AMNA NAWAZ: Roughly 12 percent of Americans are now taking the blockbuster set of weight loss medications known as GLP-1s.

And while their popularity continues to skyrocket, new concerns have emerged around the societal impacts, especially around body image.

Correspondent Stephanie Sy and producers Mike Fritz and Sam Lane have that story for the last installment of our series GLP-1s: Reshaping America.

GABRIELLA CORO, Former GLP-1 Patient: You're not going to tell me?

Why?

STEPHANIE SY: When Gabby (ph) Coro became a mom in 2021, the joy of having her son, Charlie, was soon overshadowed by what came next.

GABRIELLA CORO: It was very hard to shed the pounds.

I had gone through pretty severe postpartum depression that lasted roughly three years, and nothing was really working.

So some of the side effects include weight gain or, like, really hard to lose weight.

STEPHANIE SY: The 35-year-old college professor lives in Miami with her husband, Raul.

She says, despite repeated efforts, she struggled to lose about 30 pounds from her pregnancy.

GABRIELLA CORO: I just didn't like how I would look in pictures, I didn't want any pictures taken of me during this time.

My husband can attest he had a family member ask him if we were separated or divorced.

He's like, I don't see Gabby in any of our -- the pictures with you and your son.

And that's how I was just like, don't take a picture of me.

I don't want to be seen.

STEPHANIE SY: But, late last year, she was prescribed a GLP-1.

GABRIELLA CORO: And I took my first injection after Christmas and my birthday, so I could have birthday cake and enjoy myself.

SERENA WILLIAMS, Professional Tennis Player: Thirty-four pounds down on GLP-1s.

STEPHANIE SY: With ads fronted by celebrities flooding airwaves and social media feeds.

KENAN THOMPSON, Actor: Maybe we don't need a pill for everything, but for managing weight, there's Wegovy.

STEPHANIE SY: The health benefits beyond weight loss from GLP-1s have also fueled their growing popularity.

Besides treating diabetes, which they were originally developed for, the drugs are proving to lower the risk of heart attacks and stroke and improve a range of cognitive and behavioral health outcomes, reducing seizures, sleep apnea, and arthritis.

But for Gabby Coro, who after just three months on a GLP-1 lost nearly all her post-pregnancy weight, the decision to take them felt fraught.

GABRIELLA CORO: I felt like I was almost a traitor to everything I stood for in regards to body positivity.

The only beach body is a body on the beach, those slogans that we say, and I do believe, and here I am taking the meds.

And I was just -- I felt really shameful about it.

STEPHANIE SY: Since 2019, the number of overweight adults in the U.S.

prescribed a GLP-1 has skyrocketed by nearly 600 percent.

CHARLOTTE MARKEY, Clinical Health Psychologist: These drugs are marketed as a way to change your body and feel better about yourself.

And I think they're being oversold somewhat.

STEPHANIE SY: Charlotte Markey is a clinical health psychologist at Rutgers University and the author of several books on body image.

CHARLOTTE MARKEY: Body image is linked with depression, anxiety, substance use disorders.

When people don't feel comfortable in their own skin, then the consequences are really vast.

And it's no wonder why advertisements that suggest you can take a medication to fix your body image are compelling.

But what we don't have is any data that actually shows that taking these weight loss medications will improve body image.

STEPHANIE SY: She also worries GLP-1s may fix one issue, while creating others.

CHARLOTTE MARKEY: And I do see in my practice that there are people who have been prescribed these drugs, and they're not eating enough, and they are essentially developing eating disorders as a result of the medication.

WOMAN: Real.

WOMAN: Beautiful.

STEPHANIE SY: She says it wasn't that long ago that bodies of all sizes were gaining new acceptance.

CHARLOTTE MARKEY: We really saw people embracing body diversity, body acceptance, and enjoying seeing themselves in the images around them.

And then weight loss medications came on the scene, and there was less diversity.

STEPHANIE SY: There's also research that larger-body people who use GLP-1s to lose weight are facing new stigmas.

A study published earlier this year found they're viewed negatively for taking a shortcut.

Meanwhile, another study found that women's chances of being hired and finding a spouse increase after more than a year-and-a-half on the medication.

RUTH MCCLELLAND-NUGENT, Former GLP-1 Patient: So I went from a 3X, 3XL T-shirt, to a medium.

