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Kate Gombach recently celebrated four years in recovery from an eating disorder. Such a milestone once felt impossible for the 35-year-old who recalls growing up at the height of “heroin chic,” a time in the early aughts when celebrities like Paris Hilton and Nicole Richie appeared in tabloids looking extremely thin. 

“I didn’t realize that living the way I’m living now was even an option for me,” Gombach tells Mashable. “I thought trying to shrink my body constantly was what I had to do because of the body that I was born in.” 

Since Gombach completed treatment at the Eating Recovery Center, she’d mostly been able to tune out the kind of messaging and advertising that typically triggered her disordered eating. But over the past several months, that became much harder thanks to one of the most popular medications of the 21st century: appetite- and hunger-suppressing GLP-1s. 

Suddenly, Gombach saw bodies shrinking everywhere she looked, particularly amongst celebrities and on social media. Creators who once championed body positivity or neutrality began weight-loss journeys with little explanation or initial disclosure about paid partnerships and sponsored content, Gombach witnessed.

“I didn’t realize that living the way I’m living now was even an option for me.”

Even as Gombach pruned certain accounts from her feed and actively disliked weight-loss advertising on Instagram and TikTok, Gombach still encounters marketing for GLP-1, or semaglutide, drugs there, not to mention on television and the wider internet. 

“It’s not easy, and it’s not fun, but [I’m] trying to push through it, maintain my recovery, and hold on to my beliefs, despite a lot of people around me kind of switching,” Gombach says. 

Fighting to stay in recovery

She’s not alone. Mashable interviewed others in recovery who described the same seismic shift toward thinness and diet culture triggered by GLP-1 drugs. 

In just the first nine months of 2025, the pharmaceutical companies Novo Nordisk and Eli Lilly spent $700 million marketing their GLP-1 medications, Wegovy and Ozempic, and Zepbound and Mounjaro, respectively, according to Reuters.  

This advertising rush has made weight loss content inescapable for many. That might help explain why Americans are flocking to online black markets to purchase Eli Lilly’s “retatrutide,” a drug not yet approved by the Food and Drug Administration that reportedly leads to significant weight loss.  

Meanwhile, influencers pitching wellness optimization strategies, and Make America Healthy Again proponents who promote thinness as virtuousness, have revived diet culture after it fell out of favor in the late 2010s. 

Now former patients like Gombach find themselves fighting to stay in recovery. 

Social media and eating disorders

“Many people feel like they’ve come through on the other side,” said Jessica Scheer, CEO of the National Eating Disorders Association (NEDA). “But it’s a hard thing to protect now.”

Gombach spends several hours a day on social media, where she connects with recovery-focused influencers. Building that network during treatment aided Gombach’s recovery, because her friends had neither experienced an eating disorder or lived in a larger body, like she does. 

Yet experts say social media can also be risky for those in recovery as diet culture and pro-disordered eating are extremely difficult to moderate online. 

Earlier this year, the eating disorder care company Equip surveyed 828 adults about how social media influenced their body image. A number of respondents named GLP-1 ads unprompted as a distinct source of distress. 

A recent survey by NEDA found the same. Clinicians reported having weekly conversations with patients about GLP-1 advertising and increased disordered eating behaviors. 

New research published in JAMA Psychiatry suggests that GLP-1 use may be higher among people with eating disorders compared to the general population. The study authors, who did not look at the role of social media, wrote that these people might use GLP-1 drugs to achieve rapid food restriction and weight loss.

Whether or not they are actually taking the drugs, people with a history of disordered eating may be more at risk online. A 2024 TikTok algorithm study, conducted by researchers at the University of Melbourne, found that users with a history of disordered eating were served more videos featuring “toxic” eating disorder content than those without prior struggles. 

The researchers attributed the increased likelihood of seeing such videos to the platform’s content personalization system, particularly the way TikTok collects and profiles users based on personal data. The platform, they wrote, may see lingering on content as a sign of engagement. 

The researchers noted several limitations of their study, including that they evaluated videos based on hashtags, an “imperfect” indicator of their content. TikTok declined to comment on the research. 

Positive engagement or eating disorder risk?

Dr. Blair Burnette, a Michigan State University assistant professor and principal investigator of the eating- and body image-focused ARISE Lab, called the findings of the study “extremely disturbing.” She was not involved in the research.

“It was very clear that the people who were struggling were getting delivered more harmful content,” said Burnette, who is overseeing multiple studies on social media’s effect on body image, GLP-1 advertising, and eating disorders. A patient can unintentionally direct more GLP-1 related content to their feed simply by pausing on a video or searching for seemingly unrelated content, she explained. It’s become a greater worry for her as a clinician. 

Equip survey participants also reported that actively seeking body-positive or recovery-focused content led to seeing more about fitness and body transformation, as well as restrictive eating. 

GLP-1 content on social media

Dr. Elizabeth Wassenaar, regional medical director of the Eating Recovery Center, said that social media usage is cropping up more and more in treatment with the rise of GLP-1s. Patients are vulnerable to posts about GLP-1 weight loss, and platforms are responding to it, she said. “The algorithm likely curates content that gets more interaction, and when people are engaged in a mental illness, the content that gets more interaction reinforces that mental illness.”

While their effectiveness is still widely debated, many platforms offer content controls intended to weed out such posts. Still, less obvious content can derail recovery. A favorite creator suddenly posting an image of their thinner body, for example, is not easily flagged by moderation tools or necessarily clocked by users themselves. 

