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Could a 'miracle' weight loss drug mean the end the body positivity movement?

JUANA SUMMERS, HOST:

There is a lot of noise, particularly for women, around what it means to have a healthy body - how you get it and how you keep it. Don't eat carbs, don't eat fat, do eat protein, run, do yoga, lift weights. But at the end of the day, having a healthy body has been synonymous with one thing - being thin. Yet, in recent years, that idea has been challenged by body positivity activists who have preached a message of healthy at any size. And now with the arrival of a new class of weight loss drugs, often referred to as miracle drugs, is the body positivity movement at risk of fading away? It's a question that New York magazine contributing writer, Samhita Mukhopadhyay, grapples with in her recent article, "So Was Body Positivity All A Big Lie?" She joins me now to talk about her article. Welcome to ALL THINGS CONSIDERED.

SAMHITA MUKHOPADHYAY: It's great to be here.

SUMMERS: So I want to start by talking about this idea that being healthy and being thin are the same thing, which is one of the main things that you get into in this article. Let's start there. How do you see it?

MUKHOPADHYAY: The conventional wisdom has long been that, you know, no matter what your health problem is, if you go to the doctor, the doctor's going tell you to lose weight, right?

SUMMERS: Yeah.

MUKHOPADHYAY: Like, irrelevant of, you know, how your bloodwork may be or how your mobility issues are or your fitness level. And in the last couple of years, starting with body positive activists - but then also, you know, there's been quite a bit of research on this in medical science - they are seeing that the relationship between the size of your body and your health is not as linear as we have long thought, right? And so, your fitness level really matters. Your proportions matter. Your bloodwork matters.

And I think that one of the things that, you know, we're really grappling with in this moment is that we're still a culture that loves thinness, right? And so it's really hard to separate that from health. We have so internalized this idea that if you're fat, you're unhealthy, and if you're thin, you're healthy.

SUMMERS: I mean, as you're talking, I'm sitting here thinking about so many interactions I have had with health care professionals over the years where you come in with an ailment and it's like, well, how many calories are you burning? Or are you active enough? Or what's your normal lunch or dinner routine look like? And it can just be so frustrating. How do you think it is that we got to a point culturally where these two things are so intertwined in what I think many would argue could be a problematic way?

MUKHOPADHYAY: You know, we have a culture that worships thinness, right? And so, you know, Hollywood reinforces this. Media reinforces this. And it's really always been the, like, thin at any cost, right? Like, we've never criticized what people have to do to get thin or how healthy that may be, whether that's physically healthy or healthy from a mental perspective - from, like, a psychological perspective, right?

But I do think that, you know, both this media reinforcement of a type of, you know, what is considered the ideal body size really fused with also this idea of taking, you know, weight and our health - which, let's be honest, there are personal factors that lead to our health outcomes. But a lot of them are systemic - right? - like access to healthy food, having grocery stores in your...

SUMMERS: Yeah.

MUKHOPADHYAY: ...Neighborhood, living in an environment where you feel comfortable going for a walk, right? - like, all of these things that are really systemic issues that impact health outcomes. I do think it's both this internal process of, you know, we judge ourselves if we gain a little weight, you know, where, oh, I'm like, losing control. I'm not eating right. I need to do this, you know?

And those might be true, also, right? Like, we know when we're not being our best selves, and we're not taking care of ourselves. But the way that the systems - kind of both our society, our culture, and the medical system - continue to reinforce that, I think has made it very hard to disentangle those two things.

SUMMERS: You've written in this piece and in others about your decision to go on Mounjaro. You've described it as a choice that you struggled with. And you've now been off of that medication for months. I'm curious, how do you personally think about that? How has that experience changed - if it has - the way you feel about your body?

MUKHOPADHYAY: Yeah. It's been really hard. You know, the medication does a lot of different things. You know, you don't crave food as much, right? Like, your relationship to food really changes. So fried food is really hard to digest. If you eat too many sweets, you get really sick. And so there were certain things that happened while doing it where my body would have a really exaggerated reaction to something that I would have normally just eaten and been like, oh, my God, I'm being so bad. And it was like, no, you're being real bad, girl. Like, stop eating this (laughter), you know?

And so that did force me to eat fresher foods and more vegetables and more fruit. And I was craving - like, I always wanted something crunchy. So I, like, wanted crunchy salads and things like that. And that did actually have an impact on my behavior, even coming off the medication. And without it, I can tell how I feel when I'm eating well or I decide to indulge, which I do. I'm human. I love food...

SUMMERS: Same.

MUKHOPADHYAY: ...You know? You know, and I'm the child of immigrants. We have delicious food. Like, you know, I eat rice, like, all of these things, but really figuring out how to kind of balance that. And what my doctor had originally said about increased mobility was true.

I had gotten to a point where, for me and for my body, the size of my body was impacting my mobility in very subtle ways, but they were painful. And as I get older, I was feeling knee pain and ankle pain. And as I started to move more - I mean, really, all I did was I started walking. Like, I started going on these five- to seven-mile hikes and walks. And that mobility really changed my outlook. It changed my mental health. It changed my body.

And so even as I'm, you know, gaining back some of the weight, I've been - I've managed to maintain some of the lifestyle changes. And I think that that's, like, a really key piece of this that we don't talk about as much - which is, you know, how can this actually be used strategically to support people that do want to take better care of themselves?

SUMMERS: You've been open about this. You've written multiple times about your experience on Mounjaro and since then. What has that experience been like for you?

MUKHOPADHYAY: It's been really hard (laughter). It took me, like, two months to write this piece. And I think part of it is it is very hard to color within the lines that have been drawn for us in this conversation, right? It's either that you completely support it. You want to take it. It's a great medical intervention. We should all want to be thin, right? That's the dominant narrative.

But then the counter narrative is also that, like, we accept our bodies as we are. And as I write about in the piece, a lot of pressure, you know, within the community to say that, like, any move towards weight loss is perpetuating, you know, this idea that thinness is the ultimate ideal. And so, you know, part of what I wanted to - I was like, this is messy. I don't even have all the answers. But I just know that the way that I am navigating this as somebody who is a feminist, someone who is committed to body positivity, but also somebody who was facing some serious health-related concerns that I wanted to address and get ahead of, I could not be alone in this experience.

And so, yeah, it's been challenging. But it's been overwhelmingly positive in terms of the outreach that I've gotten and how many people have shared their own personal stories. I mean, my DMs are paragraphs and paragraphs of, like, heartbreaking, you know, gutting stories of people going to the doctor, the experiences that they've had or, you know, mobility issues or just so many different experiences that people have had. Or even celebrities have reached out to me and said, you know, I was feeling really judgmental about these drugs, and, like, this really helped me understand, like, you know, how I should really be thinking about it. So it's been good.

SUMMERS: Samhita Mukhopadhyay is a contributing writer with New York Magazine. Her latest article in The Cut is, "So Was Body Positivity All A Big Lie?" Thank you so much.

MUKHOPADHYAY: Thank you so much.

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Marc Rivers
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Karen Zamora
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Courtney Dorning
Courtney Dorning has been a Senior Editor for NPR's All Things Considered since November 2018. In that role, she's the lead editor for the daily show. Dorning is responsible for newsmaker interviews, lead news segments and the small, quirky features that are a hallmark of the network's flagship afternoon magazine program.
Juana Summers
Juana Summers is a political correspondent for NPR covering race, justice and politics. She has covered politics since 2010 for publications including Politico, CNN and The Associated Press. She got her start in public radio at KBIA in Columbia, Mo., and also previously covered Congress for NPR.