What Serena Williams’ GLP-1 Story Reveals About Health and Weight

When Serena Williams became the face of a new GLP-1 campaign, the internet freaked out. Most people applauded her transparency, others struggled with the idea that one of the greatest athletes of all time “needed” weight-loss medication. The CEO of Ro (the company she’s repping) was candid about why they chose her, because people would say she doesn’t need it. The strategy is to normalize GLP-1s not as last-resort medical interventions, but as lifestyle products for anyone who wishes they were a little smaller, even for those who aren’t typical candidates.

This is a big change in marketing these drugs. When a global icon known for power, discipline, and relentless effort says, “Sometimes people do absolutely everything, and it doesn’t work,” saying that the effort doesn’t count if you’re not getting down to the weight you believe is “healthy” for you, that message carries an impact for millions of people that goes far beyond health. 

And let me be clear, I am not blaming Serena for this, at least not fully.

What Are GLP-1s?

Ozempic, Wegovy, Zepbound, and Saxenda are part of a class of medications called GLP-1 receptor agonists (short for glucagon-like peptide-1). They were originally developed to help people with type 2 diabetes manage blood sugar. These drugs mimic a natural gut hormone that regulates appetite and insulin:

• They slow digestion, which can make you feel full faster
• They act on the brain to reduce hunger signals
• They stimulate insulin release and help prevent the liver from releasing stored glucose

For people with diabetes, this is fantastic, lifesaving even. GLP-1s have also been shown to support conditions like fatty liver disease, heart and kidney protection, help reduce the severity of sleep apnea. And emerging research is showing use in people with alcohol use disorder and potential in other addictions and psychiatric conditions.

There are lots of people who will benefit from taking them. But there is another side to the story. 

These drugs have exploded in popularity recently because newer, higher-dose versions (like Wegovy and Zepbound) were FDA approved specifically for “chronic weight management”, not just diabetes. 

But while they can absolutely be helpful for some, they’re not magic — and they come with real risks and a high price tag, especially for people with a history of disordered eating and eating disorders, or who are prone to under-eating or feeling triggered by appetite changes. And despite what you may think, that includes binge eating – as I explore in a previous  post.

Serena Did Everything and Still “Needed” Help With GLP-1s… Hmm

In an interview about why she’s taking these meds, Serena described her athleticism, walking 30,000 steps a day, training for hours in the heat, even having her coach raise concerns about her weight on camera. On the Today show she was blunt: “As an athlete and as someone that has done everything, I just couldn’t get my weight to where I needed it to be at a healthy place, and believe me, I don’t take shortcuts.”

What stands out here isn’t a lack of effort. It’s the myth that effort guarantees weight loss and that if you’re not losing weight (or “enough” weight) here is something broken or not working in your body that you should fix in order to be healthy.

Postpartum recovery is long and grueling. Research shows it can take up to three years for a body to fully recover from pregnancy and birth. Your hormones shift, your joints and ligaments adapt, your time, sleep, and priorities are permanently altered.

I know that feeling resonates. Many of my clients come to me saying they’ve tried everything: dieting, over-exercising, doubling down on rules — and still feel out of control with food or uncomfortable in their body. 

This is not a failure of willpower, as so many people think. But it’s also not your body doing something wrong. It’s biology. It’s life. 

Getting down to the weight you were before you had children is not always possible, necessary, or even healthy, despite what you probably hear in the mainstream media. And it’s why chasing “pre-baby weight” can leave people stuck in cycles of restriction, rebound, and shame (see my post on weight cycling →).

She Doesn’t Need GLP-1s, But That’s Exactly Why It Matters

Ro’s CEO was explicit: Serena was chosen for this campaign because she doesn’t “need” GLP-1s. That’s what makes her the perfect spokesperson. It sends the message: even if you’re not a typical candidate — even if you don’t have diabetes or major risk factors — these medications are for you too. 

The cultural impact here is huge. 

We’re not talking about a random influencer — we’re talking about Serena Williams, someone whose brand has always been power, resilience, and effort. If she needed medical help to lose weight, what does that say to the millions of women already doubting their bodies?

The Body Scrutiny Serena Has Endured

Serena’s body has been a target of racist and misogynist commentary her entire career. She’s been called “too muscular,” “too big,” “too masculine” — critiques deeply rooted in anti-Blackness and sexism. If you want to dig deeper into this history and understand how relevant it is to this conversation, I recommend Sabrina Strings’ Fearing the Black Body, Chrissy King’s The Body Liberation Project, and Mikki Kendall’s Hood Feminism. All completely excellent. 

And of course, Serena’s story isn’t unique or is it isolated to black women.

All women live in a culture that scrutinizes our bodies relentlessly, telling us thinness equals discipline and worth and that being thin will make you more lovable and marketable. 

But we can choose to unlearn this and shift the narrative. We, as people of all genders, men too!, can reject the notion that weight loss by all means is the only way we can feel good about ourselves. Body neutrality and positive body image frameworks like More Than a Body can shift the focus away from appearance toward respect, health, joy, liberation, and function.

This is also exactly the kind of work I do with clients inside Love Food Again — building body trust, reducing food obsession, and stepping off the treadmill of scrutiny and shame. Plus, of course, building sustainable nutrition practices that make you feel good. 

When “Doing Everything” Still Isn’t Enough

When Serena says, “I did everything,” we need to question what “everything” means. Because in our culture, “everything” often translates to restricting harder, exercising more, and blaming yourself when either your body doesn’t do what society tells you it should, or when you exhaust yourself trying and end up back on the couch.

