America’s battle with obesity and staggering diabetes rates has found an advocate in the GLP-1 family of pharmaceuticals. For historical context, while these drugs have long been tools in the treatment of diabetes, in 2021, Novo Nordisk received FDA approval for a new drug category (semaglutides) marketed under the names Ozempic for diabetes and Wegovy for obesity. And four years later, the big pharma industry has exploded, and Americans’ battle with obesity escalated to a new level.
Take the idea of a Nordstrom Local to the next level by adding stylist services, and health, nutritional and wellness coaches to help guide the GLP-1 patient along their journey. That could be the makings of a new retail disruption.
Miracle Drug?
These superhero drugs have now been prescribed to about 12 percent of the U.S. population. According to a RAND survey, women aged 50-64 show the highest rate of usage, however, younger adults aged 18-39 have shown a 588 percent increase in prescriptions from 2019 to 2024. And while there has been a “ripple effect” in the retail fashion industry size-wise, these “wonder drugs” have already set into motion a cascade effect that has the potential to reshape consumer behavior for the foreseeable future.
The GLP-1 breakthrough that began with pharma has blurred the lines among industries, including food, wellness, beauty, retail, and travel. Why? It turns out that these miracle drugs do more than just reduce appetite. It appears that they “rewire the brain” in a manner that suppresses impulsive reward-seeking behavior. Simply put, beyond lessening appetites, they also diminish the need for immediate gratification. That has consequential outcomes that behavioral scientists are studying to research how the “GLP-1 effect” is already altering long-established behavioral norms. If the outcome is a sustainably healthier life, how will a healthier population that lives longer impact retirement planning? Will life insurance become less expensive? Will employees become more productive at work? Will health technology and “reskilling” or upskilling workers become the next growth industries? These questions, and many more, are certain to trigger a seismic change in our society.
Cascade Effect
As a retail trend forecaster, I’ve long been interested in “trend convergence” as a force multiplier. Last year PWC US conducted an in-depth consumer study of roughly 3,000 people to explore the influence of these medications on lifestyles, spending habits, and consumption patterns. The results reveal that a seismic shift is underway.
The GLP-1 cascade effect is impacting retailing on multiple fronts most notably, fashion, fitness, and food. GLP-1 shoppers are reportedly more deliberate, spending more overall but with greater focus on wellness and long-term value. Impulsivity is giving way to more intentional spending. Not a good sign for trendy fast fashion.
New Look, New Clothes
Changes in body shape and size can drive the aspirational quest for an “ideal” appearance. Nearly half (46 percent) of GLP-1 users experiment with new styles, including form-fitting, activewear, and crop tops, items they previously avoided. Even moderate changes in weight require new apparel. For many, self-confidence from losing weight can drive the desire to buy an entirely new wardrobe. On a higher level, it can inspire a new relationship with self-identity, status, and self-expression.
PWC’s study revealed that apparel spending rises 4 to 5 percent around six months after GLP-1 treatment begins. While some of this reflects wardrobe replacement, many users describe renewed confidence and a desire to align how they feel with how they look. So, what does this mean for fashion retailing?
Since a GLP-1 shift in body size is matched by a greater demand for smaller apparel sizes, larger sizes are declining. Last June, Lululemon’s CEO said the brand was “out of stock in some of [its] smaller sizes.” At the same time, returns are increasing as consumers navigate changing body shapes, prompting retailers to rethink fit algorithms, sizing tools, and inventory planning.
If purchasing patterns continue to shift based on this weight loss movement, apparel retailers and manufacturers may face the challenge of accurate forecasting for demand across sizes and styles, which may no longer follow typical, predictable distribution. A new study from Impact Analytics suggests that retailers could experience upwards of a $5 billion margin hit by 2027, resulting from a misalignment in size demand and increased clothing returns.
Fitness Industry Shift
There are many complex and interconnected health, nutritional, and emotional factors involved in the successful lifelong outcome of these drugs. GLP-1’s gain in popularity is impacting the fitness and health profession. According to a report from investment banking firm Harrison Co., the total addressable market for U.S. fitness clubs, including gyms and boutique studios, is expected to increase by $6.8 billion because of more GLP-1 customers. That’s a whopping 20 percent increase, but there’s a caveat. Fitness often follows a familiar pattern; it starts with enthusiastic commitment, followed by waning attendance and often ending in membership abandonment. While the GLP-1 initial burst may taper, the shift from transactional fitness instruction to well-being guidance may be the biggest opportunity for the industry. The “gym as a clinic” model is emerging. Leaders from Dr. B, Anytime Fitness, Evolt, and Life Time have urged operators to “seize the moment by integrating coaching, care and accountability for members using GLP-1s.”
Practical Wardrobe Management
The GPT-1 wave impacts the fashion industry both near and long term. The average person stays on GLP-1 for about seven months and then regains about two-thirds of the weight loss. What happens fashion-wise when that occurs? Do dieters then have to go back and buy new clothes again? Or did they actually keep their old ones just in case? There are several related opportunities, including multiple wardrobes, thrifting, renting and high-tech personal services.
The dual wardrobe is nothing new, often the outcome of fad diets that fail. Trendy diets have short-term effects, prompting new wardrobes for new sizes. At the same time, the fear of weight regain motivates users to keep their old wardrobes.
The “hedging my bets” approach to diets makes thrifting an appealing way to afford multiple wardrobes for changing body sizes. Thrifting has been growing faster than new fashion sales over the last-half decade. It is projected to reach $350 billion globally by 2028, with the U.S. market expected to hit $73 billion by the same year. Resale can also be a godsend for GLP-1 dieters. A GlobalData consumer survey among 3,000 American adults conducted in association with ThredUp found that 58 percent of consumers shopped for clothes secondhand in 2024, a dramatic six percentage point increase over 2023.
Renting is another way dieters can de-risk the wardrobe costs of body shifts. Clothing rental companies are also seeing a greater demand for smaller sizes. Last year, Rent the Runway CEO Jennifer Hyman told The Wall Street Journal that more customers were switching to smaller sizes than at any point in the last 15 years. According to Future Market Insights, the rental market is expected to grow from $2.6 billion in 2025 to $6.4 billion by 2035. For GLP-1 patients trying to manage “shapeshifting,” an under $100 per-month wardrobe revitalization makes economic sense.
New AI technologies are poised to step in to help dieters find the right fit. Beginning with dynamic sizing tools and virtual try-ons, a customer can see herself in a resized wardrobe. From a personal service perspective, retailers may need to offer styling support, flexible sizing, and inclusive messaging to help consumers navigate post-weight-loss identity transitions. Take the idea of a Nordstrom Local to the next level by adding stylist services, and health, nutritional and wellness coaches to help guide the GLP-1 patient along their journey. That could be the makings of a new retail disruption.
