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Key points
- For generations, we’ve searched for new ways to make bodies smaller.
- The methods have changed. The underlying premise has not.
- The body responds negativley to undernourishment regardless of how it occurs.
- Questioning the goal can be as important as evaluating the method.
A few weeks ago, while preparing for a training on GLP-1 medications, I found myself going down a rabbit hole. What started as research on today’s medications quickly turned into an unexpected history lesson about Lord Byron drinking vinegar to suppress his appetite, Horace Fletcher insisting people chew each bite until it liquefied, rubber garments promising to “draw the fat completely away,” and amphetamines marketed to housewives as a way to stay slim while doing the laundry. It would all be amusing if it weren’t so familiar and so harmful. The deeper I went, the more one question stayed with me: What might the last two hundred years of weight-loss history teach us about this moment?
The Same Story, Different Decade
The answer, I realized, is that every generation seems convinced it has finally found the answer to the question, “How do I lose weight?” In the 1920s, cigarettes were marketed as a way to curb appetite. By the 1950s, the sugar industry was running ads claiming a spoonful of sugar gave people the “willpower to undereat.” Fast forward to the 1990s, and Fen-Phen was prescribed to about six million Americans before being withdrawn because of its association with heart valve disease (ACHI, 2024). Seen in that context, today’s conversations about GLP-1 medications feel less like the beginning of a completely new story and more like the latest chapter in a much longer one.
I understand the appeal. I’ve worked with people who spent years cycling through diets that failed to deliver on their promises. Many blamed themselves instead of recognizing that consistently eating less than their bodies needed was always going to have consequences. When something new comes along, it’s understandable to wonder whether this time really is different
What Changed and What Hasn’t
What interests me isn’t just that the methods have changed. It’s what hasn’t. Across two hundred years of weight-loss history, we’ve reinvented the methods again and again. What has remained remarkably consistent is the assumption underneath them: that making our bodies smaller is the answer to problems that often have little to do with body size. That’s the part I want to slow down and examine because it isn’t questioned nearly enough, even by people who are otherwise skeptical of diet culture.
It is easy to laugh at tapeworm pills and vibrating belt machines. It is much harder to consider that today’s tools, however sophisticated, may still rest on the same assumption. The methods have changed. The question is whether the underlying belief has
From Diabetes Treatment to Weight-Loss Medication
GLP-1 medications didn’t begin as weight-loss drugs. They were developed to help people with type 2 diabetes manage blood sugar by improving insulin regulation, slowing stomach emptying, and increasing feelings of fullness. For many people living with diabetes, they have been an important medical advancement
As researchers and <a href="https://healthylife7.com/uams-opens-new-neurology-clinic-in-doctors-building/” title=”UAMS Opens New Neurology Clinic in Doctors Building”>clinicians began using these medications, another effect became increasingly apparent: many people were losing weight. Pharmaceutical companies later developed higher-dose versions specifically for weight management, and GLP-1 medications quickly became part of the weight-loss conversation (Rosen & Ingelfinger, 2026)
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- Take our Disordered Eating Test
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What happened next was perhaps even more revealing. The public conversation quickly shifted from treating diabetes to shrinking bodies, making the possibility of a smaller body one of the main reasons these medications captured so much attention
That shift did not happen in a vacuum. These medications entered a culture that has spent generations equating smaller bodies with health, success, self-control, and even moral virtue. That shift in focus also raises another question: What happens when the body consistently receives less energy, regardless of how that reduction occurs?
How the Body Responds
GLP-1 medications reduce appetite, making it easier for many people to consume less energy. Energy is measured in calories, and when the body consistently receives less energy than it needs, it adapts to conserve energy and restore balance
Many weight-loss methods throughout history ultimately proved harmful because of the methods themselves. At the same time, regardless of how it occurs, prolonged undernourishment has harmful biological and psychological consequences. Added to that, for people with a current or past eating disorder, periods of undernourishment can contribute to the return of eating disorder thoughts, feelings, and behaviors they worked hard to overcome (Treasure et al., 2010)
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The Pattern, Not the Particulars
Stepping back from the biology, the broader historical pattern becomes hard to ignore. A new weight-loss method is introduced and greeted with excitement. It promises to succeed where previous approaches failed. People understandably hope this one will finally be different. Over time, the limitations and harms become clearer, whether that’s unexpected medical complications, disappointing long-term outcomes, or risks that weren’t fully understood when the treatment first came to market. Eventually another innovation arrives, carrying many of the same promises, and the cycle begins again. What history reveals isn’t simply a series of changing weight-loss methods. It reveals how readily we’ve reinvented the method without ever questioning whether the destination itself deserves reconsideration.
What History Can Teach Us
None of this means GLP-1 medications should simply be lumped together with every weight-loss fad that came before them. They are evidence-based medications with important medical uses, and ongoing research will continue to shape our understanding of their benefits and risks. History cannot tell us exactly what the future holds for GLP-1 medications. History is not destiny, but it isn’t noise either
What history can do is encourage us to approach every new breakthrough with curiosity, humility, and a willingness to question not only the method, but also the assumption driving it. History doesn’t ask us to reject every new treatment. It asks us to resist assuming that “new” automatically means “better” and to keep questioning the beliefs that shape our enthusiasm. If the past two hundred years teach us anything, it is that changing the method is not the same as questioning the goal
Stepping Outside the Framework
I think about this history when I sit with clients who feel like they have failed because they couldn’t make another weight-loss approach work. I want them to know they did not fail because they lacked enough willpower
For more than two centuries, weight-loss fads have promised that shrinking the body would bring happiness, confidence, health, or self-worth. Again and again, those promises have fallen short because they were built on the assumption that making the body smaller would solve problems that often had little or nothing to do with body size. That shift in perspective can be life-changing. It is the difference between believing you are broken and recognizing that you were handed a broken premise and asked to make it work.
Recovery, whether from an eating disorder, a lifetime of dieting, or chronic body image distress, is not about finding the next strategy to shrink your body. It is about stepping outside the entire framework that says your body is a problem to be solved. That is a much harder sell than a new pill or a new plan because it doesn’t promise a quick transformation or an easy answer. What it offers instead is something two centuries of chasing smaller bodies never could: the chance to stop waiting for the next miracle and begin living more fully in the body you already have.
Arkansas Center for Health Improvement. (2024). Fen-Phen timeline and history
Deseret News. (2005, April 28). Wyeth and Utahn reach settlement in fen-phen dispute
Rosen, C. J., & Ingelfinger, J. R. (2026). GLP-1 receptor agonists. New England Journal of Medicine, 394(13), 1313–1324. https://doi.org/10.1056/NEJMra2500106
Treasure, J., Claudino, A. M., & Zucker, N. (2010). Eating disorders. The Lancet, 375(9714), 583–593. https://doi.org/10.1016/S0140-6736(09)61748-7
