The “Cheating” Myth: A Body-Positive Conversation About Medical Weight Loss

"At Silver Sirens, we don’t moralise women’s health choices—we meet them with dignity,

curiosity, and care.”

Faith Agugu

In February, our focus is body positivity—an emotional topic for many of us, including me.

In the last 18 months, I lost 10 kilos—and honestly, it was a frustrating, humbling process.

The first part felt slow but possible. I tried so many things: tweaking food, walking more, lifting a little, being “good” during the week, then trying to be even “better” the next. But the final 3 kilos? They would not budge. I did everything you’re “supposed” to do. I negotiated with myself, judged myself, encouraged myself, and rolled my eyes at myself. And eventually, last November, those last 3 kilos finally shifted.

I’m sharing that not because I think everyone should lose weight (I don’t), and not because I think weight is a measure of worth (it isn’t). I’m sharing it because I know—personally and professionally—how much emotion can sit underneath a number on a scale: hope, shame, pride, grief, determination, fear. Sometimes all in the same day.

And that brings me to a topic that can feel a bit like stepping into a minefield: medical weight loss pills and injections.

A gentle note before we begin

At Silver Sirens, we are an inclusive community. We don’t have a moral position on whether a woman chooses cosmetic procedures, medical interventions, or none of the above. The same goes for weight loss.

If you choose medical support for weight loss, you’re not “less evolved.” If you don’t, you’re not “more virtuous.” Your body is yours. Your health decisions are yours.

And from my perspective as a psychotherapist: shame is never an effective long-term health strategy. It might create short bursts of behaviour change, but it tends to erode self-trust over time.

“Cheating” — why that word stings

At a recent Silver Sirens gathering, the conversation turned to medical weight loss. Some women described it as “cheating.” And other women—particularly those with lived experience of struggling with weight for decades—were understandably upset.

I want to speak to that moment with a lot of care, because it’s a perfect example of how quickly pain can surface in conversations about bodies.

When someone says “cheating,” what I often hear underneath it is one (or more) of these feelings:

• “I had to suffer for results—why shouldn’t everyone?”

• “I’m scared we’re turning normal bodies into problems to be fixed.”

• “I don’t trust the medical system, or the diet industry, or the ‘quick fix’ culture.”

• “I feel judged either way—if I use help, or if I don’t.”

• “I’m worried about side effects and long-term unknowns.”

All of those concerns are human. But the label “cheating” can land as moral judgement—especially for women who have worked incredibly hard, tried everything, and are already carrying years of body blame.

So here’s a reframe I find more compassionate (and more accurate):Medical weight loss isn’t cheating. It’s a healthcare choice—one that comes with benefits, risks, and ethical complexity.

What are medical weight loss drugs, in plain language?

These medications generally work by affecting appetite, fullness, cravings, and sometimes how the body regulates blood sugar. For some people, reducing relentless food noise makes it easier to eat in a way that supports their health goals.

That can be profoundly relieving—and also emotionally complicated. Because if it becomes easier with medication, it can stir grief: “So it wasn’t that I was weak… I was just fighting my biology.” That realization can be healing, and it can also bring up anger about years of self-blame.

Pros and cons — without the hype, without the judgement

Let’s hold this with both hands: there are real potential upsides, and real downsides.

Potential benefits (for the right person, with medical support):

• Clinically meaningful weight loss for some people.

• Improvements in certain health markers for some people (depending on their individual health profile).

• Less preoccupation with food for some people, which can free up mental space and energy.

Potential downsides and challenges:

• Side effects can be significant, especially gastrointestinal symptoms.

• Access and cost can be a barrier, which raises fairness questions (who gets support, and who is left behind?).

• There can be weight regain after stopping for many people, which can feel discouraging if it isn’t discussed upfront.

• The cultural pressure piece: some women feel they “should” do it, or feel they must keep it secret to avoid judgment.

As a therapist, I’m always interested in the meaning we attach to these choices. Two women can take the same medication and have completely different emotional experiences—depending on their history with dieting, control, trauma, people-pleasing, perfectionism, or how their body has been treated by the world.

The ethics: a few questions worth asking

Ethics isn’t about telling women what to do. It’s about making sure choices are informed, supported, and as free as possible from coercion (including cultural coercion).

Here are some gentle questions I’d encourage anyone to consider:

• “Am I doing this from self-care… or self-rejection?”

• “Do I understand the likely benefits and the likely trade-offs?”

• “What’s my plan if I experience side effects?”

• “What’s my plan if I stop—emotionally and practically?”

• “Will this support my relationship with my body, or turn it into a constant project?”

And one more, especially for us as a community:

• “Can we make room for many body truths at once?”

If you choose this route: what to consider (practical + emotional)

If you’re considering medical weight loss support, here’s what I’d suggest discussing with your doctor (and also checking in with yourself about):

• Medical suitability: your health history, current medications, and whether you meet clinical criteria.

• Monitoring and follow-up: what will be tracked (side effects, nutrition, energy, mood, sleep).

• Strength and nourishment: making sure weight loss doesn’t come at the cost of muscle, vitality, or joy; support matters here.

• Your mental health history: especially if you’ve had disordered eating patterns or a complicated relationship with control and restriction.

• Your support system: who can you talk to without feeling judged?

• Your values: what does “feeling good in my body” actually mean to you—more ease in movement, less pain, better stamina, calmer mind?

A Silver Sirens way forward

Here’s what I’d love us to practise together: curiosity over judgement.

If a woman shares that she’s using medical weight-loss support, we can respond with warmth: “How is it for you?” “What are you noticing?” “Do you feel supported?”

If a woman shares she would never choose it, we can also respond with warmth: “That makes sense.” “What feels important to you?” “What helps you feel at home in your body?”

Because body positivity, at its core, is not about everyone making the same choice. It’s about everyone being treated with dignity, whatever choice they make.

Big Hugs,

Faith & The Silver Sirens Team