How Serena Williams’ admission of using a GLP-1 drug could impact the stigma of obesity
Serena Williams’ GLP-1 disclosure may shift obesity conversations, though treatment requires a holistic approach, Northeastern experts say.
After years of hard work and 23 Grand Slam singles titles, no one could accuse Serena Williams of lacking willpower. Yet the tennis star recently revealed that she turned to a GLP-1 drug to shed stubborn weight that wouldn’t budge despite a healthy diet and rigorous workouts.
Her public disclosure could be what’s needed to destigmatize obesity, Northeastern University experts say, and encourage people who struggle with their weight to consider GLP-1 treatments.
“She could be a good role model,” says Debra Reid, clinical professor of pharmacy and health systems sciences. “She is a woman of color, and this population can be disproportionately affected by obesity. It’s more common in women in general, but non-Hispanic Black women have higher rates of obesity.”
Williams opens up
In August, Williams revealed in an interview with Vogue that she struggled to lose weight after giving birth to her second daughter in 2023.
“My whole life is being in the gym, working out, running, training, HIIT training, dancing, every single thing you can think of. I would always get to a certain point on the scale, but I could never get below that. That’s when I decided that it was time to try something different and got on the GLP-1 with Ro,” Williams said.
She has been taking a GLP-1 drug, Zepbound, which she accessed through Ro, a direct-to-consumer telehealth company. Her husband, Alexis Ohanian, is an investor in Ro and serves on its board. Williams has since partnered with the company to share her story.
While this partnership raises questions about financial incentives, Reid says her openness is important.
“Some of the myths around obesity are that people who are overweight or obese are lazy or they lack self-discipline or it’s just a problem of willpower,” she says. “And I think … you wouldn’t label her as any of those things.”
Why turn to GLP-1?
Without knowing her medical history, Reid says it is difficult to know exactly why Williams struggled to shed pounds. Hormonal changes from pregnancy, aging and lifestyle adjustments after retiring from professional tennis in 2022 may all have played a role.
Obesity is a complex disease, Reid says, and many people struggle with weight their whole life.
Weight is also shaped by body composition, or a unique mix of muscle, fat, bones and water content, says Carmen Sceppa, dean of Northeastern’s Bouvé College of Health Sciences.
“Some of us are heavier than others, but not necessarily overweight or not necessarily out of shape,” she says.
What are GLP-1 drugs?
GLP-1 stands for glucagon-like peptide-1 and is a naturally occurring hormone that triggers insulin release from the pancreas. Insulin helps move sugar from the bloodstream into cells for energy.
GLP-1 drugs, also known as GLP-1 agonists, stimulate the pancreas to release insulin and suppress glucagon, another hormone that raises blood sugar.
The first GLP-1 drug, Exenatide (brand name Byetta), was approved by the Food and Drug Administration in 2005 to treat type 2 diabetes. Since then, drugs such as Ozempic, Wegovy, Mounjaro and Zepbound have gained wide attention for their effectiveness in weight loss.
These drugs, Reid says, signal to the brain to lower appetite, which leads to significant changes in metabolism.
But the medications remain expensive, with demand driving the price. The supply, however, has improved, Reid says, and private companies like Ro have been improving access to the treatments.
“Access to care is a huge barrier, whether it be to a health care provider or to access the medication,” Reid says.
There’s typically strict criteria for who can be approved for these medications for weight loss purposes. A lot of insurance companies use body mass index and health risk factors to determine coverage.
Reid is also concerned about the misuse of GLP-1 drugs by people who don’t need to lose weight but think they do.
“It has to be a discussion between the patient and a provider to determine if the patient truly does need medication like this,” she says.
Body positivity and health
The medical community and many big medical organizations now recognize obesity as a complex chronic health condition. However, stigma persists. For years, insurers dismissed weight loss as cosmetic.
“We’ve really been working towards educating providers, first of all, about recognizing that and learning how to talk to and work with patients to really destigmatize the whole weight piece,” Reid says.
At the same time, she notes, the body-positivity movement should strike a balance.
“There is nothing wrong with being happy in your own body and not feeling ashamed of it,” Reid says. “But are you healthy? If you are at risk of developing diabetes, high blood pressure, heart disease, all these things that obesity can contribute to, then I would argue that it’s not a good thing, but it’s not about shaming.”
Public health approach
Sceppa stresses that while GLP-1 medications can drive weight loss, they also come with trade-offs.
“We lose not only fat, but also muscle mass as rapidly as fat tissue,” Sceppa says. “And muscles are very important to keep our body healthy.”
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Rather than settling on a quick approach of taking medication, she says, patients should look at what changes they could make in their lifestyle.
“Lifestyle is the best preventative medicine,” Sceppa says. “It is an approach to manage obesity.”
Such changes could include less alcohol consumption and smaller food intake.
“If you don’t want to change your intake of calories, you can increase exercise to burn more calories,” she says.
To lose one pound a week, patients need to eat 500 calories less a day or burn an extra 500 calories.
While prescribing GLP-1 drugs addresses obesity one patient at a time, Sceppa says, a broader public health approach to reach many people at scale is essential.
“As a society, we’re still going to have very large rates of overweight and obesity because we’re not addressing that issue in schools with physical education, with less screen time at the workplace,” she says. “Our lifestyle at home, school and work tends to be sedentary.”
The bigger question, she says, is whether people will need to stay on GLP-1 drugs indefinitely. “Maybe. Just like with blood pressure medication, it’s rare for someone to stop once they start.”
Ultimately, experts agree that medication is just one tool.
“You need to factor exercise in your day and change your relationship with food,” Sceppa says. “These changes don’t happen overnight but we have to be mindful.”