I'm wearing a medium today.

And it's weird to get these compliments about how great you're looking, and you know that you're very sick inside.

STEPHANIE SY: Fifty-year-old Ruth McClelland-Nugent started taking a GLP-1 last year to address diabetes.

And, for that, the medication has worked.

She also lost roughly 100 pounds.

But the Georgia resident says it's also led to a cascade of health problems.

RUTH MCCLELLAND-NUGENT: Certainly, having a lower blood pressure, a lower weight, and a lower A1C, those are very good.

But I'm not able to be very active.

I'm not able to control my emotions.

I have this hunger thing going on.

I'm weak.

I'm having trouble.

I get up and down the stairs.

I'm having trouble getting back used to walking.

STEPHANIE SY: Even though McClelland-Nugent was only on a GLP-1 for seven weeks and got off them in November, the side effects, she says, have persisted.

RUTH MCCLELLAND-NUGENT: That's the laxative.

STEPHANIE SY: And now she has to take a bag full of medications to address a variety of symptoms that she traces back to her time on GLP-1s.

RUTH MCCLELLAND-NUGENT: These are two different versions of what makes me able to eat.

STEPHANIE SY: She initially was diagnosed with gastroparesis, a rare side effect that impacts digestion and can lead to poor appetite and nutrition.

RUTH MCCLELLAND-NUGENT: When you lose muscle there, it really messes with your balance.

So... STEPHANIE SY: She also says she suffered rapid muscle loss and occasionally needs to use a cane.

RUTH MCCLELLAND-NUGENT: My goal was to reduce my blood sugar, not necessarily to lose weight.

So this has all been really weird and it wasn't expected.

DR.

TRO KALAYJIAN, Chief Medical Officer, Toward Health: I remember being 350 pounds going on an airplane and, when I asked for a seat belt extender, the flight attendant turned around and said: "We need a hog strap."

STEPHANIE SY: Dr.

Tro Kalayjian, who calls himself a contrarian to the medical establishment, can empathize with the patients he sees at his obesity medicine practice outside New York City.

DR.

TRO KALAYJIAN: I couldn't fit on rides at carnivals with my kids.

I couldn't experience life.

I couldn't go clothes shopping.

I never felt comfortable in my skin.

STEPHANIE SY: Ten years ago, Dr.

Kalayjian began a strict ketogenic diet and exercise routine.

He lost 150 pounds, weight he's been able to keep off, he says, without the use of GLP-1s.

DR.

TRO KALAYJIAN: I think these drugs are amazing.

They're an amazing tool for people with diabetes and obesity, but without a holistic approach, we are literally setting up people to fail.

Our diets have not meaningfully changed to accommodate these medications.

We didn't all of a sudden start eating nutrient-replete diets.

We didn't all start exercising, meaning we're not mitigating the side effects that we know these cause.

STEPHANIE SY: And while he does prescribe them to some of his patients, he also touts a GLP-1 off-ramp on his Web site for people suffering physical or mental side effects.

DR.

TRO KALAYJIAN: I think the biggest harm that docs can do right now is take somebody who struggled with obesity their entire life, doesn't know how to eat food to actually nourish themselves, is nutrient-depleted, has never had their psychological or emotional issues evaluated, and just give them a GLP-1 and have them eat less.

I think it's a recipe for disaster.

STEPHANIE SY: For Gabby Coro back in Miami, it's been a recipe for success.

She's comfortable seeing herself in photos again, even though she still feels conflicted.

GABRIELLA CORO: It works.

So I would say I'm so happy I did it.

I really am.

STEPHANIE SY: Would you be willing to go back on it if you needed to?

GABRIELLA CORO: I would probably feel really guilty if I did.

STEPHANIE SY: Why would you feel guilty?

GABRIELLA CORO: I would feel like I was a failure, that it's like, wow, you didn't have enough self-discipline, self-control.

You lost that weight.

I have always kind of had an issue with my appearance, and I don't think I'm alone in that.

I think most people would see something they would like to change.

STEPHANIE SY: For the "PBS News Hour," I'm Stephanie Sy.

AMNA NAWAZ: And you can watch our full GLP-1 series online covering everything from access to cost and addiction.

You can find that on our YouTube page or our Web site, PBS.org/NewsHour.