The Pill & the Needle: The New Religion of Thinness

Why the latest “miracle drug” feels like the oldest story in the world.

As someone who has struggled with body image for as long as I can remember, the popularity of the body positivity movement in recent years, fueled by social media, felt like a glimmering promise of real change in how women perceived and celebrated their bodies, rejecting thinness as the ultimate and exclusive standard of beauty. I began to believe my daughter might inherit a world that accepted her body — or better yet, didn’t notice it at all. Let her body be the vehicle of her mind and her spirit, the parts of her that truly matter most.

That vision, like the lean muscle of women taking semaglutide, is fading fast.

The progress that feminism has made on both the cultural and individual self acceptance of women’s bodies of all sizes over the past forty years was built slowly, brick by brick, and held together partly by the fact that the reality that the thin ideal was an impossible standard for the vast majority of women. Now with Ozempic, where the skinniest version of your body is accessible with just a little pill or a weekly injection, the cracks in the foundation of body neutrality are starting to show, threatening decades of progress.

Body positivity and the fight against the patriarchy placing thinness as the ultimate standard of beauty is rooted in the historical origins of feminism — in the 19th century, “dress reformers” argued against corsets and restrictive clothing, framing it as a fight for women’s health and autonomy. The 1960s and 70s saw the birth of the modern fat-acceptance movement, with activists Judy Freespirit and Sara Fishman explicitly framing size discrimination as a feminist and political issue. In their book Fat Liberation Manifesto, they assert that “fat people are full human beings, with rights to life, liberty, and the pursuit of happiness.”

The women who were subjected to the arbitrary beauty standard of thinness in the 1950s, 60s, 70s, 80s, and 90s were especially vulnerable, as the only exposure to what a woman’s body was “supposed” to look like could only be found in the media they consumed, the vast majority of which was created by men. However, in recent decades, with the insurgence of the internet and social media, we were beginning to see a democratization of the beauty standard by simply sharing it, nonstop, on our feeds. Seeing fat bodies being celebrated, strong, muscled women being applauded, and big bodies shared with confidence and self-love on social media has had a profound impact on the culture, and ultimately was co-oped by capitalism. In 2004, Dove launched their iconic “Campaign for Real Beauty,” showing women’s bodies in their ads with cellulite, wrinkles, and stomach rolls. The campaign increased Dove’s sales from $2.5 billion to over $4 billion within its first decade. Aerie’s #AerieREAL (2014) ended photo-retouching of models and showcased diverse bodies; sales rose 20% year over year after launch.

But the same market that learned to profit from women’s self-acceptance has quickly abandoned that strategy to return to profiting off women's insecurities, leaning into the misconception that thinness is linked to wellness, and your smallest body is a testament to one's discipline, hard work, and strength of character. With the mass normalization of semaglutide, a medication designed to support weight loss in diabetic patients, for cosmetic use, we see the latest and most sophisticated method of politicizing and capitalizing on women’s bodies, repackaging an oppression that our mothers and grandmothers lived under and selling it as empowerment and choice.

Additionally, despite its hype as a mass-market miracle, semaglutide remains a luxury product. Outside of diabetes care, it costs over a thousand dollars a month in the U.S., and insurance rarely pays for it. Once again, thinness has become a form of class privilege: a visible marker of access and affluence disguised as “wellness.” The intersectionality of feminism, in which the connection points between misogyny, racism, and classism are acknowledged and resisted, becomes especially threatened by the marketing of semaglutide as a “universal” solution to fatness.

Putting aside the concerning threats to women’s mental and emotional health with the resurgence of “heroin chic” as the beauty standard, the impacts of long-term semaglutide use on physical health are not well understood. The strongest data extends only two years for weight loss and three to four for cardiovascular benefit, with little known about long-term effects on muscle, bone, or metabolism (Nature Medicine, NEJM). In most trials, patients regained weight as soon as they stopped taking it, effectively medicalizing lifelong thinness (STEP trials, PMC). And even for those who stay on the injections, emerging research shows loss of lean mass and bone density alongside fat — raising serious questions about aging, strength, and metabolic resilience.

What began as a feminist reclamation of our bodies has been co-opted, medicalized, and sold back to us under the guise of wellness. Are we still in the throes of a honeymoon romance with Ozempic, a wild fever dream that will end abruptly when women wake up to the realization of the damaging impacts of its social repercussions or on their individual long term health? Or has semaglutide permanently reset the cultural landscape, forever solidifying skinniness as a woman’s highest achievement? Only time will tell. For now, I’ll continue to do my part: eat healthy and fun foods with gusto. Move my body to keep it strong, and to enjoy the wonderful capabilities it possesses. To show my daughter my soft belly and say, “This is my body! Isn’t it beautiful?”

At the end of the day, we are all doing the best we can.

Except for those capitalizing on the insecurities of women and robbing us blind as we slowly starve ourselves.

You can go fuck yourselves.