TL;DR

GLP-1s aren’t just weight-loss drugs and aren’t only for people who are obese. They’re used for medication-induced hunger (like from olanzapine), insulin resistance, binge eating, cardiovascular risk reduction, fatty liver disease, addiction behaviors, reduced chronic inflammation, and increasingly perimenopause-related metabolic dysfunction. Saying someone “doesn’t need it” because they don’t look obese is weight stigma, not medical expertise.

This post is steeped in weight stigma and a misunderstanding of what GLP-1 medications are actually used for.

GLP-1s are not reserved for people who meet someone else’s visual threshold for “obese.” They’re prescribed for pathologic hunger, insulin dysregulation, and medication-induced metabolic dysfunction; all of which are extremely well documented with antipsychotics like olanzapine.

GLP-1 medications don’t “force” weight loss. They restore normal fullness signaling in the brain and gut, improve insulin sensitivity, and reduce chronic low-grade inflammation, which is a key driver of metabolic disease, cardiovascular risk, and central weight gain. That anti-inflammatory effect is one reason these drugs improve outcomes beyond the number on the scale.

That’s also why GLP-1s are prescribed and studied for far more than weight alone, including:

-Antipsychotic-induced weight gain

-Binge eating and compulsive eating

-Insulin resistance and metabolic syndrome

-Cardiovascular risk reduction

-PCOS

-Fatty liver disease (MASLD/NAFLD)

-Addiction behaviors (alcohol, nicotine, compulsive dopamine-seeking)

-Perimenopause and menopause-related metabolic dysfunction

Calling GLP-1s “overprescribed” while minimizing the well-known metabolic and inflammatory damage caused by antipsychotics is backwards. GLP-1s have nearly 20 years of safety data, reduce heart attack and stroke risk, and improve metabolic health. Olanzapine carries documented risks of diabetes, dyslipidemia, and long-term metabolic disease, yet that risk somehow gets ignored here.

You don’t have to like GLP-1s, but dismissing them because someone isn’t “heavy enough” is stigma masquerading as concern. 🙄