The Space Between Shame and Science: drugs and obesity
- Sital Bhargava DO, MS
- 2 hours ago
- 5 min read
In the second half of 2024, the GLP-1 buzz was everywhere, and I started to quietly wonder if it was something I should consider. Almost immediately, doubt set in.
I had taken Ozempic back in 2022 and ended up in the emergency room. I’m fairly certain my husband declared—very firmly—that I should never take it again. On top of that, despite everything I’ve written in previous blog posts about the dangers of tying shame to medical diagnoses, I couldn’t escape feeling that shame myself.
Why couldn’t I stick to a workout routine?
Why couldn’t I control what I was eating?
And now I was considering a medication that “everyone” seemed to be taking.
Was I just joining another weight loss fad?
From the outside world, the reaction felt harsh—disdain for people perceived as entitled, using a medication to change their bodies, to look more desirable, to take the “easy way out.” Even knowing better, I internalized that judgment.
So what changed?
In January of 2025, I started hormone replacement therapy. I had been hesitant about that, too. Did I really need another medication in my cabinet? But the difference surprised me. My joint aches improved. My mood lifted. I slept better. Feeling better made me more open to the idea that medication could be a tool—not a failure. You would think a doctor would know that. But the compassion I have for patients does not always transfer over to me.
On this renewed quest for self-improvement, I decided to go ahead and try the Zepbound. But this time, I promised myself I would do it differently.
The first time around, I had self-prescribed and increased the dose too quickly in hopes of faster results. (Doctors really do make the worst patients.) This time, I followed all the rules. I increased the dose very gradually. I committed to strength training twice a week. And I focused on eating more protein.
As a vegetarian, it’s easy for me to rely heavily on carbs and unintentionally shortchange protein. I wasn’t aiming for bodybuilder-level intake, but I did want enough to help protect against the muscle loss these medications can cause.
I weighed 195 pounds when I started Zepbound in late February 2025. The guilt was immediate and overwhelming. Because of that guilt, I felt obligated to tell anyone and everyone that I was on the medication. I wasn’t going to be one of those people who shrugged when asked about weight loss. I was going to “own” taking the so-called easy way out.
The weight came off slowly. I increased the dose slowly. I proactively took Miralax to prevent constipation. In the beginning, I was intensely aware of every bite of food I took and every bite I did NOT take. People talk about the “food noise” quieting—and it did. That silence was strange. As the noise faded, I found more space in my head.
And at first, that space was filled with anxiety. A lot of anxiety.
Even though I was exercising, being intentional with food, and taking care of my health, the stigma around treating obesity with medication felt heavy. There’s increasing discussion about how GLP-1 medications affect brain chemistry, and that scared me. I worried the medication was changing something fundamental about who I was.
During those first few months—even though things were going well—I constantly questioned whether I was doing the right thing.
As I continued to increase the dose gradually, I began to relax. The number on the scale kept drifting down, but the biggest surprise was something I hadn’t anticipated at all.
I hadn’t realized how much the extra weight had shaped my life.
I lived in elastic-waist pants and oversized, shapeless tops. I hid my body—and often, I hid myself. I dreaded going out to restaurants, dinner parties, or events of any kind. I hadn’t recognized how deeply the weight had eroded my confidence.
One day, I tried on a pair of jeans from the back of my closet—and they fit. I couldn’t remember the last time that had happened. Don’t get me wrong, I still reach for stretchy pants and sweatshirts. But there are now moments when I choose a shape-framing top or pants with buttons—and that choice feels meaningful.
I also noticed myself in pictures. When I look back at family photos from years past, I’m missing from many of them. I was the one taking the picture, choosing not to be seen—another way of hiding. Now I find myself standing next to my kids in vacation photos. And something else changed, too: I actually look at those photos. I pause. I relive the memory. Before, I would rush past them, embarrassed by my arms, my body, my presence.
I’ve been 159 pounds since October of 2025. I’m not sure I’ll lose more weight. By medical criteria, I’m still technically in the “overweight” category. I’ve started decreasing my dosage while continuing to strength train, prioritize protein, and stay active.
I also want to be honest: there are days when I sit on the couch, watch TV, and eat French onion dip with potato chips. As a South Asian woman, I’m acutely aware that these habits compound an already elevated cardiovascular risk. That awareness hums quietly in the background—because, one way or another, there is always some noise in my head.
But this is my attempt at authenticity.
I don’t pretend to be perfect. I appreciate how Zepbound quiets food noise while increasing insulin levels and slowing gastric emptying to keep me feeling full longer. I am honest that this is a process—and that it may never truly end.
I know I will likely need to be on this medication long-term, hopefully at a low dose. I also know the science will continue to evolve. New medications will emerge. New data will challenge old assumptions. That is how science works.
And for me, naming the shame—rather than hiding from it—has made this journey not just about weight loss, but about reclaiming visibility, agency, and compassion for myself.
No treatment plan is perfect, and no patient is either—especially when the patient is also the doctor. I’m learning as I go. I make adjustments. I question myself. But I am being intentional. I feel better than I have in years, and that tells me something matters here. That feeling, more than any number on a scale, reassures me that I’m moving in the right direction.
Comments