By Hannah Carroll, Associate Director, Strategy, Inizio Evoke Brand & Creative
GLP-1, or glucagon-like peptide-1, is a hormone that’s released after we eat, lowering blood sugar levels and slowing down digestion. Medications which mimic the hormone are currently used to treat both type 2 diabetes and obesity [1]. Prescriptions of these drugs have seen a 2,082% increase from 2019 to 2022, with much of the surge linked to a social media frenzy.
GLP-1 receptor agonists have been a life-changing innovation for many. While media hype has transformed 'GLP-1' into a household name, it's also become a dirty word, with coverage often framing it as 'cheating' at weight loss. And people with obesity often face shame if they decide to take control of their weight in this way.
With media outlets using language like ‘fat jab’, ‘lazy’ and ‘easy way out’, it’s no wonder that 70% of GLP-1 users believe society negatively judges them [2].
And this unhealthy narrative could have dire consequences on the long-term health outcomes for countless people across the globe. It could prevent patients from seeking help in the first place.
It’s up to us to change the narrative – uncovering the barriers first
As healthcare communicators, we have the power to turn stigma into support. By looking at this challenge through the lens of behaviour change, we can create a shift for people who are currently too uncomfortable to ask their healthcare professional (HCP) about medications to help with weight loss.
At Inizio Evoke, we use the COM-B model of behaviour change - a framework grounded in scientific evidence that explains behaviour through three components [3]:
Capability (knowledge and skills)
Opportunity (external factors enabling or hindering action)
Motivation (thoughts, feelings and habits)
The UCL-trained behaviour change scientists in our team apply the COM-B model to these kinds of problems to ensure interventions are strategic and communications are more effective.
Using the COM-B model, we can clearly see the key barriers to GLP-1 uptake in patients are social opportunity and reflective + automatic motivation:
Capability barriers:
Poor understanding of the medication’s mode of action and benefits, along with misconceptions about who is eligible for GLP-1s (e.g. ‘I think you could only get it if you’re morbidly obese / ‘I didn’t know it was more than just an appetite suppressant’).
Opportunity barriers:
Social opportunity: The impact of peers or the cultural view on GLP-1s, including the fear of being seen as ‘lazy’ or ‘cheating’. If no-one in their social circle takes GLP-1, it could seem a more ‘severe’ intervention. Others may not even perceive obesity or eating disorders as ‘real’ illnesses worthy of treating with medication.
There may also be doctor-patient dynamics at play – if patients have previously experienced bias from their HCP and a ‘blame mentality’ about their weight.
Shifting perceptions in the mainstream: Serena Williams’ openness about using a GLP-1 medication brings mainstream visibility to a misconception we’ve been challenging: that obesity treatments are easy ways out. Her story underscores what we argue throughout this piece — that weight, health, and identity are deeply complex, and that behaviour change must extend beyond diet and exercise into how we talk about ourselves and each other. As she normalises medical support for bodies that have worked hard; one serving millions of mothers, athletes, creatives; our collective language shifts. This isn’t just about reducing weight; it’s about reducing shame.
Motivation barriers:
Reflective motivation: Cynicism – some people might think they’re not ‘worthy enough’ or ‘obese enough’ to warrant medication. They may also believe that needing medication means they’ve ‘failed’ at managing their weight themselves.
Automatic motivation: Feelings of shame when discussing their weight. Patients may also have a fear of doctors’ surgeries, hospitals and/or injections.
Using behaviour change techniques to overcome the barriers
Now we’ve identified what stands in the way of people asking their HCPs about GLP-1s, we can dive into the behaviour-changing techniques that could encourage open, shame-free conversations.
Technique 1: ‘Re-attribute cause’ – Educate public on the multifactorial causes of obesity, and therefore position GLP-1 as a tool in the wider toolkit of holistic weight management:
To empower patients and dispel myths, unbranded awareness campaigns could help educate the public on the mode of action of GLP-1 – emphasising its role in successful weight loss.
Technique 2: ‘Present information from a credible influence’ – Elevate the voices of patient advocates for GLP-1s:
Social media advocacy, speakers at events and articles in the media by credible patient sources could help reduce shame among those considering treatments. This could boost the perceived legitimacy of GLP-1 as a solution.
Use empathy-led narratives e.g. showing that other ‘people like me’ already use GLP-1s successfully.
Technique 3: ‘Valued self identity’ – Demonstrate that those who perform the behaviour are ‘proactive’ and ‘healthy’. Not ‘lazy’:
Using persuasive language in public-facing communications could demonstrate that seeking support is an admirable and positive decision. People who’ve opted for GLP-1s are PROUD of how they’ve taken control of their health and their lives.
Are you ready to help reclaim the narrative?
Healthcare agencies and pharma companies need to work together to reclaim the narrative on GLP-1s.
By implementing these proven behaviour change techniques, we can help more patients access the additional support they need to live fuller, healthier, more active lives.
If you want to know more about our behaviour change capabilities at Inizio Evoke Europe – and how we can apply them to improve people’s health and wellbeing – contact Abi Stevenson, Associate Director - Growth, at abi.stevenson@inizioevoke.com.
References
[1] https://www.ncbi.nlm.nih.gov/books/NBK551568/
[2] GLP-1 for Weight Loss | Social Stigma Prescription Drugs
[3] COM-B: Michie, S., Van Stralen, M. M., & West, R. (2011). The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation science, 6(1), 42.