Can I use a GLP-1 just to lose 10–15 vanity pounds?

It’s a fair question — the drugs work, so why not use them lightly? The honest answer has four parts: 1. The risk-benefit math is calibrated to obesity. Every medication decision trades risks against benefits. At BMI 35 with hypertension, GLP-1 risks (rare pancreatitis, gallbladder events, GI misery) are dwarfed by the benefits — SELECT even showed fewer heart attacks. At BMI 23 chasing a beach deadline, the same risks remain while the documented benefits mostly evaporate. No trial has ever studied this population, so even the efficacy you’re assuming is extrapolation. 2. The biology punishes the plan. GLP-1 weight loss reverses on stopping — about two-thirds of lost weight returns within a year (the regain data). A 12-week vanity course buys a temporary result at the cost of muscle you won’t fully rebuild and rebound appetite. At healthy weights, the loss also skews leaner — you shed proportionally more muscle than someone with substantial fat stores. 3. The eating-disorder adjacency is real. “A healthy-weight person seeking pharmaceutical appetite suppression” overlaps uncomfortably with disordered-eating presentations, which is why legitimate programs screen for ED history and refuse cosmetic-only requests, and why BMI 18.5 functions as an absolute floor everywhere reputable. 4. What the gray area actually is. If you’re at a healthy weight now after losing significant weight, relapse prevention is a legitimate, documented, low-dose lane — that’s not vanity, that’s maintenance of a medical result. The line is history and rationale, not the number on your wish list. For genuinely small cosmetic goals, the unsexy toolkit — protein, resistance training, a modest deficit, patience — remains both safer and more durable.