Considered “wonder drugs”, the rise in uptake of Ozempic and similar weight loss drugs have prompted think piece discussion, ill-judged celebrity social media posts, and even implication in a rap beef. Pharmaceutical weight loss treatments are certainly stimulating an unusually diverse cultural discourse, both good and bad.

While the discussion, hype, and visibility have no doubt had some promotional benefits for the drugs makers, one can’t help but wonder about the implications of the increasingly divisive cultural discussion for the drugs intended users, as the cultural discourse here is freighted with judgement, othering language, shame and stigma.

At Sign Salad we frequently help brands and organisations unpack thorny cultural discussion to understand the underlying drivers, and thus, how conversations can be reframed to be more positively engaging for those effected. Last year for example we undertook a project for GambleAware, breaking down the stigma of gambling harms. This project looked at how the seemingly innocent language and images used in cultural discourse presented persons experiencing gambling harms as either blame worthy (e.g. “problem gambler”), beyond help (e.g. “gambling addict”), or suffering from a pathological illness (e.g. “gambling disease”). Our analysis suggested alternative approaches, that could instead be used to communicate about and with this group in non-judgemental ways, such as more peer-to-peer and inclusive language, and statements emphasising sameness as opposed to othering this community.

Recently, Sign Salad has been using Pulsar, our social media and online analytics tool, to investigate the online conversation concerning Ozempic. Our study gathered posts from between May and June of 2024, identifying the most engaging, influential, and most widely shared material.

A lot of this discussion is positive, talking about the impact of these treatments using language associated with surprising efficacy such as “miracle” and “transformational”, but while many are experiencing the benefits, there is also significant push back and criticism, with some referring to the use of these drugs as “cheating” or taking the “easy way out”.

Sometimes the terminology used can initially seem positive but can unconsciously reinforce negative attitudes. Colloquial references to these treatments as “skinny jabs” for example, suggests a quick and effective solution to weight gain. But in focusing on “skinny” aesthetic changes, this description undermines the underlying seriousness of the medical risks faced by many users such as diabetes and heart disease, framing these treatments as primarily cosmetic.

Looking at the data set in detail, one of the first notable things was the nature of the sources coming up as influential within this discussion. Among the expected social media platforms such as TikTok and X, there were also media platforms like Breitbart and Infowars. The presence of these platforms clearly illustrates the polarised nature of the discourse concerning Ozempic and other weight loss related pharmaceuticals.

Within the cultural framework of the ‘Protestant work ethic’ there is a tendency to think that nothing positive can/or should be gained without an equal and opposite investment of labour and suffering. This mindset is deeply embedded in the fundamentals of any capitalist democracy, but it is not necessarily true, and can be particularly unhelpful with regards to the discussion of necessary medical treatment.

Looking at the language within posts from conservative sources, we can see that this concept of exchange is frequently evoked, with one article referring to Ozempic use as “a deal with the devil”, while others talk about the inevitable “trade offs” with these pharmaceutical treatments.

At worst this moral agenda is even being linked to conspiracy thinking, implicating the users of these pharmaceutical products in a perceived threatening oppressive movement, controlled by “big pharma”:

“Once upon a time, people managed their own weight. But now, we need an outside agency to do so for us. This obviously makes us less free. Big Pharma’s power increases as our diminishes.” – PJ Media

The stigmatisation here works on several levels, firstly there is an implication of a lack of self-control and a slipping of personal standards implied in the phrase “once upon a time, people managed their own weight”, secondly, there is blaming the use of a pharmaceutical product for the supposed degradation of society as a whole.

The broader societal impacts are not always explored so sinisterly, but they do suffuse the conversation in general. One interesting point here is that ahead of the makers, the organisations most referenced in the online conversation concerning Ozempic are Nasdaq, and the FDA. Indicating that key points of interest are concerning not whether and how these drugs might help people, but rather highlighting the financial opportunities indicated by its success, and querying whether or not its use should be permitted.

The subtle and depersonalising implications of these messages can have a profoundly negative effect on patients. These discussions serve to question the merits of their chosen treatment route, and suggest that the financial feeding frenzy is of more importance than the wellbeing of the users of these treatments.

No doubt these pharmaceutical treatments will have a profound effect on society, but this is likely to be positive, both for our medical systems as a whole, and for individual patients. It has been suggested that in the UK:

“greater access to these medicines will reduce the crippling strain obesity-related conditions have on NHS resources.” – The Guardian

The key voices that need to be heard in all of the noise about pharmaceutical weight loss treatments, however, are the voices of the patients themselves. For many the weight loss journey requires them to confront the stigmatising messages they have been exposed to head on. As the journalist George Chidi states in the Guardian’s Today in Focus podcast:

“I am beyond blaming myself as some moral condition for my weight condition” – The Guardian

Hearing and sharing his story of confronting and overcoming these associations, can only help to support and empower patients embarking on their own journey, illustrating that they are not ‘abnormal’ and not alone. Boosting the voices of those with lived experience of these treatments can help provide a vital spotlight in the ignorant darkness of the broader conversation.

3 Key Takeaways for Brands:

  • A semiotic language analysis of the social media space can help unearth the key cultural drivers of conversation (both those that are helpful and unhelpful) and identify positive routes forward.

  • There is a need to spotlight the voices of patients in the discussion of pharmaceutical treatments if we are to avoid and confront stigmatising language.

  • Language that can help people more readily overcome stigma and blame is well worth pharmaceutical manufacturers, public health bodies, and the media at large adopting as a matter of urgency. It presents a barrier to adoption of treatments that can improve the lives and wellbeing of patients. Our stigma reduction language guide for GambleAware can be found linked here, which may provide inspiration for your category.

Mark Lemon, Director

Language is the Best Medicine: Why words matter in healthcare