The Suffering Economy is Over

Weight-loss meds threaten a $300 billion industry built on shame. That’s exactly why we need them.

Sarah asked me to keep her secret.

She’d recently started taking a GLP-1 medication and was terrified her friends would call her a cheater. “I feel like I’m admitting some moral failing,” she whispered. “But the weight is finally coming off.”

She’s not alone. Across social media and in hushed corners of doctor’s offices, the response to GLP-1 meds is laced with hostility. “Put the fork down. It’s that simple.” “Cheating never works—you’re not learning anything.” The message is crystal clear: unless you suffer through punishing workouts or grueling diets, you don’t deserve to lose weight.

This leads patients to avoid discussing GLP-1 medications entirely, cutting themselves off from professional guidance–and recklessly ‘winging’ their weight loss journey.

Let’s be honest: these comments aren't really coming from a place of genuine concern. They’re about how our culture views success, effort, and worthiness. At their core, they’re a reaction to the unraveling of an economic and cultural system built on suffering.

Meet the suffering economy

The suffering economy is a $300+ billion behemoth that thrives on the insistence that pain is the gateway to worthiness. It consists of the $70 billion weight-loss sector hawking brutal boot camps and miracle powders, the wellness gurus peddling punishing cleanses, and sadistic TV shows like The Biggest Loser that sell transformation through humiliation. In this business, pain is not a side effect: it’s the badge of honor required to prove you’ve “done it right.”

The suffering economy doesn’t just exist in the confines of fitness. Consider:

• Women who choose epidurals during childbirth get branded “too posh to push.” It’s not a new phenomenon—when Queen Victoria used chloroform for pain relief during childbirth in the 19th century, many moralists condemned her choice as a defiance of ‘natural’ agony.

• People with depression are shamed for taking medication instead of “toughing it out” and going to the gym.

• Fitness influencers glorify “no pain, no gain,” using bloody palms and tearful confessions as proof of authenticity.

In each scenario, sidestepping pain invites condemnation, because it pokes at the deeply ingrained belief that if you’re not suffering, you’re somehow “cheating.” And that belief underpins the suffering economy: an entire system of products, programs, and expectations fueled by shame, where discomfort is the currency.

The suffering economy isn’t just alive—it’s thriving. In the United States alone, “health club” revenues grew from $20.3 billion in 2010 to nearly $35 billion by 2019—over a 60% increase.

Despite the suffering economy's growth, obesity rates have continued to climb. By 2050, an eye-watering 3.8 billion adults will be overweight or obese, representing over half of the global adult population, according to a 2025 Lancet study.

This isn't a coincidence: it's evidence that the suffering-based approach is failing spectacularly.

That failure isn’t without consequences. The culture of shame has left millions of people—including Sarah—convinced they were personal failures for not keeping weight off through sheer force of will.

And that shame has come at a very, very heavy price.

The Mental Health Cost

Let's start with the psychological damage. One comprehensive review of 105 studies covering nearly 60,000 participants found that weight stigma correlated with a ~35% decline in overall mental health.

When you're constantly told your body is a manifestation of your moral failure, that internalized shame becomes another form of weight you carry—one that's much harder to shed than pounds.

And shame destroys something essential: Worthiness. When people don’t feel worthy, they feel like they can’t change—now or forever.

The Career Cost

This condemnation spills into the workplace. Economist David Lempert found that a 10% increase in a woman's body mass reduces her income by around 6%. Plus, nearly half of UK employers admit they're less inclined to hire a person living with obesity.

And if they are hired? They get fewer raises, promotions, and leadership opportunities. All because of the entrenched perception that they "lack discipline." People with obesity also face higher healthcare costs—not just from obesity-related conditions but from delayed care because they fear judgment from healthcare providers. That brings us to our last point:

The Health Cost

In a study of over 620 primary care physicians, over 50% viewed obese patients as (please, brace yourself) “awkward”, “unattractive”, “ugly”, and “noncompliant.” A third went further, labeling them as “weak-willed, sloppy, and lazy.”

As a result, people with obesity get less time, attention, and empathy from doctors. This creates a brutal cycle: shame pushes them away from care until emergencies strike, treatable conditions turn life-threatening, and medical neglect masquerades as "obesity-related death."

This raises the question: If the consequences of shame are so great, why are obesity rates still increasing? The answer lies in a biological reality the suffering economy deliberately ignores—because doing so would threaten its very existence.

