In the decade or so since the body positivity movement gained traction in the modern era, diet culture has undergone multiple evolutions. What started as a rebellion against the size-zero ideal morphed into a glossy campaign for lean muscle and high-protein diets. It’s pivoted, this time shaped by TikTok trends and the rise of GLP-1 medications. Despite years of advocacy for body positivity, we find ourselves looping back to restrictive ideals, this time masked in new language and technology.

For dietitians and health and wellness professionals, this moment presents both a challenge and an opportunity: to unpack the persistent diet narratives of today and support patients, shoppers and clients through confusing, conflicting health messages.

A constant rebrand

Years ago, body positivity was the rebuttal to thinspiration. The third historic wave of the body positivity movement began around 2012 in response to growing social media influence and unrealistic beauty standards promoted online. It encouraged self-love and acceptance of all body types, challenging ideals like flawless skin and thin “beach bodies.” Companies commercialized the movement, but it led to increased inclusivity, such as Mattel’s diverse Barbie dolls and greater plus-size representation in fashion shows and campaigns.

But now, we’re seeing another rebrand. We’re told to chase wellness through data-driven perfection: precise macros, biometric tracking and fitness hacks delivered in 30-second TikToks. And this new aesthetic — dubbed “FitTok,” “GymTok,” “SkinnyTok” or “That Girl” — is just as aspirational, just as exclusionary and just as exhausting. And, as a VICE article explores, the return of Y2K fashion trends — like the Miu Miu mini skirt and low-rise jeans — coincides with a broader societal backslide toward glorifying extreme skinniness.

In May 2024, TikTok introduced new guidelines aimed at reducing the spread of harmful weight loss content on its platform, but have things really improved? The company said it will limit the visibility of posts promoting extended fasting, extreme exercise routines and weight-loss drugs like Ozempic on its “For You” feed. But a TikTok search in April 2025 showed over 50,000 videos on the app that still use the #SkinnyTok hashtag. Body checking — behaviors aimed at scrutinizing one’s body size or shape — has also become increasingly common on TikTok, often disguised as “fit checks,” GRWMs (Get Ready With Me) or diet videos.

A study in PLOS ONE found that just 7-8 minutes of exposure to disordered eating videos led to an immediate drop in body satisfaction, especially among those viewing weight-loss-focused content. Around 9% of the U.S. population, or 30 million Americans will have an eating disorder in their lifetime, and global eating disorder prevalence increased from 3.5% to 7.8% between 2000 and 2018, according to the National Eating Disorders Association. A CDC study additionally found that during the COVID-19 pandemic, emergency room visits for eating disorders and other mental health issues significantly increased among teenage girls. The report also noted an unusual rise in tic disorders (sudden, repetitive and nonrhythmic movements or vocalizations) among teen girls, possibly linked to content seen on social media platforms like TikTok.

GLP-1s: Medical solution or cultural trend?

Medications like Ozempic, Wegovy and Mounjaro have entered the cultural mainstream, and fast. Originally intended for diabetes and now prescribed for weight loss, GLP-1 receptor agonists are being hailed by some as miracle drugs and criticized by others for reinforcing thin-centric values.

For dietitians, this presents a nuanced discussion. Clients may ask: “Should I be on a GLP-1?” “Is this safer than dieting?” “Why is everyone I follow suddenly talking about this?” The reality is complex. These medications can be life-changing for clients or patients with medical indications and a supportive care team. But they’re also being co-opted by a culture that still rewards weight loss above all else. As health and wellness professionals, you must help clients assess not just the clinical facts, but the why behind their interest. Here’s how to navigate the modern face of diet culture with your clients.

1. Validate the confusion

Acknowledge the dissonance your clients are experiencing. It’s confusing to be told to embrace your body while seeing thinness rewarded on every screen. Say things like: “You’re not alone in feeling conflicted. The wellness space has a lot of mixed messages right now.”

2. Decenter weight from the goal

Reinforce that health behaviors, not body size, are better predictors of health outcomes. Clients may need reminding that:

Eating regularly and adequately is protective.

Losing your period is a red flag, not a badge of discipline.

Bone density, immunity and mental health suffer under restrictive routines.

3. Talk about GLP-1s factually, not fearfully

If a client asks about medications:

Discuss appropriate indications (e.g., diabetes, obesity with comorbidities).

Explain potential side effects (e.g., GI distress, muscle loss).

Frame these drugs as tools, not transformations.

And always bring it back to: “Let’s explore what’s driving your interest. What are you hoping it will change, and is there another way to support that goal?”

4. Shift focus from aesthetics to agency

Encourage clients to reclaim their health on their terms. Move for joy and strength, not punishment. Eat to nourish and energize, not to shrink. Question why chasing a thinner body feels necessary, and who profits when we believe we’re never enough.

The bigger picture

Much of what we’re up against stems from systemic issues: media algorithms, medical bias, a lack of research on female physiology and ongoing weight stigma. But dietitians can be at the forefront of change by educating clients on media literacy, normalizing weight-neutral care in every session, pushing back on one-size-fits-all recommendations and centering mental and physical health equally in goal-setting.

You don’t need to have all the answers about TikTok trends or medications. What matters most is that your clients feel heard, supported and guided by science, not shame. Ultimately, we don’t escape diet culture by ignoring it. We confront it by naming it, educating through it and holding space for those still unraveling from its grip. As a dietitian, you are uniquely positioned to be a lighthouse in the storm of wellness fads, offering clarity, compassion and credibility. Let that be your north star.