Disclaimer: VIS Expert Christina Kamilaris’ dietetic intern, Julia Schwartz, answered the interview questions for this article with Kamilaris’ oversight and approval.

It seems that every time we turn on the TV or open up social media, we see an ad for Ozempic, Zepbound, or another GLP-1 medication. GLP-1 medications have taken the world by storm over the past year, and they aren’t going anywhere. 

As more social media influencers, celebrities, our close family and friends, and even professional athletes rapidly lose weight with these medications, it is so easy to fall into the comparison trap. And GLP-1s aren’t the only contributor. These days, diet culture and skinny culture seem to be louder than ever. 

The pervasive message that women need to become as small as possible makes listening to and accepting our bodies challenging. Being strong and fueling our bodies for health and performance almost feels … wrong. Many of us struggle with body image, overthink our fueling habits, and question if we too need to change our bodies. 

But are GLP-1s or those fueling patterns that our favorite social media influencers are promoting really a good choice for women athletes? Are they even safe? How can we tune out the outside noise and do what is best for our bodies in a world that makes it feel so complicated? We talked to VIS Experts Meghan Vogt, LCSW, Heather Caplan, RD, Christina Kamilaris, RD, and her dietetic intern, Julia Schwartz.

What are GLP-1s?

Every time we eat, our intestines release a hormone called glucagon-like peptide-1 (GLP-1) that regulates blood sugar and digestion. 

“It tells the pancreas to release insulin, which helps move glucose away from the bloodstream into your cells for energy,” Schwartz says. “It also slows stomach emptying and signals the brain that you’re full. As a result, blood sugar rises more gradually, you feel fuller for longer, and appetite decreases.” 

GLP-1 is normally broken down in the body about one to two minutes after it is released. GLP-1 receptor agonists (GLP-1s) mimic the body’s natural GLP-1, further increasing insulin release and slowing stomach emptying. This reduces appetite and food cravings, typically leading to weight loss.

GLP-1s may be prescribed to improve blood sugar control and decrease cardiovascular risk in people with Type 2 diabetes and obesity. But they are not prescribed in isolation. “These medications are most effective when used alongside sustainable nutrition, physical activity, and other lifestyle habits; they’re not a replacement for them,” Schwartz says.

Like all prescription drugs, GLP-1s are meant to treat specific conditions under the guidance of a medical professional. Their long-term effects are not yet fully understood and they can be harmful if misused, especially by children and adolescents. 

We know very little about the long-term impacts of GLP-1s, and there is especially limited research on the safety of GLP-1 drugs for children under the age of 14, even among those with obesity or related health conditions. Since childhood and adolescence are critical periods of growth and development, GLP-1 use during this time could be very dangerous. 

“It tells the pancreas to release insulin, which helps move glucose away from the bloodstream into your cells for energy. It also slows stomach emptying and signals the brain that you’re full. As a result, blood sugar rises more gradually, you feel fuller for longer, and appetite decreases.”

Julia Schwartz

Concerns for Women Athletes

Our experts agree that GLP-1 medications warrant caution, especially for young women athletes because they make it more difficult to meet the energy demands of sport. 

“Athletes may struggle to consume enough calories, carbohydrates, and protein to fuel training, recover properly, and adapt to workouts,” Schwartz says. 

Decreasing our overall energy intake also increases our risk of deficiency in nutrients that are critical for sports performance. For example, iron facilitates oxygen transport, playing an important role in aerobic training and adaptation. Women athletes have higher iron needs because iron is lost throughout the menstrual cycle. It is hard to get enough iron if we aren’t eating enough. In states of low energy availability, our bodies also produce higher amounts of hepcidin, which blocks iron absorption.

Calcium and vitamin D play critical roles in bone health. Undereating alone puts stress on our bodies. This stress, combined with a lack of bone-supporting nutrients significantly increases our injury risk. 

GLP-1s can also cause side effects like nausea, bloating, and other gastrointestinal issues that impede our health and performance.

One of our biggest assets as women athletes is our strength, and we work hard for that strength! GLP-1s can lead to significant reductions in muscle mass, especially without adequate protein and resistance training. Muscle loss certainly compromises athletic performance, but its negative effects don’t end there. 

“Building and maintaining muscle improves strength, power, and recovery, but it’s also associated with better metabolic and cardiovascular health, improved insulin sensitivity, and greater independence as we age. It’s equally important for bone health,” Schwartz says. 

Restricting our fueling and losing weight with GLP-1s without the guidance of a professional just isn’t worth it.

There are some situations where a woman athlete may be prescribed a GLP-1 if she is living with obesity or type 2 diabetes. In such cases, athletes should work closely with their doctor and a registered dietitian to make sure they are meeting their fueling needs. “The goal is to improve health, not simply to become smaller,” Schwartz says.