Biology beats willpower

What most people don’t understand is your body is a stubborn weight-keeping machine. A landmark UCLA analysis of 31 long-term dieting studies revealed a truth most of us would rather keep our heads buried in the sand about: diets rarely work. Over 80% percent regain the weight within five years.

But why do our bodies fight off our hard work?

Your body has a biologically predetermined weight—often called a “set point”—which it defends vigorously.This genetic influence is so powerful that identical twins raised in separate households in entirely different environments still end up with remarkably similar body weights, according to a widely cited study published in the New England Journal of Medicine.

Cut calories, and your metabolism slows down. Increase exercise, and your hunger hormones scream louder. Lose weight, and your body will burn 300-400 fewer calories per day than someone of the same size who was never “heavy.”Even years after shedding pounds, your body will still try to claw back lost weight. Contestants on The Biggest Loser epitomize this cruel reality—most regained significant weight after the show, and their metabolisms remained suppressed six years after the cameras stopped rolling.

“But if it's all biology, why wasn’t obesity a problem two or three decades ago? Why now?".

It's a fair question, and the answer lies in epigenetics. Our DNA hasn't changed significantly over thousands of years, yet the difference from our cavemen brethren and us is our environment. Ultra-processed foods, chronic stress, disrupted sleep are the modern forces that flip genetic switches instructing the body to store fat aggressively.

Worse still, these epigenetic signals don’t stop with you. They are passed down through generations. The impact begins early, sometimes even in the womb. If a mother experiences chronic stress or poor nutrition during pregnancy, her child can inherit an epigenetic blueprint primed for obesity, predisposing them to weight struggles and health problems long before they've taken their first bite.

The GLP-1 curve

After decades of the suffering economy's failure to address obesity, we're finally witnessing a turning point. For the first time in modern history, the obesity trend line is bending—not because of more brutal diets or punishing exercise regimens, but because of medical science.

The FT

So, what’s the science behind GLP-1 medications? In plain English: they mimic a hormone your gut releases after eating to signal fullness and slow digestion. The difference between these medications and traditional dieting is that GLP-1s gently recalibrate your body’s hunger settings instead of throwing it into chaos. In short: the medication works with your biology, not against it.

This is exactly why GLP-1s threaten the suffering economy: they expose how much of our approach to weight management has been built on unnecessary struggle.

How the Suffering Economy is Reacting

The economic stakes are enormous. The traditional weight-loss industry—from diet programs to wellness brands and supplement makers—are all facing disruption. Weight Watchers International’s shares have lost 97 percent of their value since mid-2021, and Jenny Craig, once an iconic diet brand, recently filed for bankruptcy.

Fitness influencers are scrambling, and their defense mechanisms are predictable: some claim the medications are "unnatural" (despite working through natural hormonal pathways), others catastrophize about side effects (while minimizing the serious health impacts of untreated obesity).

You'll notice the backlash is almost never based on scientific objections—it's emotional defense of a crumbling ideology. It comes from people who've invested their identities in "doing it the hard way" or businesses watching their suffering-based model implode.

The Road Ahead

GLP-1s aren’t a perfect solution. They’re costly, potentially require lifelong use, and come with side effects—sometimes severe. Their accessibility and insurance coverage remain in flux. But none of these caveats undermine the core principle: less suffering can be a good thing.

Historically, when medicine introduces an option that lowers pain—from anesthesia to epidurals—we eventually accept it. The same is likely to happen with GLP-1s.

Yet deeper questions remain: Are we ready to let go of the moralism around health and bodies? Can we uncouple our sense of worthiness from how much we’ve suffered? For people who’ve overcome weight issues the “hard way,” can they find an identity that doesn’t hinge on feeling superior?

We can dismantle the suffering economy, but it will require much more than a new medication. It demands a culture that rejects shame as a motivator. If less pain is possible—whether in childbirth, depression, or weight loss—why cling to the old ways?

For Sarah, her GLP-1 injection means she might finally conquer the weight that’s haunted her since childhood—without letting shame script her path. One day soon, her confession won’t be a secret at all. It’ll be a sensible, mainstream choice, like wearing glasses for nearsightedness or taking insulin for diabetes.

And for tens of millions of people just like her, that day can’t arrive soon enough.