Bye-bye BBLs: How Y2K fashion and Ozempic created a new class divide

The way American culture recycles itself has a frightening irony to it. Like Y2K fashion, which included low-rise jeans, barely-there camisoles, and belly-button piercings, the body ideal that typified the early 2000s—heroin chic—also makes a victorious comeback. This time, however, the goal of extreme thinness is about access rather than just starvation or chain smoking. More than ever, the shallow ideal of society is determined by wealth.

Enter the Olympic era, when losing weight requires a prescription (and frequently a high cost) rather than merely willpower or deprivation. Originally created to treat diabetes and obesity-related disorders, GLP-1 receptor agonists such as Ozempic and Wegovy have become popular diet choices for people looking to lose weight. The harsh truth? In the United States, the greatest luxury is health and the thinness that has come to represent it.

As a class divide, thinness

In the 1990s, models like Kate Moss popularized the gaunt and hollow style known as “heroin chic,” which was frequently condemned for promoting a particular (and possibly harmful) aesthetic. However, Ozempic is a new form of exclusivity. These days, access to medical innovations that are physically out of reach for the majority of Americans is more important than appearance.

Without insurance, a month’s supply of Ozempic or Wegovy can cost up to $1,000, which is well beyond the means of many.

Recent studies show that whereas Medicare patients, who make up about 19% of the US population, only account for 28.5% of Ozempic prescriptions and 1.2% of Wegovy prescriptions, commercial insurance covers over 89% of Wegovy prescriptions and 61% of Ozempic prescriptions. States differ greatly in their Medicaid coverage; some, like California, allow broad access, while others make it practically hard to get these drugs.

When the patent for the active ingredient in Ozempic, semaglutide, owned by Novo Nordisk, expires in 2031, there probably won’t be a generic version of the medication. For instance, a generic version of the drug might cost only $100 instead of the current $1,000, which is 90% less.

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This leads to an unsettling situation: wealthy people utilize these drugs off-label to lose a few pounds before a trip or red carpet event, while those with real medical concerns, such Type 2 diabetes or obesity, frequently find it difficult to obtain them.

Think about the innumerable celebrity endorsements and rumors in Hollywood about who is taking Ozempic to keep their body in shape. These medications have evolved into status symbols in and of themselves, contributing to a new wave of pressure on body image in which socioeconomic position is directly associated with thinness. Being slender is no longer the only goal; having the money to attain and maintain it is much more important.

The ramifications are severe. Weight-related illnesses can be fatal for those who are impoverished or do not have proper health insurance. The fact that people who don’t need these drugs are monopolizing them draws attention to a stark disparity in the American healthcare system: the wealthy grow thinner while the poor get worse.

How bodily pressure is fueled by economic uncertainty

Beauty standards have historically been influenced by cultural and economic instability, especially for women. Today s economic stability mirrors theheroin chic eraof the 90s and early 2000s, when economic recession and rapid globalization, and the extreme thinness of supermodels symbolizedrestraint and controlin an uncertain world.

Let’s fast-forward to today. The COVID-19 pandemic has fundamentally altered the way we think about health, safety, and stability. For millions, it was a period of weight gain, mental health struggles, and loss of control. Y2K fashion s comeback feels less likea playful throwbackand more like a return to restrictive ideals that prey on women s insecurities during times of uncertainty.

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Low-rise jeans and crop tops demand aflat stomach, a feature unattainable for many without significant dieting or, increasingly, weight-loss medication. These trends, paired with the mainstreaming of drugs like Ozempic, send a clear message:thinness is back, and it s asexclusiveas ever.

The pandemic amplified our collective desire for control, particularly over our bodies. For many women, weight gain during COVID-19 became a scapegoat for broader struggles. This isn t surprising in a society steeped in diet culture, which equates thinness with worthiness and offers weight loss as the solution to every problem.

The rise ofGLP-1 drugsis a testament to how diet culture operates: it creates the conditions for a problem (in this case, pandemic-related weight gain and anxiety) and then markets itself as the solution. This isn t new. The$72 billion diet industrythrives on our insecurities, constantly shifting the goalposts of what it means to be healthy.

Ozempic and its counterparts represent the ultimate intersection of health and consumerism. They re sold as medical miracles, yet their off-label use highlights how thinnessnot healthis often the real goal. The widespread desire for these medications speaks to a deeper truth about American culture: the pursuit of thinness has never been about health, but about conformity, control, and class.

What s at stake

This isn t just about individual body image struggles; it s about the broader implications of tyingthinness to wealth. The normalization of Ozempic as a weight-loss tool risks reinforcing harmful beauty standards while further marginalizing those who lack access to healthcare. It s a reminder that, in America, even our bodies are subject to thewhims of capitalism.

We must questionwhose interestsare being served by these trends. Who benefits when ultra-low-rise jeans replace curve-hugging styles, when heroin chic displaces the hourglass ideals that dominated the 2010s, and when Ozempic becomes the new Brazilian Butt Lift? The same people who ve always profited from shifting beauty standards: retailers rushing to stock size 00 again, pharmaceutical companies marketing thousand-dollar miracle drugs, and the wealthy who can afford to chase each new body ideal. Meanwhile, theplus-size community that fought for representationover the last decade, the models who celebrated their curves, and patients who genuinely need these medications are left watching from the sidelines as their hard-won progress erodes.

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In reclaiming control over our bodies, we must reject the narrow ideals that seek to define them. True health is about more than a number on a scale, just as true style is about more than fitting into the latest fashion orbody trends. The real revolution will come when we decouple worth from weight and when healthcare is a right, not a luxury.

Amy Stretten (she/they) is a Black / Indigenous queer Femme journalist, commentator and the creator of cultural fashion platform The Chief of Style. She was recently featured in queer fashion bookDapperQ Style: Ungendering Fashionfrom HarperCollins. Her work has appeared on CNN / HLN, ABC News, NYPost, United Nations TV, Snapchat News, TYT Network, Aboriginal People s Television Network, HuffPost Live and ABC / Univision s Fusion network. You can find her and her on Instagram@ChiefofStyle

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