Can you be body-positive and take Ozempic? I did — but for pain, not weight loss. Here’s why

Disclaimer: The mentioned organisation, All Bodies on Bikes, is a weight-neutral organisation. This means it does not make assumptions about anyone’s health, worth, fitness or ability based on body size. Its events, online, and community spaces are rooted in respect, inclusion, and the belief that joyful movement is for every body—without pressure to change how a person's body looks or a person's weight. It also does not engage in discussions about weight. The article below includes frank discussion on weight and is written from the author's personal persepctive only. Please read with awareness.

I made my name in cycling as an unapologetically fat endurance rider. For years, I have advocated for plus-size riders, and the need for bigger cycling clothing, improved transparency on weight limits, and inclusive riding communities. My journey was even chronicled in a 2021 documentary by Shimano, All Bodies on Bikes, which led to the creation of a nonprofit dedicated to size inclusion, an organization I now proudly lead as Executive Director.

I’ve never let my body size or weight limit me. I have completed five Unbound Gravel races at over 250 pounds, yet I’ll be the first to admit that my weight has made life challenging over the years. From needing a seatbelt extender on airplanes to ongoing knee pain, life as a bigger bodied athlete is not easy.

After an unsuccessful knee surgery in 2023 led to chronic pain, my orthopedic surgeon recommended weight loss as a solution. But throughout my life, I’ve tried just about every diet out there. Counting calories, cutting carbs, Weight Watchers—you name it. None ever led to lasting results. Instead, I live an active lifestyle and have come to a place of genuine self-love and acceptance with my body. I wasn’t interested in pursuing intentional weight loss again, especially not just to change a number on the scale.

But, as my doctor explained, this was about the impact of carrying extra body weight on my joints. Given my lifelong struggles with dieting, he suggested there might be an underlying issue contributing to my body size and recommended I see an endocrinologist.

That referral marked the beginning of my journey with GLP-1 receptor agonists—a class of medications originally developed to treat Type 2 diabetes, but now increasingly prescribed for weight management. At first, I was very hesitant. These drugs, including Ozempic and Wegovy, have sparked heated debates about body image, diet culture, and what it means to pursue “health.” But for me, this wasn’t about chasing a thinner body or losing weight, per se. It was about relieving pain and staying on the bike for the long haul.

As it turned out, I had insulin resistant PCOS (polycystic ovary syndrome). PCOS is a common hormonal disorder that affects up to 1 in 10 people with ovaries, though it often goes undiagnosed. One of the lesser-known but significant effects of PCOS is how it can impact metabolism and weight. Many people with PCOS experience insulin resistance, meaning our bodies struggle to use insulin effectively, which can lead to higher blood sugar levels and increased fat storage. This metabolic imbalance makes it easier to gain weight and significantly harder to lose it, even with lifestyle changes like diet and exercise. This explained why I was seemingly doing everything “right,” that is, eating a balanced diet and exercising frequently, while still carrying excess weight.

As a public figure who cultivates weight-neutral cycling spaces and communities, taking a GLP-1 felt antithetical to my identity. If my body changed on this medication, which was likely to happen, would I be betraying my values? Would I be sending the wrong message to the All Bodies on Bikes community? What does it mean to advocate for body acceptance while making a choice that may lead to weight loss and body changes for myself?

What’s more, how would it impact me on the bike?

The side effects of GLP-1s have been widely talked about: nausea, fatigue, gastroparesis (delayed stomach emptying) and more. I got lucky and only experienced mild nausea and constipation, however, the impact on my appetite was huge. I suddenly had almost zero hunger signals. A banana at breakfast would satiate me until lunch, when half a peanut butter sandwich would fill me up. Which to be clear, is not enough food for anyone, let alone an endurance athlete.

It quickly became evident that the appetite suppression part of the drug worked a little too well, especially as an endurance cyclist who continued to train and ride throughout this experience. My body, that I had learned to listen to closely over the years, was suddenly not sending the same signals. I wasn’t hungry at all. While that’s often seen as a benefit, it’s actually the opposite of what an endurance athlete needs. You need calories to perform.

Instead of being able to eat intuitively and trust that I was meeting my daily needs, I found myself having to set reminders to eat, planning each meal for maximum nutritional density. Thank goodness for custom alerts on my Wahoo Elemnt Bolt, which is one of the best bike computers! Paired with my heart rate monitor, it sends me a reminder to eat after every 100 calories burned on the bike.. This has mostly kept me from bonking while riding but it definitely isn’t fool proof. I also found that liquid calories, small frequent snacks and protein-dense meals helped ensure I was fueling my body properly.

As the months went on, I started to notice small changes in both my body and my riding. Clothes felt a little looser. I could see my collarbone for the first time in my life. My chronic joint pain and inflammation receded, and my period started becoming normal and lighter. Perhaps most excitingly, I was able to climb hills that I had previously walked up. I felt stronger on my bike and noticed I was consistently hitting PRs on segments I rode all the time.

My first public appearance in a noticeably smaller body was at Mid South 2024. At that point, I had lost nearly 20% of my starting body weight. An acquaintance remarked that I looked “faster” than ever, and a social media follower commented “You’re getting skinny girl!” While I think these comments were intended to be positive, I was a little surprised. I’ve always been adamant that we shouldn’t comment on anyone’s body, regardless of size, and have publicly asked people not to comment on my body. My weight loss was not intentional, and I had no desire to promote it as such.

Navigating the social and personal ramifications of a visibly changing body is intense. I was once again reminded how poorly society treats fat people. Whereas before I was mostly invisible, I now get unsolicited cat-calling from men, people are way nicer, and my concerns are taken seriously at the doctor.

After a complication with my prescribing doctor and insurance, I have been off the medication since May 2025. My last dose was two weeks before Unbound Gravel, where I successfully rode 109 miles (and had to relearn all my eating strategies on the fly, as I was suddenly very hungry!) Sadly, my joint pain and inflammation have come roaring back into my life, along with my appetite. And so my health struggles continue.

I hesitate to share this story as a leader in the body positive world. Other leaders have been vilified for losing weight (see Lizzo) and changing their bodies. As I’ve gone through this process, it’s only reinforced my belief that all bodies are good bodies, all bikes are good bikes, and all rides should be celebrated. Regardless of my weight or size, my values, my personality, and my love of cycling are the same. Whether I wear a size 22 or a size 14, I still believe that everyone should get to experience the joy of cycling, with equipment, clothing, and a community that supports them.

I also believe you should do whatever feels right for you to live happily, healthily, and pain-free, and it’s truly no one’s business but yours and your health care provider.

If there’s one thing I’ve learned through this journey, it’s that health is not one-size-fits-all, and it’s never just about the number on the scale. The decisions we make about our bodies, our medical care, and our well-being are deeply personal, and often far more complex than they appear from the outside.

I didn’t take a GLP-1 to become thin or fit into a narrower mold of what an athlete looks like: hell, I’m still considered “obese” by all measures. I did it to manage chronic pain, stay active and keep riding bikes. My story isn’t a prescription or a path for anyone else; it’s simply a reminder that we all deserve access to tools that help us feel good in our bodies, no matter what they look like.

Editor’s note:

If you’re an elite athlete, be aware that semaglutide is currently on the WADA Monitoring Program. This means that while drugs like Ozempic are not currently banned by WADA, the agency is monitoring its use in sports to determine if it should be added to the Prohibited List in the future.