How the ‘Ozempic Effect’ Is Changing Clothing Sizes Across the U.S.

Retailers across the U.S. are noticing a striking change on their racks. Plus-size apparel, once in constant demand, is showing up more frequently in resale markets. The growing use of weight-loss drugs such as Ozempic and Zepbound has reshaped clothing needs, creating what many in the industry now call the “Ozempic effect.”

Jennifer Johnson, founder of True Fashionistas in Naples, Florida, has tracked the change firsthand. For years, her resale store struggled to source enough larger sizes to meet demand. Customers would grab them instantly. Today, the pattern has flipped.

“Now our extra small area is smaller than our extra large,” she said.

With more clients downsizing, her store layout has been restructured multiple times to keep up with shifting inventory.

Resale Stores Riding the Wave

Instagram | tamuhealth | Nearly 12% of U.S. adults use GLP-1 drugs, and 14% are interested, a Rand survey found.

The shift isn’t limited to Florida. Across the country, resale businesses are experiencing similar changes. Janet Curran, owner of Do Good Co. in Kansas City, said donations and purchases have transformed.

“We’ve seen a real shift in our donation patterns and customer needs since more people started using weight loss medications,” she explained.

Smaller sizes are now moving quickly, while customers return frequently for wardrobe updates as their bodies change.

Recent data backs up these stories. A Rand survey revealed that 11.8% of U.S. adults reported using GLP-1 drugs, while another 14% expressed interest. Yet despite the noticeable impact on resale, there’s little sign that major retailers or manufacturers have scaled back plus-size production. Brands like Walmart and Levi Strauss declined to comment, leaving many questions about the long-term impact on apparel strategies.

Retailers Adjusting Extended Size Runs

Avneet Singh, founder of Regent Row, a menswear brand sold at Nordstrom and Macy’s, confirmed that retailers are changing how they stock larger sizes.

“Retailers are putting fewer extended sizes on the rack. You’ll see tighter size runs in store and more ‘online-only’ tags once you hit 2XL and up,” he said.

Singh added that GLP-1 drugs have shifted the curve within the larger size market. Many men who once wore 5XL or 6XL now purchase 3XL or 4XL. But height remains a constant.

“Tall remains critical even as waists come down,” Singh emphasized.

Ignoring tall customers, he warned, would leave a large segment of the market unserved.

For his brand, demand for 3XL and 4XL has grown, but 5XL and 6XL continue to sell strongly. Retailers, however, are increasingly outsourcing production of extended sizes to outside vendors instead of carrying them under private labels. Singh believes this reflects both risk management and shifting customer bases.

Plus-Size Shoppers Still Underserved

Freepik | Towfiqu Barbhuiya | Resale stores adapt quickly as shoppers shift from larger to smaller sizes with changing fashion needs.

Despite these shifts, many experts caution against reducing plus-size options. Mallorie Dunn, faculty at the Fashion Institute of Technology and founder of SmartGlamour, called the idea dangerous.

“Plus-size customers are grossly underserved as it stands — they need more options, not less,” she stressed.

Research consistently shows that 68% to 72% of Americans wear plus sizes, yet these garments represent only 12% to 18% of industry revenue.

Kara Richardson Whitely, founder of the Gorgeous Agency, echoed the warning. She argued that brands stepping away from plus-size apparel are “leaving money on the table.” As an author and advocate, she highlights that the presence of drugs like Ozempic does not erase the needs of plus-size consumers.

Her memoir “Gorge: My Journey Up Kilimanjaro at 300 Pounds” is even set to become a movie starring “This Is Us” actress Chrissy Metz. Whitely believes that while waistlines may shift, the plus-size market will remain powerful and essential.

Affordability Keeps Market Shifts Limited

Another key point is cost. GLP-1 medications remain out of reach for many Americans. Marty Bauer, director of ecommerce at Omnisend, explained that adoption is limited until prices fall.

“Until there is a big drop in drug prices, the mass adoption needed to reshape the clothing industry is unlikely,” he said.

Drugmakers are working to address this. Novo Nordisk recently announced price reductions on Ozempic, making it available for less than half its original list price through multiple platforms. Eli Lilly has also expanded access to its drug Zepbound, including plans for a needle-free pill alternative that could boost adoption.

Still, Bauer notes that production and pricing will depend on demand. If sales dip, smaller production runs could drive prices higher, slowing widespread adoption even more.

Retail Impact Already Visible

Instagram | @truefashionistasresale | Jennifer Johnson watches larger clothing sizes go on clearance as the industry starts feeling the drug effects.

Back at True Fashionistas, Jennifer Johnson continues to watch her racks with interest. She believes the full effect of these drugs on the apparel industry is still in its early stages.

“We are still in the infancy stages of how this will affect people as they age and continue using the drug,” she observed.

Her own store’s research at mall retailers already shows a pattern: “The larger sizes are all on clearance.”

Fashion’s Balancing Act Ahead

The Ozempic effect is reshaping apparel in ways few predicted. Resale businesses and certain brands are adjusting quickly to demand for smaller sizes, yet experts caution that the plus-size segment remains significantly underserved. Ignoring this majority of American shoppers could alienate loyal customers.

Affordability also plays a crucial role. Until GLP-1 drugs become widely accessible, the fashion industry will need to maintain inclusive sizing across the board. Retailers who balance emerging trends with longstanding needs are best positioned to thrive.

As the resale market grows and GLP-1 adoption continues, one fact is clear: fashion must evolve, but inclusivity must remain at the heart of that evolution. Brands that continue to serve all body types while responding to new trends can ensure that style and inclusivity move forward together.