Serena Williams, GLP-1s, and the Risk of Normalisation

Serena Williams ignites new GLP-1 attention

When Serena Williams recently revealed that she had used a GLP-1 medication to support postpartum weight loss, it ignited a fresh wave of public attention around these drugs as the first sports celebrity to publicly open up about usage. For many, her admission was empowering: a global athlete acknowledging that even at the highest level of fitness, weight management is complex, physiological, and sometimes requires medical support. Yet beneath the headlines lies a more nuanced story, one that spans the intersection of medicine, celebrity culture, and health policy. Williams’ disclosure may reshape public perception of GLP-1 receptor agonists, but it also risks fuelling demand and misconception in ways that Australia’s healthcare system is still ill-prepared to manage; not to mention that this certainly brings to the spotlight the ongoing societal pressures around weight management and body image. 

Celebrity disclosures have long influenced public health behaviour, for better and for worse. When a cultural icon like Williams openly endorses a therapy, it reframes its social meaning. GLP-1 medications, once viewed primarily as diabetes drugs or last-resort interventions, are rapidly being normalised as legitimate, even aspirational, tools for weight management; and the research is backing this up. In one sense, this destigmatises the use of pharmacotherapy for obesity, recognising it as a chronic, relapsing medical condition rather than a moral failure, inappropriately stigmatised with shame and anxiety. But in another, it accelerates the medicalisation of weight loss in the public imagination, inviting demand from those who may be ineligible, poorly informed, or unprepared for the realities of long-term treatment. When demand spikes ahead of evidence or supply, the consequences ripple through clinics, pharmacies, and policy systems alike. You can already understand the framed conundrum this poses. 

The evidence

We know that the clinical evidence for GLP-1 receptor agonists and dual agonists is robust and expanding by the minute. Trials such as STEP have demonstrated substantial and sustained weight loss with semaglutide at 2.4 mg, while the SELECT trial reported a reduction in major adverse cardiovascular events in patients with overweight or obesity and established cardiovascular disease, even in the absence of diabetes. These findings confirm that the benefits extend beyond weight reduction to cardiometabolic risk modification. Yet they also underline that obesity, like diabetes, is a chronic condition requiring continued therapy, and offers these drugs as a concurrent therapy to lifestyle modification where appropriate. However, discontinuation is consistently associated with weight gain, reinforcing that these drugs are disease-modifying rather than curative; this is important to note.

Adverse effects remain common and must be managed carefully. Gastrointestinal symptoms are frequent and dose-dependent. Cases of pancreatitis and gallbladder disease have been reported, though causal links remain under review. The long-term safety profile at obesity-level dosing is still emerging, and continued pharmacovigilance is warranted. For clinicians, patient selection, dose titration, and monitoring are critical to safe and effective use. Education about expectations, particularly that benefits are sustained only with ongoing therapy, should be integral to prescribing conversations.

Availability continues to curb public interest

In Australia, enthusiasm for these medicines must be balanced with the realities of access and regulation. Ozempic (semaglutide) is PBS-subsidised only for type 2 diabetes. Wegovy, the higher-dose formulation approved for chronic weight management and for cardiovascular risk reduction in adults with overweight or obesity and established cardiovascular disease, is not subsidised. This creates a familiar inequity: clinical approval without affordable access. Out-of-pocket costs, commonly exceeding $400 per month, place therapy beyond reach for many patients who meet medical criteria. Given that obesity prevalence is higher in lower socioeconomic groups, this situation risks exacerbating existing health disparities.

Supply instability adds further complexity. Demand for GLP-1s used off-label for weight management contributed to prolonged shortages of Ozempic between 2022 and 2024, prompting the Therapeutic Goods Administration to restrict new initiations and prioritise diabetes care first and foremost. Although supply has since improved, local shortages persist intermittently, and clinicians are advised to verify availability before prescribing. The combination of fluctuating stock and heightened public interest has also created fertile ground for counterfeit or compounded products — an emerging safety concern noted by both the TGA and the World Health Organisation.

The Williams effect may therefore amplify both opportunity and risk. On one hand, her experience reinforces a more compassionate and evidence-based view of obesity treatment. On the other, it may accelerate a surge in public demand that the system is not yet equipped to meet. For clinicians, this is a moment to lead with clarity and consistency. Consultations should emphasise medical eligibility, the chronic nature of therapy, the importance of ongoing lifestyle support, and the potential adverse effects. Clinicians must resist social or cosmetic pressure to prescribe outside established indications and be prepared to counsel patients about the limitations of the evidence base.

The future use of GLP-1 receptor agonists

At a policy level, the conversation prompted by Williams’ disclosure may offer an opportunity to revisit Australia’s approach to obesity pharmacotherapy. There is a credible argument for a targeted PBS subsidy, limited initially to high-risk patients with established cardiovascular disease or severe obesity, aligned with the populations studied in SELECT. Such an approach could balance cost containment with equity, allowing the health system to gather real-world outcomes data while expanding access to those most likely to benefit. Any expansion, however, should be accompanied by national prescriber education, standardised monitoring frameworks, and transparent post-marketing surveillance.

Ultimately, the intersection of celebrity, medicine and policy is not new, but the speed at which social influence now travels presents unique challenges. Many in the diabetic care space are already predicting common use of GLP-1 therapies in the future, as a relatively safe, effective and sustainable option. GLP-1 therapies have shifted the paradigm of obesity care; they deserve to be integrated thoughtfully, not sensationalised. Williams’ candour can be used as a teachable moment, a prompt to advance public understanding, strengthen clinical stewardship, and advocate for equitable, evidence-based access. The task for the profession is to ensure that this moment of visibility translates into sustained, responsible progress rather than another cycle of hype, scarcity and unmet expectation amid unknown long-term outcomes.