The reality is, most people can’t keep weight off long-term. Studies show that dieting and weight loss attempts frequently lead to weight regain, and often more than before. This cycle,  called weight cycling,  is harmful to metabolic and cardiovascular health. Yet our healthcare system rarely acknowledges that harm.

This is why I’ll be writing more soon about the health costs of weight cycling, because it’s not just frustrating, it’s dangerous to health and if I’m being honest, I think one of the biggest public health issues of our time. 

How This GLP-1 Campaign Is Harmful

There are two layers of harm in this campaign.

First, the cultural harm: by putting Serena front and center, Ro is normalizing GLP-1s as a default “solution” for anyone who feels stuck with their weight. The ad doesn’t highlight the original medical purpose of these drugs — blood sugar management for type 2 diabetes — it highlights weight loss as health. That message reinforces diet culture’s lie that the number on the scale is the most important metric of wellness. It also sidelines conversations about sustainable habits, postpartum recovery, and body trust.

Second, the clinical harm: these medications are not risk-free, and they’re not for everyone. We have almost no long-term data on whether GLP-1s improve binge eating outcomes. Short-term studies suggest some reduction in binge frequency, but we know that any cycle of restriction fuels rebound eating. And since most people don’t stay on these medications longer than a year, we can reasonably expect that many will face weight regain and renewed disordered patterns.

We also need to talk about the risks for people with eating disorders. While GLP-1s can be powerful tools for managing diabetes and sometimes lowering cardiovascular risk, their appetite-suppressing effects are a double-edged sword. 

As this article on GLP-1s and eating disorders explains, Ozempic and other drugs in this class can worsen malnourishment, disrupt recovery, and negatively impact mental health. Researcher Dr. Cynthia Bulik cautions that this “focus on weight and erasing the desire to eat could indeed do harm.” 

The uncertainty highlights what I tell my clients all the time: if you have a history of disordered eating, you need a healthcare team who will look at your whole self — not just your weight or blood sugar — before prescribing a medication that affects your appetite and weight in ANY WAY. 

What Serena’s Story Has To Do With You

You don’t need to be an elite athlete to relate to Serena’s story. Plenty of people I work with feel like they’ve “done everything right” – cut carbs, tracked calories, exercised excessively, only to feel exhausted and frustrated that their body won’t do what they want it to. 

That’s because biology doesn’t care about our thin-obsessed culture. Restriction increases cravings, makes the food noise increase and the binges stick around.  Stress hormones affect appetite. Sleep, hormones, and life stage (hello postpartum, perimenopause, menopause) all shift how bodies respond. You are not broken for struggling.

And here’s the connection: when someone as disciplined as Serena Williams says effort wasn’t enough, it proves what I want you to know — your weight does not dictate your health. If your labs are good and you’re “overweight” you are healthy. 

We live in a culture that reduces health to a number on the scale, and relentlessly tells us that any weight gain is the worst possible problem and something to fear and change at all costs. 

How To Decide If You Should Take a GLP-1

If you’re considering GLP-1s, I’d encourage you to start with a pros and cons list. Look not only at the medical side but also at your relationship with food and body image.

• If you have type 2 diabetes, high blood sugar, or cardiovascular risk, these drugs can absolutely be worth discussing with your doctor.
  
• If you have an eating disorder history or are undernourished (no matter your weight), they can pose serious risks. Work with an ED-informed provider who will take your full picture into account.
  
• Be realistic: these drugs are meant as lifelong medications. If you stop after losing weight, your body will likely return to where it was. That’s not failure, that’s biology. You are not likely going to be the exception, sorry to say.
  
• And most importantly: think about whether this aligns with how you want to live. Will a suppressed appetite and difficult side effects support your long-term wellbeing?
  

I’m not here to tell you don’t do it. I’m here to tell you to go in with your eyes wide open.

What I Tell My Clients About GLP-1s

Many of the people I work with have lost and regained the same 20, 30, even 50 pounds—over and over again. They’re exhausted by it. They come to me wanting to end that cycle once and for all, to stop obsessing about their body, and to find a way of eating that truly supports their health in a sustainable way.

That usually means shifting the focus away from weight loss so we can quiet the scarcity mentality and rebuild trust with food. High-dose GLP-1s, which dramatically suppress appetite, can make that process harder—I won’t sugarcoat it. At the same time, I know these medications can be genuinely useful for some people with health concerns, family history, or high blood sugar.

My advice? Work with an eating disorder–informed clinician who can monitor your appetite, nutrition, and well-being closely—and be sure you’re comfortable with the likelihood of lifelong use. It’s a big decision. If you’re at that crossroads and this post resonates, consider reaching out for support.

Final Thoughts

GLP-1s are not for everyone. But they can be a helpful tool for some. My suggestion: find a doctor who isn’t pushing them but will have an open conversation about risks and rewards. If you have a history of eating disorders, talk to your ED practitioner — or book an appointment with me to get support.

I’m not trying to scare anyone off these meds. I want you to be informed, to protect your relationship with food, and to choose healthcare that supports your whole self.

Because at the end of the day, your body isn’t a shortcut project. It’s your home. And you deserve care that strengthens your health and trust — not just shrinks your weight.

About Emily

Emily Van Eck, MS, RDN specializes in Intuitive Eating, eating disorders, body image, women’s reproductive health, and healing from years of weight-bias and disordered eating. She helps people find balance, consistency, and peace with their eating habits so they can feel confident to get outta their heads and into their bodies. Emily is a registered dietitian and certified Intuitive Eating counselor with a master’s degree in nutrition science. Read more about her practice, values, and experience here.