Recently, Rebecca Diamond heard from friends who had gone on a GLP-1 like Ozempic or Wegovy that people treated them differently after significant weight loss. As an economics professor at Harvard, this piqued her interest.
“I went to just look to see what the literature says on economic and social outcomes of these drugs,” Diamond told me. “But I couldn’t find a paper, which I was sort of shocked by.” So she took it upon herself to dig through the data and published a new paper on her findings.
She looked at a dataset comparing GLP-1 users, non-users, and people who were interested in using a GLP-1 but hadn’t started. Both the users and the want-to-users had high BMIs. When controlling for a bunch of variables like health and race, the data told an uncomfortable story.
For non-working women, those who started GLP-1s were 27 percentage points more likely to have started a job within 18 months of their weight loss than those who weren’t using GLP-1 but wanted to.
When Diamond looked at data about women and relationships, the jump was even bigger: women on GLP-1s were 29 percentage points more likely to have started living with a partner or gotten married over 18 months.
This is just one working paper based on a large survey dataset about lifestyle, and there are many potential factors at play. It has not been peer-reviewed. Diamond cautioned against taking this as clear causal evidence of weight discrimination.
But it points to something bleak, which most people intuitively know (and other research has shown): Obesity is a penalty in society, and it penalizes women disproportionately in social and economic ways.
The value of “first impression” moments
Interestingly, starting a GLP-1 didn’t appear to help women who already had jobs earn more or work more hours. And women already in partnered relationships were no more likely to stay or leave their relationships than women who weren’t taking the medication.
The biggest changes appeared at moments that depend on first impressions: getting hired or finding a new partner.
That doesn’t necessarily mean employers are discriminating based on body weight. Health issues related to obesity can affect the ability to work. Plus, weight loss could improve confidence or self-empowerment. But Diamond found no significant mental health changes, and that health improvements could only explain part of the boost in employment opportunities.
That left open the possibility that something else was at play, like how we are perceived by strangers.
That’s why the positive effects on jobs and marriage only appear in new social situations. If you already have a job, your boss knows how well you can work. If you’re already married, your spouse loves you for other reasons than your appearance.
As the paper describes:
The markets that respond are the ones where someone forms a fresh impression of a woman’s body weight: a prospective partner, or an employer considering an applicant who is not employed. For women, the arrangements that do not respond are the ones already in place, where any first impression occurred long ago and where weight is one characteristic embedded in a much richer stock of information.
The cost of GLP-1s exacerbates inequality
It doesn’t feel like a surprise that traditional beauty standards in body size impact a woman’s dating experience. And there’s not so much of a social or moral stigma for people having a preference for traditional beauty standards in the dating market.
However, that’s not true in the labor market: for most jobs, body size shouldn’t affect who gets hired. And yet, it’s impossible to read this paper and not imagine that’s rampant discrimination based on physical appearance going on — and only for women.
The idea that in the age of Ozempic, “hotness” is a requirement for finding a job is something my colleague Amanda Hoover wrote about recently, and pointed to an unsettling data point: “The Society for Human Resource Management surveyed about 1,000 human resource professionals in 2023 and found that about a quarter said obese employees are more likely to be perceived as unmotivated and lazy than slimmer workers.”
The positive effects on men’s jobs from starting GLP-1s were much smaller, and the data on unpartnered men were too small to analyze. Although there was a quirk: partnered men were more likely than women to leave a relationship after starting a GLP-1.
There’s another level of inequality that the paper touches on: who can afford GLP-1s — and who gets to reap those positive social and labor market benefits from taking them.
In Diamond’s study, 40% of GLP-1 users were paying out of pocket for the medicine, at about $300/month. The women who started taking GLP-1s also had the highest household incomes, while the women who wanted to take GLP-1s but hadn’t started had the lowest, suggesting the high cost could have been a barrier.
Basically, if Diamond’s theory is right — that weight loss reduces the economic penalties on body size — then unequal access to these medications could exacerbate inequalities. Wealthier women who can afford GLP-1s out of pocket could stand to become wealthier in the labor and marriage markets (which have financial benefits).
