Is fat on the way to becoming extinct?
GLP-1 medications for weight loss soaring
Over the past few weeks, my algorithm, like many others, has been filled with clips of Oprah Winfrey and Serena Williams speaking openly about GLP-1 medications and the role they played in their weight-loss journeys. That matters.
When people of that stature speak candidly about something that was once whispered about, it shifts the culture. It normalises curiosity. It gives people permission to ask questions they may have been sitting with quietly for years.
Serena Williams, in particular, was very clear. She said she tried everything from intense exercise, disciplined training, strict dieting and still struggled. It was only after incorporating a GLP-1 medication, under medical guidance, that she saw meaningful change. That honesty resonated, especially with women who feel they have done “all the right things” and still found their bodies resisting.
A national conversation
This article is not meant to tell anyone what to do with their body. It is meant to begin a national conversation grounded in evidence, not hype, about what GLP-1 medications are, who they may help, and how they should be used responsibly. Right now, too much of what people know is coming from celebrity interviews and social media clips, not from doctors or science.
At the same time, last week I saw a flyer promoting a health forum with the words “big belly and big back” splashed across it. I shook my head. It was meant to be catchy, maybe even motivating, but it highlighted how casually body shaming has slipped into conversations about health. As if embarrassment is an acceptable tool. As if the goal is a perfect body rather than an overall healthy one. We need to pause there.
Life-changing results
GLP-1 medications are not new. Drugs such as Ozempic (semaglutide) have been prescribed for years to treat Type 2 diabetes. Clinically, they work by mimicking a naturally occurring hormone that regulates appetite and blood sugar, helping people feel fuller and consume fewer calories. Large clinical trials, including the STEP studies published in The New England Journal of Medicine, showed average weight loss of roughly 10–15 per cent over about a year when semaglutide was used alongside lifestyle changes. For people living with obesity and related conditions, those results can be significant and, in some cases, life- changing.
But one of the most persistent misconceptions is that these medications replace long-term lifestyle change. They do not. Even in clinical trials, GLP-1s were most effective when combined with nutrition, movement, and ongoing medical support. Treating them as substitutes rather than supports sets people up for disappointment and, in some cases, harm.
That nuance is often lost online. This is where science and culture are currently out of sync. The science speaks carefully, in data and conditions. The culture speaks loudly, in before-and-after photos and shortcuts. When those two drift too far apart, people make decisions under pressure rather than with understanding.
About two years ago, someone reached out to me after seeing Ozempic being sold on social media by someone they follow. The post showed a photo of the medication laid out on someone’s bed, with a simple caption: “DM to order”. No prescription. No medical oversight. No information about storage, dosage, or authenticity. That moment has stayed with me because it captured just how dangerous this trend can become.
These are not supplements. They are prescription medications that require medical assessment before starting blood work, screening for contraindications, and ongoing monitoring once treatment begins. Buying injectable drugs from a stranger on the Internet without knowing if they are real, expired, improperly handled, or even safe puts people at serious risk.
International regulators have since warned about counterfeit and compounded versions of semaglutide sold illegally online, some of which contain incorrect or harmful ingredients. This concern is not anecdotal, it is now reflected in global guidance. In December 2025, the World Health Organization (WHO) issued its first global guideline on the use of GLP-1 medicines for treating obesity, formally recognising obesity as a chronic, relapsing disease, not a personal failing or lifestyle flaw.
The guidance strikes a careful balance. The WHO acknowledges that GLP-1 therapies are the first medications shown to be genuinely effective in helping adults with obesity lose weight and improve metabolic outcomes. At the same time, its recommendations are conditional, not blanket endorsements, citing limited long-term safety data, high cost, health-system readiness, and serious equity concerns.
Crucially, the WHO is explicit that medication alone will not solve the obesity challenge. GLP-1 therapies should only be used as part of a comprehensive approach that includes healthy diets, physical activity, and ongoing support from qualified health professionals.
Counterfeit products
The organisation also flags exactly what we are now seeing globally and locally: rising misuse, counterfeit products, unregulated access, and widening disparities. Without proper oversight, access to these drugs could deepen existing health inequities and expose people to serious harm.
Widespread misuse not only endangers individuals. It puts additional strain on hospitals and health systems already managing chronic disease, emergencies, and limited resources. Preventable complications become everyone’s burden.
There is also an uncomfortable truth emerging. As access to GLP-1s remains uneven, thinness risks becoming less about health and more about affordability. When the line between “fat” and “skinny” starts to look like income, shame deepens and public health loses.
Here in Jamaica, my concern is not about people seeking help. Obesity is a public-health challenge, not a personal failure. Bodies are complex. Hormones matter. Genetics matter. Mental health matters. No one should be shamed for using a medically appropriate tool under a doctor’s care.
My concern is about how these drugs are being accessed and discussed. Globally, the surge in off-label use has already contributed to shortages for diabetic patients who rely on these medications for disease management. Research from the United States suggests that a significant share of prescriptions in recent years were written for weight loss rather than diabetes treatment. That imbalance has real consequences.
This conversation feels unavoidable right now because bodies are visibly changing. People are drinking less. Protein has become a buzzword. Weight loss is happening faster and more publicly than before. But speed should never outrun sense.
Popularity alone is never enough
As Minister of Health and Wellness, my position is simple: I go where the science goes. That means recognising the potential of GLP-1s while also insisting on evidence, oversight, and equity. Popularity alone is never enough. If you are considering a GLP-1 medication or already using one, the most important step is to consult with your healthcare provider. Speak to your doctor. Ask questions. Understand the risks, the benefits, and the role this medication plays alongside long-term habits.
GLP-1s may well change how obesity is treated worldwide. The science is evolving, access is expanding, and the conversation is only getting louder. That makes it even more important that we slow it down enough to include doctors, evidence, and common sense.
Trends move quickly. Bodies do not. The real question is not whether fat is becoming extinct. It is whether we can talk about weight, health, and medicine with honesty, humility, and care before culture does all the talking for us.
Dr Christopher Tufton is Jamaica’s Minister of Health and Wellness. E-mail: cctufton@gmail.com