When Even Serena Says the Struggle Is Real: What GLP-1 Meds Are (and Aren't), and Why the Judgment Needs to Stop

By Dr. Tomi Mitchell

Serena Williams just did something that shook the internet: she opened up about using a GLP-1 medication to support her weight-loss journey. That’s right—the same woman who dominated tennis courts globally for more than two decades, who trained harder than most of us can imagine, and who had access to the best nutrition, training, and wellness teams around her.

And yet… even Serena struggled with her weight.

If that doesn’t drive home the message that weight is complex, deeply personal, and often unpredictable, I don’t know what will. And if a powerhouse with every resource imaginable felt it was time to seek support through medical means, what does that say about the rest of us—people navigating busy schedules, stress, and life’s unpredictability without a personal team of world-class trainers and nutritionists?

Let me make one thing crystal clear: weight is not simply about discipline, willpower, or character. It’s about biology, environment, emotions, and yes, sometimes medical intervention. Period.

You’re Not Lazy. You’re in a System That Makes You Blame Yourself

We live in a society that worships thinness but punishes people no matter where they fall on the spectrum:

• Gain weight? You must be lazy.

• Lose weight? You’re obsessed.

• Use medication? You’re cheating.

• Don’t lose weight? You’re not trying hard enough.

  
  

I call BS.

We’ve created a lose-lose culture where people are expected to hustle for perfection while being vilified for seeking help. This isn’t just exhausting—it’s dehumanizing. I’ve treated thousands of patients, and one truth stands out: wanting help doesn’t make you weak. It makes you human.

We need to stop framing weight as a moral failing. Bodies change, life is unpredictable, and the factors that influence metabolism are many and often outside of personal control. Judging someone for choosing a medical option to support their health is cruel—and it’s also counterproductive.

What the Heck Is a GLP-1 Anyway? (And No, It’s Not a Miracle Drug)

GLP-1 stands for Glucagon-Like Peptide-1, a naturally occurring hormone in your body that helps regulate blood sugar and appetite. The medications that mimic it—Ozempic, Wegovy, Mounjaro—were originally developed for diabetes management. Along the way, researchers noticed an interesting side effect: consistent weight loss.

Here’s how GLP-1 medications work:

• Slow gastric emptying: Food leaves your stomach more slowly, helping you feel full longer.

• Signal satiety to the brain: You feel satisfied before your plate is empty.

• Reduce cravings and stabilize blood sugar: Spikes and dips are less dramatic, which can reduce emotional eating.

• Improve insulin sensitivity: This helps your metabolism run more efficiently.

  
  

Tirzepatide (Mounjaro) even targets an additional hormone, GIP, further supporting metabolic regulation.

But here’s the catch: while these medications can help, they aren’t magic. They don’t replace lifestyle changes, they don’t heal emotional wounds, and they don’t automatically “fix” your body image.

These Meds Can Do a Lot, But They Can’t Do This…

GLP-1 medications can help with physiology: appetite, metabolism, insulin function. They can take the edge off the body’s natural defenses against weight loss. But they cannot:

• Fix a toxic relationship with food.

• Heal emotional trauma or unresolved grief.

• Change how you feel about your reflection in the mirror.

• Teach you self-compassion, boundaries, or sustainable lifestyle habits.

That’s where comprehensive care comes in. The real “magic” happens when medications are paired with a personalized strategy that includes nutrition, movement, emotional support, and sleep. This isn’t about shortcuts. It’s about giving your body—and your brain—the tools it needs to succeed in a system that hasn’t always played fair.

Fat-Shaming Isn’t Just Rude—It’s Dangerous

Here’s a truth we cannot ignore: fat-shaming is not just mean; it’s a public health hazard.

Shame keeps people from going to the doctor. It drives disordered eating. It can lead to underdiagnosis of serious conditions like heart disease, diabetes, or hormonal imbalances. And it robs people of joy, confidence, and basic dignity.

In my practice, I’ve seen how internalized weight stigma fuels a vicious cycle: people punish themselves through extreme diets, overexercise, or self-blame, only to see minimal results because biology is complicated and unyielding at times. Weight stigma doesn’t just hurt feelings—it actively harms health.

People’s worth is not defined by a number on the scale. Your labs, your energy, your mental health, and your lived experiences matter far more than any external judgment.

The Double Standards Are Exhausting (And We’re Done Playing That Game)

It’s exhausting how quickly society judges women (and men) on every front:

• “You’re too big.”

• “You’re trying too hard.”

• “Love yourself the way you are.”

• “But don’t get too confident.”

Damned if you do, damned if you don’t. It’s whiplash-inducing and toxic.

When Serena says, “I got help. This worked for me,” she’s doing more than sharing a personal choice—she’s challenging a culture that shames people for seeking support. She’s creating space for the rest of us to acknowledge that sometimes, help is necessary, and that’s okay.

Health Is About Function, Not a Dress Size

Let me be blunt: the number on the scale doesn’t define your health. What matters is function:

• Are you sleeping better?

• Is your blood sugar stable?

• Are your joints functioning without pain?

• Are your moods more balanced?

• Can you show up fully in your life?

That’s health.

For some, GLP-1 medications are a bridge to that version of themselves—the one with energy, confidence, clarity, and the ability to move without pain. That’s not vanity. That’s reclaiming agency over your body and your life.

This Is What a Real Health Plan Looks Like

You don’t need to “earn” your worth by suffering. A sustainable wellness plan should include:

• Balanced, joyful nutrition: Not punishment or deprivation, but real food that fuels your body.

• Movement you actually enjoy: Because consistency beats intensity every time.

• Restorative sleep: Because your body cannot heal or function optimally without it.

• Emotional and spiritual work: Therapy, journaling, meditation—whatever keeps your inner world aligned.

• Accountability and support: Friends, coaches, medical professionals who see your humanity.

• Medical tools when appropriate: Medications like GLP-1s are not failures—they are options.

You are the expert on your body. If a GLP-1 medication is part of your plan, great. If it’s not, that’s also great. What matters is evidence, safety, and what actually works for you.

To My Fellow Physicians: Stop Shaming and Start Supporting

Colleagues, it’s time for a paradigm shift.

• Listen more.

• Assume less.

• Provide evidence, not ego.

• Normalize seeking help.

• Stop making people feel like failures for needing medical support.

This isn’t about promoting a drug; it’s about promoting dignity, choice, and health.

Dear Reader: Your Body, Your Business

Whether you’re considering GLP-1s or not, hear this:

• You are not lazy.

• You are not broken.

• You are not a lost cause.

You deserve health, peace, and support that actually works for you. If Serena Williams can say, “I needed support, and I took it,” then you have every right to do the same—without explanation, without shame.

To Serena: Thank You for Shifting the Conversation

Thank you for using your voice. Thank you for challenging judgment. Thank you for making space for the rest of us to say:

"Yeah. Me too. And I’m done feeling ashamed for it."

Because strength isn’t measured by struggling in silence. Strength is knowing when it’s time to ask for help—and doing so without apology.

-- Dr. Tomi Mitchell, MD