The economics of body ideals: when flesh was fortune

Historical literature and artwork have depicted larger bodies as a marker of prosperity and wealth, when food was scarce and such a luxury was only accessible to the affluent – being “plump” was a display of privilege. With the dawn of industrialised agriculture, food became cheaper and readily accessible to the masses, a new symbol of class, education, abundance of time and discipline was needed: slimness became the new beauty standard. It signalled self-control, time for exercise rather than labouring like the working class, and access to ‘quality’ calories rather than bulk consumption. To be slim was to appear modern – a visual shorthand for sophistication and social mobility.

Advancing further to present times, we have continued to see an evolution in body trends reflective of societal standards and norms. In times of abundance – such as the 2010s cultural fixation on pronounced curves emblematic of the Kardashian influence or the early 2000s fitness boom – reflected confidence, consumption, and prosperity. As economic confidence wanes, the ultra-thin, “clean girl” aesthetic echoes a broader move towards restraint and minimalism. 

Just like the “lipstick index” – the observation that cosmetic sales rise during times of economic recession, where consumers seek affordable symbols of pleasure when larger luxuries are out of reach – body trends also become expressions of economic psychology. While a fuller figure can signal vitality and access, a lean sculpted body signals discipline and control. As wealth inequality grows, the ability to curate a specific silhouette; training different muscle groups, eating a specific body, mastering one’s body has become a quiet display of privilege.

Despite revolutions in power, wealth, and technology that all have the potential to be the dominating status symbol, our obsession with the body endures. We still treat appearance as a moral barometer – a subtle reflection of discipline, control, and self-worth. Social media has only intensified this logic, transforming self-image into both performance and currency. In the shadow of global uncertainty and economic hardship, the body has become both a symptom and a signal – tightening, shrinking, and optimising in rhythm with the market itself. 

The advent of weight-loss injections such as Ozempic and Mounjaro, as revolutionary as they may be, reveals a more sinister undertone; when economies falter, we turn inwards, seeking control through the prick of a needle. In the UK, these medications aren’t publicly available for weight loss to the public, meaning those who choose to take it must go private. With prices up to hundreds of pounds per month, it is almost as though individuals are paying a subscription in order to have society’s ‘ideal body’. But how did we arrive at society’s current body standards? What implications does unequal access have on different socioeconomic groups? Where might societal body standards be going with these drugs in circulation?

Just like the “lipstick index” – the observation that cosmetic sales rise during times of economic recession, where consumers seek affordable symbols of pleasure when larger luxuries are out of reach – body trends also become expressions of economic psychology.

Weight-loss drugs – how did we get here?

Peptides such as GLP-1 and GIP were first theorised to exist by Ernest Starling in 1906, one year after he had coined the term ‘hormone’, when proposing how gut activity might influence the pancreas. Three decades later, Belgian physiologist Jean La Barre would use the word ‘incretin’ to describe a substance within the duodenal mucosa, which, when injected into dogs, would lower their blood glucose. La Barre also had the foresight to predict the massive impact understanding of this mechanism could have for diabetes mellitus treatment, but it would not be until the 1970s and 80s that the actual hormones GIP and GLP-1 would be isolated and demonstrated to cause insulin release.

The next progression was the manipulation of these natural hormones to develop drugs that could be manipulated for therapeutic benefit. While examining Glia monster venom in the early 1990s, John Eng discovered exendin-4, a compound with a shared structure to GLP-1 but degraded across hours instead of minutes. Sold under the brand name Byetta from 2004 as a licensed type 2 diabetes treatment, this breakthrough paved the way for second- and third-generation, molecularly-designed GLP-1 agonists such as liraglutide and semaglutide (the active ingredient in Wegovy and Ozempic), and dual GLP-1/GIP agonists such as tirzepatide (Mounjaro). Within two decades, incretin therapies have undergone revolutionary change. In 2004, a diabetic using a novel GLP-1 agonist would have had to take multiple injections per day, yet that is now down to one jab every week or even a daily oral pill (Rybelsus).

How do they cause weight loss?

In very simple terms, there are two main ways to cause weight loss – either decrease the energy intake or increase energy usage, and GLP-1 agonists primarily work by the former. By enhancing the firing of neurons in the brain relating to satiety and encouraging the reception and release of other satiety signals like leptin and CCK, leading to lower appetite, these satiety signals can also slow gastric motility and lead to longer feelings of fullness after meals.

