by Kathryn Pasquariello, CEED Summer Research Fellow and PhD student in clinical psychology at Suffolk University
It’s another Saturday night and there’s nothing to stream. I reluctantly flip to live broadcast and the thrills of cable TV fill the screen. Moments later, the soft smiles of paid advertising talent (so often a thin, able-bodied, White set) frolic across fields of technicolor daisies—birds chirp, the sun shines, butterflies take flight. Such wondrous splendor awaits those chosen few, fortunate to have gained access to fill-in-the-blank new weight-loss wonder drug or supplement in the pursuit of health. Much like an emergency weather alert, side effects begin to fill the sliding reel along the bottom third of the screen—and your ear canal. It’s easy to brush them off as you gaze at the happy people whose lives have been incalculably improved—their hair more voluminous, their teeth somehow whiter. Where is the representation of the possible side effects? In this case, side effects that include (but are not limited to) nausea, vomiting, cramps, dehydration, and organ damage.1 They have to show those warnings, of course, but the effect is whiplash-inducing. Not to mention the subtext that, hey, your insurance won’t actually cover those pills, or these monthly shots you have to take for the rest of your life—so good luck getting them in the first place.2 It’s a slurry of information, leaving us wondering, but is this right for me?
If you live in the Wild West of US drug (and supplement) advertising, you better be paying attention.
Interestingly, for those in Spain, the practice of directly or indirectly promoting pharmaceuticals is banned by General Advertising Law 34/1988.3 The drug manufacturer Novo Nordisk, makers of the blockbuster drugs Ozempic (approved for treatment of type 2 diabetes) and its twin Wegovy (approved for weight loss), whose rise has given way to many such ads like the ones described above, has been accused by the Spanish Minister of Health of violating this law by its direct-to-consumer medication advertising.4 Novo Nordisk has relied on social media and billboards to get their point across (places where, notably, requirements to share relevant consumer warnings are often much more lax). And between the far-reaching claws of #SkinnyTok5 and 24/7 access to doctors on demand, it’s easier than ever to cherry-pick your health advice—without knowing if a product (supplement or pharmaceutical alike) is right for you. Companies use this to their advantage by preying upon fears of illness and death from obesity6 while subtly reinforcing the ideal that thin = best.7-9
It is this same ideal that has perpetuated some of the most dangerous public health issues we face today, including the rise in eating disorders.10 Decades of research confirm that thin-ideal internalization, body dissatisfaction, and weight stigma are potent risk factors for disordered eating.10-13 And so when pharmaceutical ads result in the perception that weight loss is a moral failing or medical necessity (no matter your actual health status), they not only pathologize larger bodies but implicitly endorse the very thinking that fuels restrictive eating, compulsive exercise, and body checking. The result is the glorification of rapid weight loss without an understanding of which population specifically these drugs are designed to serve, or the lifestyle changes necessary for long-term health, body weight aside. As more companies, pharmaceutical and beyond, strive to achieve the Ozempic effect, the line between medical treatment and socially sanctioned self-harm will continue to blur.14,15 For those vulnerable to eating disorders, the messages spread by weight loss drug advertisements are not just misleading, they’re dangerous—and in the European Union, they’re illegal.4,16,17
Novo has since taken down the social media posts in question, with a statement that their intention was to “raise awareness without stigma.”18 But many believe the damage has been done, and that Novo Nordisk is simply one company of many taking advantage of a vulnerable population. Such marketing in the US can ultimately instill more fear than encourage meaningful action, while simultaneously damaging the direct doctor-patient relationship (as patients seek out any doctor who will prescribe any drug they believe they need—because after all, their favorite news station, or their favorite influencer, said so). The rise of glucagon-like peptide 1 receptor agonist (GLP-1) drugs, and the parallel changes in what’s possible with advertising, will undoubtedly impact the clinical landscape for eating disorder populations.
References
1. Novo Nordisk. Possible Side Effects of Ozempic® (semaglutide) Injection. 2024. https://www.ozempic.com/how-to-take/side-effects.html (accessed).
