Huge, red trigger warning: Discussion of weight loss drugs and intentional weight loss.
Depending on how much celebrity culture or you follow, you may know that Ozempic has recently become the weight loss drug du jour. It’s actually a diabetes medication, but it recently got FDA approval to be used by non-diabetics for weight loss purposes. Along with its cousins Wegovy and Mounjaro, Ozempic has been receiving a steady drip of coverage because of its promise as a purported “miracle drug.”
Obviously there are many angles on this to unpack:
- The eating disorder angle: the fact that even articles and conversations about these newer weight loss drugs can trigger harmful thoughts and behaviours in people who have worked and are working to heal their disordered eating and eating disorders.
- The bullshit angle: the fact that people gain the weight right back once they go off the medication points to the reality that some bodies are just naturally fat; that the manufacturer has engaged in super shady advocacy and marketing practices, including spending a hundred million dollars advertising Ozempic last year.
- The literal shit angle: these drugs cause nausea, diarrhea, vomiting, and other GI symptoms. One memorable line from the buzzy article about Ozempic in The Cut was, “I heard somebody say all the gays at CAA are on it and they’re all shitting their brains out.”
- The health research angle: we don’t know what happens to people who’ve been on Ozempic (and other semaglutide products) for weight loss for more than two years. It’s the fen/phen debacle all over again (fenfluramine/phentermine was the super-hyped weight loss drug that famously stopped people’s hearts from beating back in the 1990s). There’s the sketchy fly-by-night websites people are buying it from. Oh, and there’s also the pancreatitis, thyroid cancer, and renal failure, but anything for “health,” right, folks?
- The disillusionment angle: the fact that the Ozempic discourse and demand truly reveals the degree to which gestures at body positivity were empty, meaningless gestures from the jump. “I just want to be healthy,” was always a cover-up for a desire to lose weight. I guess it’s good that we can finally be honest now, though.
- The access issue: diabetics are having to go without this medication because of it being used in this manner. One Canadian province just announced they would not be selling Ozempic to Americans through the mail, in order to preserve the supply they need for diabetic patients.
- The reality check: the fact that none of this does anything to alleviate weight stigma, and in fact, makes weight stigma so much worse (I can only imagine how dehumanizing it will be the first time someone says to me “if you can just take Ozempic to lose weight, why wouldn’t you?”). It’s gonna be a new level of having to justify your existence as a fat person.
But the angle I’ve been thinking about this most is actually the most basic: the anxiety so many people appear to have about having an appetite.
A staple of most articles about Ozempic features first-hand takes from a handful of people taking the medication. They speak with wonder and breathless awe about their ability to simply not feel hungry. In all the coverage, it’s the underlying fear of experiencing hunger signals at all that I have been most intrigued by.
From The Cut:
From The Guardian:
From a different article in The Cut:
Let’s be clear: a) feeling full from just drinking a glass of water in the morning is really only normal among people who are going to die within 24 – 72 hours, and b) what we’re really talking about here is normalizing starvation. You know, starvation, that thing that’s notoriously bad for your health? The thought that simply not eating has gained (more) cultural merit is profoundly disturbing. All of that is bad enough, but the idea that a people would do this to themselves intentionally in the name of “health”? is entirely off the rails.
Abby Rose Morris really nailed it on the head with these observations on Twitter (which aren’t showing up properly as formatted tweets because Twitter is breaking the hell down):
(Update! Abby Rose and I were both so agitated about this topic that we recorded an episode of her podcast, More Than Tracy Turnblad, about precisely this issue!)
BEING HUNGRY IS NOT A MENTAL ILLNESS OR DISEASE. And the longing to be free from the sensation of hunger is absolutely screaming “there is something else going on here.”
For many, it’s a longing for effortlessness, a wish to simply be unencumbered. Some people want to forget they have a body at all. If you have no desire to eat, then you are free from desire, period. Being able to deny your hunger, and be free from it entirely, is to float above it all.
And if you don’t desire anything, or need anything, you’ll never be in a position to get hurt.
A hunger signal, on the other hand, is a nasty reminder that you have an animal’s body. It says, you have needs. Hunger embarrasses us in a way that other physical signals, like thirst or having to pee or even feeling horny, does not. It’s a marker of a moral failure. It’s a threat. And when you feel afraid of a physical signal like hunger, you live with that threat every damn day of your life.
What a terrible way to live (ask me how I know.) (orthorexia. I know because of years of orthorexia, the unhealthy obsession with health).
If you believe you should just subsist on almonds and kale, you may be scared of not getting your needs met, and likely have a problem with boundaries. Trapped in a diet-binge cycle? You have a core belief of your own brokenness that you are trying to heal in a backwards way. Stare in awe at the model who seems to subsist on cigarettes and Perrier? Pause next time you find yourself doing that, and tune in. What is it exactly that you think she has that you don’t?
If you are a non-diabetic thin person who has found a way to take weight loss drugs, I’m going to suggest that you’d be way better off getting some coaching (from someone like me) or psychotherapy around the beliefs that are driving you to endanger your health in this way.
If you are a non-diabetic fat person who is taking weight loss drugs, please know that I do not blame you. The idea that there could be a one-way ticket out of being discriminated against based on your size sounds uh-may-zing. The dream of living in a socially acceptable body is very real.
Ultimately, though, there are better ways of dealing with difficult emotions, systemic barriers and fundamental embarrassment of having a body than forcing an injectable eating disorder on yourself. There are pathways to healing and to managing emotions that enrich your brief experience of life on earth. You don’t have to shit your brains out first in order to find that out. I can help.