Are we going backwards on body confidence?

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Body confidence in the UK is at a crossroads. The everyday conversation around weight and appearance has shifted from supermodels and diet clubs and is now dominated by weight-loss drugs, biohacking and viral body trends. But beneath it all, the shadow of fat shaming remains. It is just evolving.

The last time I remember weight loss dominating public conversation quite as much as it is today was back in the late 2000s, when size 0 was all the rage and Kate Moss’s famous quote, “nothing tastes as good as skinny feels” echoed everywhere.

This attitude wasn’t new to me: as a teenager in the 1990s I experienced the supermodel phenomenon firsthand. I remember pinning magazine cut-outs of supermodels – Christy Turlington, Naomi Campbell, Claudia Schiffer – to my wall and feeling triumphant when my waist reached 24 inches, just like Tatjana Patitz (my personal favourite). Looking back, it’s clear these influences shaped my teenage relationship with my body, for I even had a brief stint on Weight Watchers when I was 16 years old. Today’s teens may not be measuring their waists against glossy magazine pages, but the pressure to conform remains the same – if anything, with weight-loss drugs becoming commonplace, there’s now even less excuse not to conform.

Are we going backwards on body confidence?

How big an issue is being big?

Obesity increases the risk of health problems like type 2 diabetes, cardiovascular disease and mental health problems. Today, over two-thirds of men and almost 60% of women in England are overweight or living with obesity, with around one in four adults classed as obese. These numbers are putting enormous pressure on our health system. The biggest rises are in low-income communities, where there is typically more reliance on cheaper, processed foods. But the cultural baggage that comes with weight gain doesn’t care about gender, class or your postcode. Those living in a larger body can experience problems finding or staying in a job, typically have lower earnings and face barriers to career progression – all of which worsen inequalities. So, the pressure for those in a larger body is more than a body confidence issue.

How are things changing?

Women’s bodies remain the focus of continual attention and scrutiny in the media, often making the headlines of many a woman’s weekly magazine or a certain online newspaper. Weight stigma is growing with men too though.

Recent research has shown that weight stigma is affecting boys and men almost as powerfully as women, with social pressure not just to be thin, but to be muscular and ‘shredded’ – a drive that is strongly linked to orthorexia. Social media disseminates this messaging without compunction, and yet we have seen hospital admissions for eating disorders in boys dramatically increase by 84% in just the last five years.

Now we live in a new era of GLP1s – the ‘magical’ weight-loss jabs that are being used by celebrities and school-run mums alike. The NHS has approved and recommends GLP1s for use in managing type 2 diabetes and, under strict criteria, for weight management alongside diet and exercise. However, many fall outside these criteria and are choosing to go privately to achieve their desired weight loss goal.

How GLP-1s have changed the conversation

As a registered nutritional therapist and experienced eating disorder nutritionist, working with the complexities of food behaviours and our relationship with food daily, the desire to lose weight is as strong as it’s ever been. It’s just the ‘how’ that has evolved as GLP1s become mainstream and generally ‘accepted’. My worry though is that we are not going backwards in body confidence but that we are creating a bigger divide between a new “medically approved” ideal and those who are struggling, or may not have access to medication or support to help them with their weight loss.

In recent weeks I’ve started to read first-person articles about the anxiety of weight-gain if private prescriptions of GLP1s becomes unaffordable. In August, the wholesale price of Mounjaro increased by as much as 170% for the highest dose, to bring the UK “in line with Europe and other developed countries”, meaning that currently one-month’s supply will range from around £180 - £300 a month depending on the dose.

I do think GLP1s have their place in our modern world, but we must stop thinking that there is always a one-size fits all solution to the problem of being overweight. For some people these drugs can be life-changing (alongside important factors such as maintaining muscle mass, eating nutrient dense foods and focusing on protein), but I also think it is too early to know the full effects, good or bad, of these drugs and their wider potential. Yet none, not one, of the above weight-loss methods I have mentioned is sustainable on its own. And this herein lies the challenge with body confidence.

Fork full of Caesar salad. Healthy Caesar salad made with Romaine lettuce, grilled chicken breast, eggs, croutons, tzatziki dressing and parmesan cheese. Concept of a healthy diet

If weight-loss drugs have made slimming ‘easy’, where does that leave body confidence?

As someone with over 16 years’ experience working in this space, as well as having my own moments and insecurities with my weight both as a teenager and again in menopause, weight loss and body confidence are not only intertwined but they are way more complicated and nuanced than just using a medication to achieve the desired effects.

Our relationship with food starts the moment we are born. We all grow up with beliefs about food that are typically passed down from our parents or carers, or picked up on by advertising, social media and our new world of ‘influencers’.

We are rarely taught hunger and fullness cues as children, but we are fed lines such as such as “You can’t get down from the table until you’ve cleared your plate” or “Sweets are only allowed at the weekend”, creating ‘rules’ that stick with us into adulthood.

Then there is advertising and social media world – it is all about being good or bad, healthy or unhealthy, whole foods or junk foods. There is no balance. Food is used as a reward or a treat, for comfort or punishment (in those who restrict) or it has become something we have to earn. It is a very complex, emotional world before we even throw in hormones, genetics, neurodivergence, blood sugar sensitivities and stress!

There have been more positive steps towards body confidence over the years though. Certainly, from the early 2010’s, #bodypositive and similar phrases became commonplace across social media, and we have seen a new era of plus-size models and influencers, all challenging the ‘ideal standards’ that mainstream media and fashion tends to portray. As with all things, I think this has been taken to the extreme as well and there is a fine line between being a metabolically healthy plus-size and being an unhealthy plus-size.

These broader societal trends filter into my daily practice. For many clients living in a larger body, the appeal of weight-loss drugs is undeniable – even though most of them know the solution is rarely that simple or sustainable, but they crave being ‘normal sized’. What concerns me more is that some of my eating disorder clients – typically those with bulimia or binge-eating disorder – want the drugs too. It is also estimated that 1 in 7 adults seeking obesity treatment meet the criteria for binge-eating disorder. I would suggest that this is probably higher, for there are many that either don’t seek help, or go undiagnosed, and yet they too could be seeking, or offered, weight-loss drugs which has the danger of fuelling disordered eating further, especially once they stop.

So where does that leave us when it comes to body confidence? I don’t think we’re going backwards, but I do think the ‘divide’ between the drive to be thin and the empowerment of body positivity is getting wider. Right now, as we approach the end of 2025 I think the body positivity movement has been overtaken by the GLP-1s and I suspect this will continue for a few more years yet. Celebrities and influencers will continue to also drive the ‘inspiration’ to be thin, shredded, toned or sculpted, especially for the younger generations. For those of us in midlife, I think we are seeing more positive role models in the media who haven’t had work done or resorted to pharmaceuticals, but that is also probably to do with age.

My biggest fear around this is the next generation. Recent data published by the NHS England has found that one in 10 children are obese by the time they start primary school. What is life going to look for them by the time they are an adult?

For fat shaming however has never left us, and I’m not sure it ever will sadly. If only we could move to a world where being in a larger body was as accepted as neurodivergence is becoming in recent years? If we ever hope to move past fat shaming – and close, not widen, the body confidence gap – we must radically improve both our national food system and nutrition education, starting in primary school. Real, lasting change lies in education and science, not the next miracle drug or Instagram trend.