2. Bulik, C. M.; Hardaway, J. A. Turning the tide on obesity? Science 2023, 381 (6657), 463. DOI: 10.1126/science.adj9953
3. Law 34/1988 on General Advertising. Law 34/1988 on General Advertising. Spain, 1988.
4. Galvin, G. ‘Very obvious:’ Novo Nordisk may be illegally advertising Ozempic, says Spain’s health secretary. Euro News: 2025. https://www.euronews.com/health/2025/06/27/very-obvious-novo-nordisk-may-be-illegally-advertising-ozempic-says-spains-health-secretar
5. Martin, H.; Hohman, M. What is SkinnyTok and why did TikTok ban it from search? TODAY.com, 2025. https://www.today.com/health/mind-body/what-is-skinnytok-banned-on-tiktok-rcna211003 (accessed).
6. Mouzo, J. ‘Obesity can kill’: Controversial campaign by Ozempic drugmaker sparks backlash. El Pais, 2025. https://english.elpais.com/health/2025-06-18/obesity-can-kill-controversial-campaign-by-ozempic-drugmaker-sparks-backlash.html.
7. Garner, D. M.; Garfinkel, P. E. Socio-cultural factors in the development of anorexia nervosa. Psychol Med 1980, 10 (4), 647–656. DOI: 10.1017/s0033291700054945
8. Owen, P. R.; Laurel-Seller, E. Weight and shape ideals: Thin Is dangerously in. J Appl Soc Psychol 2000, 30 (5), 979–990. DOI: https://doi.org/10.1111/j.1559-1816.2000.tb02506.x.
9. Brownell, K. D. Dieting and the search for the perfect body: Where physiology and culture collide. Behav Ther 1991, 22 (1), 1–12.
10. Schaefer, L. M.; Burke, N. L.; Thompson, J. K. Thin-ideal internalization: How much is too much? Eat Weight Disord 2019, 24 (5), 933–937. DOI: 10.1007/s40519-018-0498-x.
11. Fitzsimmons-Craft, E. E. Social psychological theories of disordered eating in college women: review and integration. Clin Psychol Rev 2011, 31 (7), 1224–1237. DOI: 10.1016/j.cpr.2011.07.011
12. Stice, E.; Marti, C. N.; Durant, S. Risk factors for onset of eating disorders: evidence of multiple risk pathways from an 8-year prospective study. Behav Res Ther 2011, 49 (10), 622–627. DOI: 10.1016/j.brat.2011.06.009
13. Cruz-Sáez, S.; Pascual, A.; Wlodarczyk, A.; Echeburúa, E. The effect of body dissatisfaction on disordered eating: The mediating role of self-esteem and negative affect in male and female adolescents. J Health Psychol 2020, 25 (8), 1098–1108. DOI: 10.1177/1359105317748734
14. Columbia University. The Ozempic Effect: Everything You Need to Know About Medical Weight Loss. https://columbiasurgery.org/news/ozempic-effect-everything-you-need-know-about-medical-weight-loss
15. Shmerling, R. What happens when a drug goes viral? Harvard Publishing: Harvard Publishing, 2023. https://www.health.harvard.edu/blog/what-happens-when-a-drug-goes-viral-202302212892
16. Shreiner, M. Is the US one of only two nations that allow direct advertising of prescription drugs? Wisconsin Watch, 2025. https://wisconsinwatch.org/2025/05/prescription-drug-direct-advertising-us-new-zealand-pharmacy/ (accessed).
17. Velo, G.; Moretti, U. Direct-to-consumer information in Europe: the blurred margin between promotion and information. Br J Clin Pharmacol 2008, 66 (5), 626–628. DOI: 10.1111/j.1365-2125.2008.03283.x
18. Rada, A. G. Spanish officials investigate Novo Nordisk’s obesity awareness campaign. BMJ 2025, 389, r1319. DOI: 10.1136/bmj.r1319
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