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Body image, and the media around all of this

The culture that has grown up around these medicines is not neutral scenery — it is a market, and you are standing inside it while trying to make a health decision.

8 min read1.3k wordsUpdated 5 June 2026Reviewed by Jonah

The thing nobody consented to

Something changed in the last couple of years and members felt it before anyone named it. You start a medicine for a health reason, or you consider starting one, and within days the machinery notices. Your feed reorganises itself around bodies. Adverts arrive. Strangers with very white teeth explain your own life to you. A newspaper you have read for a decade begins running a column about it every weekend, and the tone is somewhere between a health story and a gossip story and neither of those is a health story.

I want to say this early and clearly: none of that is scenery. It is a market. There is now a very large amount of money in the neighbourhood of this decision, and where the money is, the content follows, and the content is not built to help you decide anything. It is built to be watched.

You are trying to make a considered choice about your own body while standing inside an advertising environment that has been optimised, with real skill and real budgets, to make you feel a particular way about that body. That is a hard place to think from. It is not a personal failing that it is hard.

Transformation content is a genre, not a report

The dominant form is the transformation post, and it is worth looking at as a piece of media rather than as evidence, because as media it is extremely well made.

It has a shape: a person who was unhappy, an intervention, a person who is happy. It compresses a long, dull, non-linear stretch of somebody’s life into a couple of seconds. It is filmed in different light, at different times of day, with different clothes, different posture, a different camera lens, and often months of other unmentioned things in between. It ends where the story is most flattering and never returns to check.

None of that means the person is lying. Most of them are not. It means you are being shown the two moments in a long period that differ most, chosen precisely because they differ most, and then invited to draw a conclusion about causation that the two moments cannot support.

Sunil says something in the reading group that transfers perfectly here: the study is usually real and the claim on top of it is not. The same is true of a person’s account of their own life. The experience is real. The story built on top of it, edited for an audience, is a product.

Before-and-after culture as something done to people

I want to be careful here, because plenty of members have posted their own images and felt good about it, and I am not interested in shaming anybody for that.

But before-and-after culture is not mainly something people do. It is something done to them. The format existed long before these medicines and it exists because it sells things — it sold slimming clubs, it sold gym memberships, it sold meal replacements, and it now sells prescriptions and a great deal of unregulated material besides. Its whole engineering is to make a body into a problem with a purchasable solution, and to make the earlier body into evidence of the problem.

What that does to the person in the pictures is rarely discussed. The earlier version of you gets recategorised, publicly, as the bad one. Your own past becomes a cautionary image. And you acquire an audience with expectations, which is a genuinely awful thing to have while making medical decisions, because now stopping, pausing or changing course is not a private choice — it is a disappointment you owe someone.

This is why you will not find that format on this site anywhere, in any of our pages, and why our community agreements rule it out. It is also why we do not publish figures of that kind at all. Our design choices explains the reasoning.

Being commented on

The part members find hardest is not the internet. It is the office kitchen.

People will remark on your body. They will do it warmly, believing it to be a kindness, and often in front of others. They will ask what you are doing. They will announce their conclusions about you to a room. And whatever they say, the underlying message received is the same one: your body is a public matter and people have been keeping notes.

Members describe two distinct pains here. The first is obvious — the comment lands badly, and if you have a history with any of this it lands on ground that was already sore. The second is stranger and gets talked about less. Praise for a change implies a judgement about before, and hearing the judgement out loud from someone who has known you for years can be genuinely destabilising. Several members have said the compliments hurt more than the criticism, and were much harder to explain to anybody.

There is no clever line that stops it. What members use, mostly, is something short and boring that closes the subject without a confrontation: I would rather not talk about my body, but how are you? Boring is the active ingredient. Telling people, or not has more on the surrounding decisions.

What has actually helped members

Collected from the body-image circle. None of it is a fix and all of it is cheap to try.

Curating hard, without ceremony. Not a dramatic exit from anything — just muting, unfollowing and marking as uninterested, repeatedly, for a fortnight, until the machinery learns you are a poor customer for that material. Members are consistently surprised by how much better a fortnight of that feels, and how quickly the feed reverts if they stop.

Getting the mirror out of the negotiation. Checking, comparing and inspecting all feel like gathering information and are in fact a way of keeping the subject alive. Doing less of it feels worse for a few days and then reliably feels better.

Clothes that fit the body currently in the room, whatever it is doing. Wearing something that does not fit as a way of talking to yourself is a conversation, and it is not a kind one.

Attention to function rather than appearance. Not as a slogan — as a genuine redirection. What did this body let me do this week that it could not do, or that I enjoyed, or that I would like to do again. Ren’s circles are full of that language and it does something.

And company. This is the one that works. Saying the ugly version of the thought out loud in a room where nobody flinches takes most of its power away.

When it is more than discomfort

Body dissatisfaction is close to universal and is not, by itself, an illness. But there is a point where it stops being a bad feeling and starts being the organising principle of a life, and I would rather name that point than leave you to guess at it.

If checking or avoiding has become something you build the day around. If you are declining things you want to do because of how you will look doing them. If your mood for a whole day is set by a moment in front of a mirror. If the thought has moved from I do not like this to I cannot be seen. Those are not character flaws and they are not vanity, which is the accusation people most fear and the least accurate word for any of it.

That is the point to bring in someone trained. A national eating-disorder charity in your country will talk to you about body image even if eating is not the issue. Your GP or family doctor can refer. University counselling services and employer assistance schemes are free, confidential and consistently underused. Our support resources page describes the kinds of service worth finding, and the warning-signs guide is the companion to this one.

I hold ed-recovery-aware and you are welcome there before you have decided anything at all.

Sources

  1. Beat, media guidelines for reporting on eating disorders and body weight — the reasoning behind avoiding transformation imagery and figures.
  2. Academy for Eating Disorders, guidance on responsible public communication about body weight and eating disorders.
  3. Tiggemann M, Anderberg I. Social media is not real: the effect of idealised versus realistic images on social comparison and body image. New Media and Society.
  4. Advertising Standards Authority, rulings on the promotion of prescription-only weight-management medicines to the public.
  5. Fardouly J, Vartanian LR. Social media and body image concerns: current research and future directions. Current Opinion in Psychology.

We name the trial, the journal and the year, because vague confidence is how people get hurt.

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