65% of Americans Say Willpower Alone Is Not Enough for Most People To Lose Weight and Keep It Off, According to New Research

For too long, weight loss has been seen as a simple equation: If you consume fewer calories through your diet than you expend, you should start to see the pounds drop. Being thoughtful about nutrition is, of course, unquestionably important. And exercise is just as crucial for our mental health as it is for weight loss. But the popular view of weight loss as the inevitable result of diet and exercise-related willpower has never told the whole story. 

A new survey from the Pew Research Center shows that many Americans now understand that weight loss is affected by a wide range of factors—not just willpower. The survey found that about two-thirds of Americans (65%) say “willpower alone is usually not enough for people who are trying to lose weight and keep it off.” 

That’s a dramatic shift from the rhetoric that’s been most common in recent history. “The world has believed that obesity is a personal choice for years and years unfortunately,” says Craig Primack, MD, FACP, FAAP, FOMA, a physician specializing in obesity medicine. “It’s not a personal choice. This is a medical disease.”

Americans’ views on weight loss over the last several decades are often traced to a study from 1967 called “Behavior Control of Overeating,” which treated weight loss as something to achieve with personality changes. 

The centrality of willpower to weight loss has been debunked among scientists several times in the years since that study—going as far back as at least the ’90s. And in 2013, Dr. Primack notes, the American Medical Association released a public statement recognizing obesity as a medical disease. 

According to recent data from the CDC, about 42% of adults in the United States have obesity, and around 74% are considered overweight. That puts them at increased risk for several other diseases, including type 2 diabetes, heart disease, stroke and even some types of cancer. 

But the AMA statement about obesity didn’t change the stigma around the disease—or the bias that many people living with obesity experience in the healthcare system and in their day to day lives. “A lot of people still believe that you can just eat less and move more and it works,” Dr. Primack, Senior Vice President of Weight Loss at Hims & Hers, adds. “It doesn’t work, or we wouldn’t have the problems that we have today.”

The Pew findings show that Americans are starting to understand the limits of seeing weight loss as the product of willpower alone. A major factor informing this change in public opinion is the recent advent of GLP-1 weight loss medications, which many people have successfully used in their treatments for type 2 diabetes and obesity. 

About three quarters of Americans have heard of drugs like semaglutide (better known by the brand names Ozempic® and Wegovy®), according to the survey. The survey found that 53% of respondents who know about these medications think they are good options to help with weight loss for people with obesity or another weight-related health condition. (Only 19% said the drugs are not a good option in this case, and 28% said they’re not sure.)

Weight loss injections work by mimicking the hormone glucagon-like peptide-1 and targeting the parts of our brains that regulate appetite. The fact that these medications are now available to people who have spent years struggling with diet and exercise alone has shown many people the complexity of the science behind weight loss and management. 

People living with obesity face a major medical hurdle when trying to lose weight (and keep it off). The hormones that control your appetite change after you lose weight, oftentimes driving you to regain it. Some people describe the hormone’s effects on their brain as food noise, or “the relentless and distressing desire to keep eating.” In the simplest of terms, weight loss medications help quiet that noise, which willpower alone, or setting a rigid resolution for yourself, just cannot do.

The new Pew survey also asked respondents whether they think these medications are a good option for people who want to lose weight but don’t have a weight-related health condition. The numbers are radically different for this question: 62% of respondents said no, 26% said they’re not sure, and only 12% said yes. 

These responses reflect some interesting paradoxes: On the one hand, weight loss-related demand for Ozempic has led to supply shortages that have made it difficult for diabetes patients to access the critical drug. The shortage coupled with an onslaught of media coverage about celebrities using the medications to shed pounds has prompted a backlash that some now refer to as “Ozempic shaming.”

Jessica Yu, Ph.D., a clinical psychologist and Senior Director of Patient Experience at Hims & Hers, recently addressed the rise of Ozempic shaming. It’s not just celebrities who are getting critiqued online because others think they’re using weight-loss injections. The conversations seep into everyday life. “Why do people care so much about others’ weight? And why do they feel like they have the right to comment on it?” she writes. “From my perspective, the answer lies in societal expectations around thinness.”

To some people, taking medication to lose weight is akin to cheating. But that’s the wrong way to look at it, Dr. Yu says. “Choosing to use weight loss medication doesn’t indicate that a person lacks willpower; rather, it signals that obesity simply isn’t easy to treat,” she writes. And “asking for help when faced with a daunting task is a sign of strength.”

Dr. Primack agrees. He notes that anti-obesity medications can be one of four important pieces to the weight-loss treatment puzzle for most people who have struggled in the past. The others include:

• Dietary change, especially emphasizing protein and staying away from ultraprocessed foods

• Regular physical activity, which doesn’t have to mean going to the gym everyday—it’s really about movement. Though strength training is really important, he notes, especially if your treatment plan includes weight-loss injections. (Some people who take GLP-1 medicines lose muscle because they aren’t consuming enough vital nutrients and exercising.)

• Behavior modification of some kind. Oftentimes we eat because we're happy, we're sad, we're bored, we’re lonely, we're tired. Understanding the roots of our emotional relationships to food, and having some self-compassion in the process, is crucial.

Every body is unique, and no one plan will work for everyone. But the fact that many Americans now understand weight loss as a complex pursuit—not a simple matter of wanting it badly enough—is an important development in treating obesity.