In fact, Scheer explained, eating disorder content readily “shapeshifts” into whatever nutrition and wellness trends are taking over the internet at any given moment. Unhealthy or restrictive food habits can be repackaged as “clean eating.” Compulsive exercise is reformed into “hot girl walks” or daily gym vlogs. GLP-1 influencers are lumped in with wellness advice accounts.

“It’s a great business model.”

Scheer points to advertising phrases like “take control of your health” or “get back control of your body,” which mirror the mindset of many people experiencing disordered eating habits. 

Co-opting the language of recovery

The diet industry has also co-opted the language of recovery and anti-diet spaces to sell their own products. For example, GLP-1 ads often promise to quiet “food noise,” or incessant rumination on hunger and eating. Food noise happens to be one of the most common indicators or struggles among people with eating disorders, explained Sharon Maxwell, a weight inclusivity advocate, consultant, and content creator. 

“People with eating disorders are very susceptible,” said Maxwell. “It’s a great business model.”

Maxwell started posting online after they left a restrictive cult upbringing and were diagnosed with an eating disorder. They built a career offering weight inclusive curriculum to large businesses and eating recovery facilities, even collaborating with Meta’s former moderation team on better age-gating of eating disorder content. But in recent years that work has dwindled. 

The human safety teams Maxwell once worked with have been reconfigured or shrunk, they note. In the year since, they say they’ve seen a rise in anti-fat content. And as platforms bank on questionable drug and wellness advertising revenue, Maxwell says creators they used to work alongside have pivoted to sponsored GLP-1 posts.

Eating disorder recovery in the era of GLP-1s

Content about GLP-1s, already hard to moderate, is supercharged by stereotypes about larger bodies and weight loss. GLP-1s are much less criticized because they result in thinner bodies, said Wassenaar. Though researchers are still learning about their long-term effects, GLP-1s have surged in popularity, even as established interventions that have nothing to do with body size, like vitamin K shots for infants and life-saving vaccines, are increasingly rejected. 

For those in recovery, this type of messaging can generate guilt and shame, explained Wassenaar. GLP-1 marketing constantly suggests the need to change one’s physical appearance — and that there are several choices available for doing so. 

“You could make a choice to be on a medication. You could make a choice to be on a diet. You could choose a lower calorie food, but you’re not, and that’s why you think your body is flawed,” Wassenaar said of the normalization of weight loss interventions. “It’s insidious.”

“I don’t have to lose weight. I don’t have to go down that path.” 

Maxwell says they’d be lying if they didn’t feel enticed to use GLP-1s for weight loss. 

Gombach similarly wonders about GLP-1s. She says two of her doctors tried to prescribe her a GLP-1 based on her body mass index, despite the fact that she’s in good health. “Would people be nicer to me if I did that?” Gombach asks.

Maxwell and Gombach say GLP-1s aren’t the solution to such thoughts.

“It’s not the medicine itself that sounds appealing to me. It’s the outcome of being in a smaller body,” Maxwell said. “I know what happens if I engage in intentional weight loss, and that is a relapse into anorexia, and I’m not willing to do that.”

Managing social media while in recovery  

Since entering treatment, Gombach finished her masters in clinical mental health counseling and specializes in eating disorder care. That may give her unique insight into coping with ubiquitous weight-loss messaging, but she still uses multiple strategies herself. 

Gombach leans on practices she learned in acceptance and commitment therapy, which focuses on aligning behavior with one’s values. When Gombach sees content that could trigger negative feelings about her body, she affirms that it’s not for her and doesn’t match what she wants for herself. 

She also focuses on “clarity of intention,” or the reality that an influencer, brand, or pharmaceutical company preys on people’s insecurities so that they’ll buy a product and feel better or achieve greater acceptance. 

Then there’s training her algorithm. She immediately unfollows a creator when they announce they’re on a GLP-1 drug. Every few months, she mass unfollows accounts that have begun sharing diet culture content. Gombach also tries to adjust her ad settings, but frequently sees harmful marketing content nonetheless. 

Gombach says she hasn’t considered quitting social media because “it’s still something that ultimately helps me.” 

Time to turn away from social media?

Dr. Erin Parks, co-founder and chief clinical officer of Equip, says even former patients’ best efforts to filter content run headlong into algorithms that don’t distinguish between thinness and health. 

She doesn’t discourage patients from eliminating screen time altogether, because it may be helpful to them. Yet, she does want them to consider whether being on their phone is like attempting not to drink but spending all their time in a bar. 

Parks recommends people in recovery curate their feed with a clinician when possible and stay open to their changing needs. Content they find tolerable one day may trigger disordered eating thoughts the next. That’s why she says it’s important for people to closely monitor their social media use, including their intended time spent versus reality, as well as how they feel before, during, and after scrolling. 

Maxwell has also scaled back their time online because of GLP-1s. They stopped posting about eating disorder recovery years ago, opting to highlight the joys of living in a larger body. “So often in eating disorder recovery we’re obsessed with staying in the disorder, and then we become obsessed with the process of recovery, and that almost replaces the eating disorder,” they explained. “My life isn’t about recovery, recovery allows me to have a life.”

While the rise of GLP-1s has made the desire to escape weight stigma difficult to ignore, Maxwell still envisions a future where social media can support those in recovery and fight weight discrimination. 

“I do have hope,” Maxwell said. “How much? Not as much as a few years ago, but it’s still there, and I’m still holding on. I’ve got a vice grip on it.”

If you are concerned about your eating behavior, visit the National Eating Disorders Association (NEDA) website for more information. You can also text CONNECT to 741741 for immediate support from a trained volunteer at the Crisis Text Line.