A weighty ISSUE

Our WIAM board discusses body image, the rise of weight loss medications and whether there’s pressure on aesthetic practitioners to conform to certain body types

While beauty ideals have changed across the decades, one thing that has remained constant is the scrutiny that exists around women’s bodies. With the body positivity movement currently taking a backseat1, we are seeing a resurgence of the 00s trend to be ultra-thin, mainly attributed to the rising popularity of GLP-1s.2 But even then, women can’t win.

Both singer Nelly Furtado and former Spice Girl Mel C have recently been subjected to online criticism and body-shaming comments. Furtado received negative comments about her weight and size after a video of her performing was posted, while Mel C was criticised for being too “unfeminine” and athletic after being photographed on a yacht with her partner.

As an appearance-centred sector, these types of narratives about women’s bodies filter through not just to patients but to practitioners too.

So what happens when practitioners themselves are struggling with body image, and what role does the rise in weight loss medications have to play in shaping current body ideals? We asked our WIAM board for their thoughts.

IS THE ERA OF BODY POSITIVITY OVER?

The body positivity movement gained momentum in the 2010s, championing acceptance of bodies of all shapes and sizes. While some criticised the movement for glamourising obesity3 , for many it was a positive step forward in challenging the idea that thinness equates to beauty or health.

At the same time, we saw a trend for exaggerated hourglass curves with tiny waists and shapely bottoms, driven by Kim Kardashian. Within our sector, this led to a worrying number of women seeking high-risk Brazilian Butt Lift procedures, resulting in the tragic death of Alice Webb in September 2024.

However, more recently, we are seeing a cultural shift back to a preference for extreme thinness, echoing the size zero trends of the early 2000s2,5 , with conversations around self-acceptance and diversity when it comes to body type being overshadowed by a media obsession with weight loss medications.

As a sector at the coal face of this trend, it needs to be asked – are these headlines around weight loss drugs fuelling a return to harmful body ideals, and what role do aesthetic practitioners have to play in redressing the balance?

THE WEIGHT LOSS JAB EFFECT

While many aesthetic practices focus on the face, an increasing number are moving into weight loss and body treatments in light of the surging popularity of medications such as Ozempic (licensed for weight loss as Wegovy in the UK) and Mounjaro.

While there is no denying these medications have been groundbreaking when it comes to treating obesity and metabolic disease, their uptake among non-obese populations — including aesthetic practitioners — could be fuelling the return of dangerous body ideals.

Ozempic has become as much of a brand name as Botox, and the media is flooded with stories about who’s on it. From Serena Williams, Elon Musk and Oprah Winfrey to Sharon Osbourne, Lizzo and Meghan Trainor, many have spoken out about their use of the medications, while speculation is rife about use among others who have dramatically lost weight.

For practitioners working in aesthetics — particularly women, who face disproportionate pressure to conform to a specific body type — the impact of this should not be underestimated.

Nurse practitioner Tracey Dennison, who has a qualification in lifestyle medicine, comments, “It’s about being healthy, not just looking healthy. I also think a huge part of the problem is that we have been trained to get people on this medication and keep them on it (although that is absolutely not what I practise). Therefore, there are very blurred lines around titrating doses down and managing a patient to successfully transition off the medication and maintain their weight loss, which is potentially even trickier amongst clinicians for all kinds of reasons.”

Dr Mayoni Gooneratne, founder of Human Health, comments, “There’s a balance that can be struck where we encourage a healthy weight/appearance because it enhances that individual’s health, which to my mind is physical, mental and spiritual. Not just some esoteric ideal.”

BODY IMAGE AND AESTHETIC PRACTITIONERS

The prevalence of body dysmorphic disorder (BDD) varies from one study to another. It is believed that BDD currently affects 1.7% to 2.9% of the general population6 , but there is a consensus that patients with the disorder may be more likely to present themselves at aesthetic practices.

A meta-analysis and review of the data on the prevalence of BDD published in the Journal of Cosmetic Dermatology in April 2025 put the overall prevalence of BDD among plastic surgery patients as high as 24%.

And practitioners are not immune. In fact, it is thought that there may be a high prevalence among aesthetic practitioners in particular. A study published in The Aesthetic Surgery Journal7 suggested that 8.2% of aesthetic practitioners exhibit symptoms consistent with possible BDD, which was significantly higher than in the general population.

LEADING BY EXAMPLE

For aesthetic practitioners who work in an image-driven environment, appearance can be seen as part of their personal brand, and they may experience pressure to “look the part”.

But with the advent of weight loss injections, these pressures may have found a new focal point: the number on the scales.

However, if a practitioner visibly engages in extreme body modification, whether through repeated cosmetic procedures, aggressive dieting, or the off-label use of weight loss medication, patients may interpret that as an endorsement of those behaviours.

This raises an ethical question: Do aesthetic practitioners have a responsibility to address their own body image issues to set a healthier example?

Dennison says, “Practitioners effectively want to be a good advert for their businesses, but we know that a percentage of the population has body dysmorphic disorder, so therefore a percentage of practitioners must have it too. In my opinion, that is where the danger is.”

Dr Mayoni comments, “There is a huge role here for the responsibility the aesthetic profession has within the wellness space. We have to live by the sword and die by the sword. We need to take the responsibility seriously if we are advocating for less body fat with injection/ body devices; then we should also be advocating for it to be done safely and well.

“It also begins with the clinician. We must walk the walk and talk the talk around health, weight and alcohol and drug consumption.”

Aesthetic consultant Vanessa Bird comments, “I think it’s important to remind practitioners that they do not have to offer these medications. Body is a different business case and requires different clinical and communication skills from facial aesthetics. Just because you can, doesn’t mean you should.”

PRACTICAL STEPS FOR PRACTITIONERS

If you are struggling with your own body image, our WIAM board have a few pieces of advice.

• Seek support – Consider professional help if you are struggling with body dysmorphia, disordered eating, or obsessive appearance-related thoughts.

• Be transparent but responsible – If discussing personal treatments with patients, frame them in the context of health and evidence, not trend or pressure.

• Promote diversity in beauty – Showcase a range of body types in your marketing and social media.

As weight loss medications become more mainstream, the practitioners prescribing them and the industry as a whole have an important role to play in shaping the next generation of beauty norms. We can either reinforce the return to unrealistic and often unhealthy body standards or take an active role in promoting a health-focused vision of appearance. At WIAM, we hope it is the latter.

REFERENCES

1. https://www.psychologytoday.com/gb/blog/brain-boost/202501/so-is-the-body-positivitymovement-still-a-thing

2. https://www.shoutoutuk.org/2025/03/04/size-zero-models-and-semaglutide-what-happened-to-body-positivity/

3. https://pressbooks.pub/btugman/chapter/theline-between-body-positivity-and-glorifyingobesity/

4. https://www.jccp.org.uk/NewsEvent/jccp-launches-new-guidance-on-buttockaugmentation-other-body-contouringprocedures-guidance-for-enforcement-bylocal-authority-authorised-officers

5. https://www.bbc.co.uk/news/articles/c4gm9rygdymo

6. https://www.hamiltonfraser.co.uk/content-hub/body-dysmorphic-disorder-in-aesthetics

7. Patricia Barrera, Fernando Felice, Madara Orlovska, Steven Harris, Body Dysmorphic Disorder in Aesthetic Practitioners: A Cross- Sectional Study of Prevalence, Awareness, and Psychological Implications, Aesthetic Surgery Journal Open Forum, Volume 7, 2025, ojaf070, https://doi.org/10.1093/asjof/ojaf070