Since using weight loss medication, Allie Olivares has quieted the voice of her eating disorder in her brain while getting more comfortable running around with her 6-year-old.
But her 80 pounds of weight loss while taking Wegovy has not come without challenges of its own, she said.
“I still deal with a lot of body dysmorphia,” said Olivares, who lives in Philadelphia. “I’ll look in the mirror, and it’s almost like a funhouse mirror where like one minute I’ll look at myself and be like, ‘OK, yes, like I see myself for how I am.’
“I’ll look away, and I’ll look back and suddenly my body just looks much larger.”
Injection pens move along a conveyor at the Novo Nordisk A/S production facilities in Hillerod, Denmark on June 12, 2023. The success of Novo’s bestsellers Ozempic and Wegovy drugs that help people lose significant amounts of weight, has created something of a gold rush in the pharma industry with about 40 companies developing products that will intensify competition. Carsten Snejbjerg/Bloomberg/Getty Images
Olivares says she has had a positive experience with the GLP-1 agonist medication, which mimics hormones in the gut involved in insulin regulation and appetite. It is also sold under the brand Zepbound for weight loss. But she warns that losing weight is not a cure for everything that’s not right in your life.
Sure, many people approach Olivares differently in a small body, but even those “nice” comments are a double-edged sword, she said. They often make her feel as if she was not acceptable before the weight loss.
“I’m the same person. I’m a mom. I’m a designer. I’m a wife. I’m a daughter,” she said. “I do all the same things. It’s just the package in which I come in is smaller now. So why am I being treated differently?
“It definitely reinforces this feeling of ‘Am I only worth what’s on the outside?’”
The experience Olivares had after losing weight isn’t unique. New York City psychologist Alexis Conason warns that people should not expect the work to be limited to decreasing a number you see on a scale.
Body image is not always tied to body size
If you have a negative voice in the back of your head that picks your body apart, it may not go away when you lose weight, said Conason, who is also a certified eating disorder specialist.
“Body image is not a reflection of weight. Body image is about the way that we see and feel about our body internalized,” she said.
Many people try to lose weight hoping to feel better about their body, only to find that they still don’t once they have lost the weight, Conason said. And that could lead to a dangerous cycle of continually feeling as if the answer is to get even smaller.
Conason recommends separating your efforts to improve your body image from any efforts you might take on to lose weight.
“Many people are able to work in therapy to accept their body and improve their body image even without losing weight at all and feel much better about themselves,” she said.
It’s crucial that you build a better relationship with your body independent of its appearance because those thoughts aren’t always dependent on your size, said Dr. Genesis Ettienne, a licensed mental health counselor and marriage and family therapist in the Miami metropolitan area.
“Self-confidence is a muscle that you have to flex,” regardless of your weight, she added.
The comments don’t stop
Since her weight loss, Olivares has found that many of her social interactions begin with a comment about her body.
“Noticing the weight loss is one of the first things (people) say to me when they meet me,” she said.
While there is a part of her brain influenced by diet culture that’s happy that people see her body is smaller, it also can make her uncomfortable, Olivares said.
“People tend to see weight loss as an invitation to publicly comment on people’s bodies,” Conason said. “Our bodies are so personal and really should not be objects for conversation.”
There is little research on eating disorders and semaglutide, experts said. Johner Images/Getty Images
It’s important not to comment on people’s bodies, she said — even if it is about losing weight.
On one hand, seeing a body doesn’t tell the whole story. Perhaps that person lost weight because of an eating disorder, grief or some other distressing event, Conason said.
On the other, even if the weight loss is seen as positive, commenting on people’s bodies can make them feel more on display, which can feel overwhelming and intrusive, she added.
Ettienne said she hears every day how her clients feel as if their weight loss has become the entirety of their storyline in the minds of the people around them.
What you can do about it
That is where it is essential to communicate boundaries around whether and how you are comfortable talking about your body with others, she said.
Maybe your approach is a direct conversation to say, “I know I lost weight. I don’t want to talk about it.” Or it can be something lighter to brush off body-centric conversations, she said.
Direct conversation can be easier when you are closer with the person, Olivares said, but for others, she tends to try to casually pivot the conversation away from body talk.
Olivares also has to work hard to deal with her body dysmorphia, she said. And that can mean avoiding mirrors for a bit.
“If you’re not going to be able to see yourself in reality, it’s OK to disengage from a harm-reduction perspective,” Olivares said.
Usually, she finds that her dysmorphia is connected to other behaviors or feelings, so she encourages people going through similar experiences to dedicate time to sit with it and ask themselves where it is coming from, she added.
“Even if you’re physically in a smaller body, if you’re not addressing the mental framing (of) body dysmorphia,” Olivares said. “It can be really hard no matter how small you get to see reality.”
If you are struggling with body image or a cycle of feeling as if you must lose more and more weight, seeking professional help is the best next step, Conason said.
“Looking for a licensed mental health provider who specializes in eating disorder care is really the best thing to do,” she added. You can find resources and referrals at The National Alliance for Eating Disorders.
