a weight-loss drug used to suppress appetite, and she had gastric bypass surgery in 2009. "I don't think I've ever really spoken to any of my friends about weight-loss drugs," she says. "It was always kind of a taboo topic, and also I feel like I don't remember any of my friends ever having problems with their weight, so it was never really a discussion."

Renata D'Agrella Kenen started taking weight-loss medication in January 2024. "It took me about six months or maybe even a year to decide to eventually go on it," she says. "I tried to [lose weight] naturally first. I worked with a nutritionist and a trainer and nothing was really working." Her doctor offered either weight-loss drugs or blood pressure medication as options for losing weight, so she picked Zepbound. "I had a few friends who were scared of the side effects. They were like, 'Are you sure? I've heard some pretty scary things online,'" she says. "They were just really concerned for my safety, but overall they were pretty supportive."

While there are plenty of anecdotes of friendships faltering due to the decision to take weight-loss medication, Kenen says it's only made her friendships stronger. "Everyone is just really, really happy for me because they see how happy I am," she says. "I feel like I've been able to do more with them. Last year, I went to a music festival and I was having all of these health issues . . . it really took a lot out of me and I felt like I was slowing the group down." But at another music festival with her friends this year, Kenen's experience was different: "I could really keep up, I could have fun with my friends, I could be a little bit more active and run around the festival and had more endurance."

While Kenen's experiences with her friends have been ultimately positive, a common criticism of the proliferation of weight-loss drugs is that they've worsened anti-fat bias. Fatphobia, whether it's internalized or directed toward others, can cause tension between friends. "When people are really bought into a thin beauty ideal and this notion that size is an indicator of health, and have potentially spent their lives wedded to that ideology, it can be really hard to shake," says Maddie Friedman, MA, LCSW, a therapist at Equip. "When you see conflicting philosophies in a friendship, it can feel really hard to eat together or go shopping or talk about what's going on in pop culture if there's a lot of commenting on body shape and size or conflating body shape and size with health.

"We have been experiencing a sad pendulum swing in our broader culture around body acceptance. And now with the readily available nature of GLP-1s and people seemingly shrinking in pop culture, I think that a lot of people who were potentially working towards body acceptance or body neutrality are losing that community or are losing that greater sense of acceptance in their lives, because people are now realigned of this myth of controllability when it comes to body size."

But going through big life changes does offer the opportunity to strengthen bonds. Slater, who had previously avoided discussing her experience with obesity and weight-loss drugs, began posting about it on social media, which has connected her with hundreds — even thousands — of people who are going through the same thing. "Some of my closest friends now are people that I've met through posting on TikTok," she says. "They're an incredibly supportive group and they just understand you as a person on a deeper level because they've also lived their life with obesity. There's a lot more to connect on."

If your friendships have changed due to weight-loss drugs and you're unsure of how to handle it, Friedman recommends talking it through with a professional — any kind of transformation, including weight transitions, can be hard to process on your own. "For a lot of folks who are navigating changing in body shapes and size, regardless of how or where or why, it can be really useful to talk to a mental health professional about how that's going and how that's impacting their self-esteem and their sense of self, independently and in relation to others," she says.

On the flip side, if you're the friend of someone taking weight-loss drugs and you want to better process it or be there for them, Friedman says to ask yourself what this situation is bringing up for you. If you need to set a firm boundary, then you can do so in a respectful way. "Conversations about weight, shape, and size can be really off-putting and more severely triggering, especially folks with lived experience of eating disorders," she says. "Since most people have experienced not feeling great in their body at some point in their lives, I think it's OK to be able to say, 'Actually, talking about this doesn't feel great for me' or 'Can we talk about something else?' or drawing a more direct [boundary]."

Nina and her friend are doing alright — they've made the choice not to talk to each other about diet or exercise anymore. "The whole conversation happened all at once and we haven't spoken about it again since. We usually lay everything out on the table when we have a disagreement —we don't let it drag out."

Holly thinks GLP-1s have changed her friendships with her two besties forever. "I thought that they were both perfect and beautiful the way that they were," she says. The friends have since gone off the medication, and Holly notes her relationships with them have recovered. "We really don't talk as much about weight loss and food and image-centered things anymore," she says. "It feels a little bit like things are back to normal with us."

Elizabeth Gulino is a freelance journalist who specializes in topics relating to wellness, sex, relationships, work, money, lifestyle, and more. She spent four and a half years at Refinery29 as a senior writer and has worked for House Beautiful, Complex, and The Hollywood Reporter.