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Serena Williams, weight loss and the perils of mixed messaging
This article was originally published in The Gazette.
Retired tennis star Serena Williams revealed during a recent TV interview that she is taking a GLP-1 medication to help her achieve a “healthy” weight.
“I literally tried everything. I mean running, walking, biking, stair climber. ... You name it, I did it,” she said. “I mean, even down to trying to play a professional sport.”
Williams is a spokesperson for Ro, a direct-to-patient telehealth company based in New York, which offers GLP-1 medications — a class of drugs used to treat Type 2 diabetes and obesity.
With 23 Grand Slam titles and four Olympic gold medals, money is not an issue for Williams and neither is health care access. If she can’t manage her weight with exercise alone, who can? She is shedding light on the fact that weight management is complex, and exercise alone might not be enough to help manage weight — even for an Olympic athlete. Her revelation could positively influence people’s understanding of the role of exercise and weight management by acknowledging that exercising more will not necessarily result in weight loss.
“My coaches telling me: ‘You have to lose weight, you have to lose weight,’ “ Williams said. “I’m playing professional tennis. I’m literally training five hours a day, and I would always work my way to one point on the scale and it would never go below that.”
There is a widespread public perception that if people exercised enough, they would be able to control their weight. However, Williams’s story supports current evidence that shows exercise can improve several markers of physical and mental health and prevent chronic diseases and premature death, but its effects on weight loss are minimal. She may be the highly admired, strong and fit role model and advocate needed to show weight management is a complex issue, and exercise should be valued for health and not promoted for weight loss.
Her decision to use GLP-1 medications shows that even someone who exercises a lot may still need additional weight management support. This challenges deeply ingrained stereotypes that overweight people are bigger because they are lazy, don’t try hard enough, or are not motivated enough to engage in healthy habits. By sharing her story, Williams is normalizing her need to seek medical treatment, which could help reduce stigma in society.
However, what we are concerned about is how these celebrity endorsements are advertised, because the narrative is mostly focused on weight loss.
GLP-1 medications are evidence-based effective treatments approved for treating chronic diseases such as obesity and Type 2 diabetes. Obesity is a complex, multifactorial, progressive, relapsing, chronic disease characterized by abnormal or excessive adiposity that impairs metabolic, biomechanical and psychosocial health. This is why losing weight can be difficult, but also why having effective treatments — such as pharmacotherapies and bariatric surgery — to reduce excess adiposity is important.
But as a growing number of celebrities highlight their weight loss with these drugs without clear information on the medical necessity of their use, it raises important questions: Can anyone take a GLP-1 to lose weight no matter how healthy and fit they are? Can someone who just wants to lose 20 pounds before their wedding be eligible to take these medications?
These medications are not intended for modest, short-term or cosmetic weight loss goals. As the scientific and medical communities work to move obesity care away from weight loss as a primary goal — given its links to body image and disordered eating concerns — portraying GLP-1s mainly as weight loss tools warrants careful consideration.
Angela S. Alberga is an associate professor in the department of health, Kinesiology and applied physiology at Concordia University. Marilou Côté is an assistant professor and clinical psychologist at Université Laval. Renee J. Rogers is a senior scientist in obesity and physical activity in Kansas City, Kan. Ximena Ramos Salas is an independent research consultant in obesity and stigma in Kristianstad, Sweden.