However, this weight loss comes at a cost. A recent study (Ghusn and Hurtado, 2024) found that individuals on liraglutide commonly experienced GI symptoms, including nausea in 2 in 5 participants and diarrhoea in about 1 in 5, with debate existing in regards to whether GLP-1 agonists increase risk of more severe side effects such as pancreatitis and bowel obstruction (Sodhi et al., 2023).

The cost of thinness

The surge in weight-loss injections marks not just a medical shift, but a social and economic one. As drugs such as Ozempic and Mounjaro enter the mainstream, they expose how deeply body aesthetics remain tied to privilege and access. What was once achieved through time, labour, and willpower can now be purchased — but at a steep cost. For now, that cost keeps the privilege exclusive. With private prescriptions typically ranging between £130 and £200 per month, the ability to “opt in” to pharmaceutical thinness remains largely confined to higher-income groups.

According to NICE, semaglutide is available on the NHS to obese individuals with a BMI over 35 and at least one weight-related health condition, meaning that a high proportion of individuals who seek to use GLP-1 agonists for weight loss do not fit this criteria, and must go private. Depending on the dose of semaglutide, going private could cost up to £300/month, representing a significant cost barrier. Moreover, stopping semaglutide treatment has been associated with weight regain if lifestyle changes are not kept up (difficult when you stop taking a drug that suppresses your appetite), meaning you must keep paying this subscription-like service to have the body of your choosing. With the median yearly salary in the UK at around £37k, losing over 1/10^th of your yearly take-home pay represents a major financial burden for the average person. This pricing creates a level of inequality, whereby those with more disposable income have easier access to these drugs and more control and autonomy over their body images. But just what impact might this have on future aesthetic trends? Will these drugs remain expensive, or will being slimmer be more and more affordable? Does this mark a new era of body image?

This exclusivity risks formalising a new kind of bodily hierarchy: one where economic capital converts directly into physical conformity. Those able to afford the drugs can align more closely with the modern ideal of discipline and restraint, while those without such access may find themselves further marginalised. Research consistently shows that people in larger bodies face measurable disadvantages in the workplace – from lower wages to fewer promotions – and an expanding market for weight-loss injections may only intensify those disparities. If the aesthetic standard narrows further, exclusion will not simply be social but propagate existing financial disparities.

As the market for weight-loss drugs accelerates, questions of accessibility will define who benefits from this pharmaceutical revolution – and who is left behind. Analysts project the global market for GLP-1 medications to reach nearly US $50 billion by 2030, a surge driven not only by medical demand but by cultural aspiration. Yet economic expansion does not guarantee equal access. If these drugs remain tethered to private healthcare and premium pricing, the aesthetics of thinness will consolidate even further among the affluent, reinforcing visual and social boundaries between classes.

If, however, competition drives costs down – through generics or government subsidies – the consequences may be more complex than egalitarian. Broader affordability could usher in what economists might call “aesthetic inflation”: as pharmaceutical thinness becomes attainable for more people, the baseline for what counts as “fit,” “healthy,” or “desirable” will rise accordingly. Those unable or unwilling to participate may find themselves newly excluded, not by cost but by cultural pressure.

For lower-income groups, this tension exposes a familiar paradox. Increased accessibility might improve physical health outcomes, but it could also tighten social expectations – turning medical intervention into moral obligation. In this way, Ozempic’s future is not just an economic question of who can afford it, but a societal one: how far we are willing to let the market define the boundaries of acceptable bodies.

The next frontier of the body market

The economics of the body are unlikely to settle. For now, high demand and limited supply will keep injections expensive, but wider competition and insurance coverage could soon bring costs down – and with them, new pressures to conform. As pharmaceutical thinness becomes more accessible, the aesthetic bar will only rise. Alternatives like bariatric surgery or behavioural therapies transition to bygones, too slow for a culture hooked on instant results. 

Either way, the logic remains the same: the body has become a marketplace, its value fluctuating with supply, demand, and desire. Whether through a needle or a knife, the pursuit of control persists – leaner, faster, and ever more profitable.