GLP-1 stigma is different in men. Here’s how to cut through it
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A lot of men come into appointments already feeling judged about their weight. Online masculinity content often pushes the idea that men should ‘fix themselves’ through discipline alone, so some patients see GLP-1 medications as weakness instead of treatment.
—Ryan Peterson, MD
Good health and physical attractiveness are clearly on people’s minds these days, men included.
Epic Research reported that US adult GLP-1 prescriptions rose from about 1,900 to 9,000 prescriptions per 100,000 patients between Q2 2021 and Q1 2026. [] In 2024, 26.5% of U.S. adults with diagnosed diabetes used GLP-1 injectables, with similar use in men and women. []
At the same time, looksmaxxing and manosphere-linked appearance content have become visible enough to generate peer-reviewed research, physician warnings, and mainstream reporting. []
For physicians, the issue is how online masculinity narratives shape obesity treatment, body image, sexual health concerns, and trust in medical advice.
Related: ‘Bigorexia’ is on the rise—how can physicians help?GLP-1 stigma is starting to sound like discipline language
Male patients may not describe stigma as shame. They are now framing it as discipline, toughness, or self-control.
“A lot of men come into appointments already feeling judged about their weight. Online masculinity content often pushes the idea that men should ‘fix themselves’ through discipline alone, so some patients see GLP-1 medications as weakness instead of treatment,” says board-certified physician Ryan Peterson, MD. “Because of that, some men delay getting help even when their weight is affecting their health.”
That maps onto emerging stigma research. A 2026 Rice University study found GLP-1 users were socially penalized compared with people who lost weight through diet and exercise. []
A 2026 Georgetown study also found greater stigma toward GLP-1–associated weight loss than toward that achieved by diet and exercise. []
Betsy Greenleaf, DO, a quadruple board-certified physician, takes a similar view. “I think the stigma around GLP-1 medications is unfair and outdated. Obesity and metabolic dysfunction are not simply willpower problems.”
That does not mean physicians should present GLP-1s as stand-alone treatment. Muscle loss, nutrition quality, protein intake, resistance training, sleep, alcohol use, and cardiometabolic monitoring still matter. “The GLP medications are a tool in our tool box but are not the answer,” Dr. Greenleaf says.
Watch for 'looksmaxxing' red flags
“Looksmaxxing” is often presented online as self-improvement, starting with grooming, fitness, or cosmetic curiosity.
But it becomes clinically relevant when it shifts into compulsive appearance monitoring, extreme restriction, supplement stacking, anabolic steroid use, unsafe procedures, or self-injury.
A 2025 analysis of more than 8,000 comments from Looksmax.org concluded that looksmaxxing communities harm men’s health by body shaming users, encouraging body alteration, and normalizing self-harm. []
Daniel Careaga, MD, a board-certified plastic surgeon, says red flags include “rapid weight loss, extreme dieting, drastic restrictions, excessive focus on their appearance, or undisclosed use of supplements.”
Michael Chichak, MD, adds that physicians should also look for “disrupted sleeping patterns, unstable mood states, and preoccupation with body image and masculine ideals.”
Gevork Tatarian, MD, shares his practical screening cue: “Physicians should pay attention when young men describe body goals in rigid, obsessive, or internet-derived language: ‘looksmaxxing,’ ‘bone smashing,’ extreme cutting, jawline obsession, very low body-fat goals, or fear of looking ‘low value.’"
Sexual health discussions could be an entry point
According to Sergey Terushkin, MD, FACS, FASMBS, bariatric surgeon, many young men may not open a discussion of their health concerns by citing depression, shame, or body dysmorphia. They may open with libido, erections, fertility, gym performance, or confidence.
“A man is not going to enter a room and say he is feeling depressed or insecure about his appearance,” says Dr. Terushkin. “He will bring up his libido, his workout performance, self-confidence, ability to reproduce, or how he gets along with other people. These are also valid reasons for a visit to the doctor.”
That is the opening that the physician can pick up on. Then, the physician can ask about sleep, stress, alcohol, cannabis, anabolic steroids, supplements, nonprescribed peptides, pornography use, erectile function, fertility goals, mood, and suicidal thoughts.
The 2025 systematic review of online discussion board comments found that emotional suppression, self-reliance, and fear of judgment do, in fact, deter men from seeking mental health support. []
For physicians, this supports the use of direct, function-based questions rather than abstract emotional screening alone.
Do not start by attacking the influencer
Immediate dismissal often confirms the patient’s concern. Dr. Peterson says, “Men who spend a lot of time in online fitness or manosphere spaces may already distrust doctors before the appointment starts. Instead of arguing, it helps to listen first and explain things in simple language. Patients are more open to advice when they feel respected instead of dismissed.”
“When patients lack trust in physicians due to listening to podcasts and TikTok, debating does not help much,” Dr. Terushkin says. “My usual reply to such patients would be ‘Let’s see what your body is really doing at this moment,’ or ‘I’m more concerned with your lab results and imaging rather than your online debates.’”
Dr. Tatarian uses similar language: “My job is not to judge where you got the information. My job is to help you separate what may get you a fast result from what may hurt you long term.”
Collaboration over confrontation is also Dr. Careaga’s preferred approach. “I ask what resonated with them, and review it together in light of their health. A collaborative discussion is better than a debate, and it fosters long-term trust with the patient.”
Related: Getting men more engaged in their healthcare