On your recent Metro-North rides to the Grand Central station or adventures on the D train, you may have noticed ads for weight loss drugs featuring images of people injecting themselves with medium sized needles underneath simple mantras like “A weekly shot to lose weight,” “Lose up to 35 pounds” or “Now prescribed online.” Some say that these promotions are positive because they de-stigmatize medical obesity treatment, normalizing medication that can help people reach their health goals. However, I believe that these ads normalize unrealistic body image expectations.

Many of the ads I have seen have been sponsored by Ro, a healthcare company and online pharmacy that markets Ozempic and its active ingredient semaglutide. Ozempic is a GLP-1 also known as glucagon-like peptide-1 receptor agonist drug which was originally approved in 2017 by the American Food and Drug Administration to treat type 2 diabetes. It triggers the release of insulin to move glucose from the bloodstream into the cells, which converts sugars contained in the food we eat into a usable form for our bodies. Ozempic helps regulate blood sugar levels in diabetics; it was never meant to be used as a weight loss treatment. However, another function of the drug is to suppress hunger hormones, so Ro has taken Ozempic to the markets as a magic pill to get you skinny quickly. 

After a social media craze about Ozempic where many influencers and celebrities made videos about their experiences taking the drug, Ro created a program to put out their ads on the NYC subway system beginning in July 2023. And from my experience, they put out a lot. When I’m scanning the map of the stops on the way to Brooklyn, my view is interrupted on the top and the sides by injection images. When I’m checking to see if Tremont or Fordham Road is the next stop because I can’t hear the muffled conductor’s announcement, I see people standing in front of these ads as they wait for the next train. When I’m squeezed next to friends in a six person seating arrangement on the way back from the city to campus, I see the ads above their heads as we’re trying to have a conversation. It feels like the ads are everywhere I look, as if they are interrupting my view of the world to remind me of what the world thinks I should look like. 

There is intentionality behind the sheer amount of these promotions. The more we see it, the more the treatment is normalized, which can have some benefits for people who would experience significant health changes by using the drug. But at the same time, this makes the expectation more normalized. This ultimately perpetuates negative body image that is already easy to adopt subconsciously in the age of social media. They are problematic because they make a normative statement about the ideal body, prescribing not only medicine but also the idea that if you don’t look like a size 0 model, there is something wrong with you, and you need to fix it — and do so fast. 

There is also intentionality behind the location of the ads. Public transportation cultivates a transition state as people are moving from one place to another, meaning they are more likely to be distracted and vulnerable. This emotional state makes it easier for people to accidentally internalize the expectations promoted by the advertisements, believing that a thinner body is necessary for health and happiness, which is not always the case. Many New Yorkers with far commutes have a long time to stare at these ads and think about all the ways their bodies could change. The way Ro advertises easy access via online prescription adds fuel to the fire — it provides a quiet voice of temptation that says, “Why not try it out?” This can be dangerous for those who are not getting the other side of the story or lack proper health education.

The company claims that the subway advertisement program was a step in the right direction of helping people reach their health goals and communicating clearly their treatment options. In an article explaining the rationale behind the campaign, Ro expresses its desire to “start an important, sometimes difficult, conversation focused on a goal of de-stigmatizing obesity as a condition and highlighting a new, incredibly effective treatment that may, for the first time, be a real solution for millions of people.”

I’m not trying to claim gaslighting — the drug definitely is working for weight loss (with side effects, of course). I am more so trying to wave a red flag. I worry about the kind of message we are sending by marketing a thinner version of ourselves as a medical priority. Some of the ads feature people looking at a skinnier version of themselves in the mirror, as if their body is not good enough the way it is. We all deserve to feel our best — both physically and mentally — and to have access to resources that can help us get there. Everyone has a right to be healthy, but healthy looks different for everyone. We should not feel pressure to conform to an image of health pushed by a company that capitalizes on a broken culture to make a profit.