The Medications are not the Problem

Before GLP-1s, chronic conditions like diabetes and metabolic syndrome were difficult to manage. The availability of GLP-1s has significantly improved the health trajectories and quality of life of those with these conditions. 

The mechanisms and side effects associated with GLP-1s are complex. Even the most experienced medical researchers and practitioners do not fully understand their long-term effects. Our society strays away from this complexity and sends a generalized message that smaller is better. 

This message, not the GLP-1s themselves, is a problem.

“So many young people are hearing that losing weight is the goal and that being smaller automatically means being healthier or more successful,” Vogt said. “For athletes, that message can be especially harmful because performance depends on having enough energy available to train, recover, and adapt. ”

We often still hear the myth that “lighter is faster” or that only one body type can succeed in a given sport. But these statements are overgeneralized and often untrue, especially for women athletes. 

Weight is just one of over 40 factors that play a role in performance, and focusing on weight negatively impacts several other factors, including strength, speed, and power. When we underfuel or pursue unnecessary weight loss, we increase our risk for REDs, which can affect hormones, bone health, recovery, performance, and overall well-being.

Performance gains happen as we adapt to consistent training. The more weeks, months, and years of training we can stack, the better. We can’t do this in an underfueled state. 

Underfueling is Multifaceted

When we’re chasing athletic goals, we try to do everything “right” so we can reach our performance goals. We’re willing to train hard and push our limits each day, but we can’t do this if we don’t fuel adequately. And fueling adequately isn’t easy for everyone. 

“Strong, healthy, well-fueled bodies don't always fit the narrow beauty standards that dominate social media,” Vogt said. “As a result, many athletes feel caught between two competing goals. They want to become stronger for their sport, but they also feel pressure to become smaller.”

Far too many women athletes aren’t eating enough to support their health and athletic performance. The dialogue surrounding GLP-1s and social media have certainly made it harder to listen to our bodies and fuel for sport, but they aren't the only problem. 

Caplan explains that while cultural norms about body size, health, and athleticism prevent athletes from fueling well, many athletes don’t even know what proper nutrition looks like for them. 

“Athletes may experience a lack of access to adequate nutrition, or little or no nutrition resources in their programs—anywhere from youth sport programs to high school or collegiate programs,” she said. “On top of all of that, athletes may be getting misinformation from social media sites about how much they should be eating, or in some cases, encouraging restriction or poor sport nutrition practices.”

Unfortunately, this underfueling is often praised in our society. 

“Underfueling can look a lot like discipline,” Vogt said. “The reality is that many athletes who are underfueling don’t look like they’re struggling. They look dedicated. That can make it difficult for coaches, parents, teammates, and even the athletes themselves to recognize when there’s a problem.” 

It is important to work on our nutrition as athletes, but underfueling is not the path to sustainable training and athletic performance. As women athletes, our energy demands are high and meeting those demands can be challenging. 

The thing that actually requires discipline is fueling enough with the nutrients we need, not restricting. If you want to improve your nutrition, you can book a session with a registered dietitian who has experience working with women athletes.

“Strong, healthy, well-fueled bodies don't always fit the narrow beauty standards that dominate social media.”

VIS Expert Meghan Vogt, LCSW

Tuning Out the Noise

There are plenty of registered dietitians who share evidence-based information on social media. But Schwartz warns that there are just as many accounts that promote harmful quick fixes, fear-monger entire food groups, and make broad claims without credible evidence.

As our world continues to push the message that smaller is better, it is important that we tune that out and focus on what truly matters to us. 

Since social media can completely distort our self-image and overcomplicate nutrition, many of us lose the ability to understand what our own bodies need. 

“Social media scrolling is a habit of looking outward, but one of the keys to fueling adequately and taking care of yourself is to learn how to check in with how you are feeling, and to fuel for your needs, not someone else's,” Caplan said. 

Just because social media exists doesn’t mean it has to impact the way we view and fuel ourselves. If it does, we may need to take a break or unfollow triggering accounts.

Vogt reminds us that the way our bodies look does not dictate what they are capable of, regardless of what social media may want us to believe. 

“Social media is not a performance metric,” she said. “The body that gets the most attention online is not necessarily the body that performs the best, recovers the fastest, or stays healthy over time.” 

Instead of conforming to what we see on social media, Vogt encourages us to ask, “What does my body need to perform, recover, and feel its best?” 

If we struggle to understand our fueling needs, the best course of action is to work with a sports dietitian. Working with a mental health professional like Vogt is also highly beneficial, especially for athletes struggling with disordered eating.

The messaging surrounding GLP-1s is not going away anytime soon, and neither are the other toxic food and body conversations on social media. But we don’t have to let them impact our own decisions and view of ourselves. 

Let’s listen to the experts. The way our bodies look does not define us as athletes or as people, and fueling our bodies allows us to stay healthy and happy. And health is a precursor to performance.