Many have done that declared Drugs like Ozempic could end obesity by reducing the appetite and waistlines of millions of people around the world.
Looking past the hype, this is not only untrue, it can also be harmful. The focus on weight, as opposed to health, is a hallmark of diet culture. This defines the pursuit of thinness as more important than other aspects of physical and cultural well-being.
The Ozempic buzz is not only rooted in health and medicine, but also plays on ideas about them fat stigma and fatphobia. This can perpetuate the fear of fatness and fat people, and the behavior associated with them be harmful to people living in larger bodies.
Not the first ‘miracle drug’ for weight loss
This isn’t the first time we’ve heard that weight-loss drugs will change the world. Ozempic and his family of GLP-1 mimicking drugs are the latest in a long line of weight loss drugs. They all looked promising at that moment. But none have lived up to the hype in the long run. Some have even been withdrawn from sale because serious side effects.
Science improves step-by-stepbut diet culture also keeps us in a cycle of hoping for the next one Wonder drug. So medications like Ozempic may not deliver the results people expect, perpetuating the cycle of hope and shame.
Ozempic does not work the same for everyone
When we talk about the results of studies with Ozempic, we often do so focus on the average (also known as the average) results or the maximum (or peak) results. So studies could be that show those taking the drug lost an average of 10.9% of their body weight, but some lost more than 20% and others less than 5%
What we don’t talk about much is that responses are variable. Some people are “non-responders”. This means that not everyone loses the same amount of weight as the average, and some don’t lose any weight at all. For some people, the side effects will outweigh the benefits.
When people take medications like Ozempic, their blood sugar levels are better controlled by increasing the release of insulin and lowering the levels of another hormone called glucagon.
But there is a greater variation in the amount lost weight than the variability in blood sugar control. It’s not clear why, but it’s likely due to differences in genetics and lifestyle, and the fact that weight is more complex to regulate.
The treatment must continue. What will this mean?
When weight loss medications work, they are only effective as long as they are taken. This means that in order to maintain their weight, people must continue to use them for a long time. One study found an average weight loss of more than 17% after one year Ozempic achieved an average net weight loss of 5.6% more than two years after stopping treatment.
Short-term side effects of drugs such as Ozempic include dizziness, nausea, vomiting and other gastrointestinal complaints. But because these are new drugs, we simply don’t have data to tell us whether side effects will increase the longer people take them.
We don’t know if either effectiveness will decrease in the long-term. This is called tolerance to medications and has been documented for other long-term treatments, such as antidepressants and chemotherapeutics.
Biology is only part of the story
For some people, using GLP-1 mimicking medications like Ozempic will be validating and empowering. They will feel like their biology has been “normalized,” in the same way that blood pressure or cholesterol medications can return people to the “normal” range of measures.
But biologically speaking: obesity is not just about GLP-1 activity of many others hormones, physical activity and even our gut microbes are involved.
General, Obesity is complex and multifaceted. Obesity is not just caused by personal biology and choice; it has social, cultural, political, environmental and economic determinants.
A weight-focused approach misses the rest of the story
The weight-oriented approach suggests that leading with thinness means health will follow. But changing appetite is only part of the story when it comes to health.
Obesity often is associated with malnutrition. We try to separate the effects in research using statistics, but if we focus on the benefits of weight loss drugs without addressing the underlying malnutrition, we are unlikely to see the consequences. improved health outcomes for anyone who loses weight.
Obesity is not a problem isolated from people
Even if well-intentioned, the rhetoric surrounding the joy of “ending the obesity epidemic” can harm people. Obesity does not occur in isolation. They are people who are obese. And the celebration and hype of these weight-loss drugs can reinforce harmful fat stigma.
Framing these medications as a “cure” exacerbates the binary view of thin versus fat, and healthy versus unhealthy. These are not binary outcomes that are good or bad. Weight and health exist on a spectrum.
Ironically, even though fat people are told to lose weight for their health, they do shamed for ‘cheating’ or taking shortcuts through the use of medications.
Drugs are tools, not miracle cures
The creation of these drugs is a start, but they remain expensive, and the hype has continued shortages. Ultimately, complex challenges are not addressed with simple solutions. This is especially true when people are involved, and even more so when there isn’t even agreement on what the challenge is.
Many organizations and individuals view obesity as a disease and believe this framework will help people seek treatment.
Others don’t think it’s necessary to attach medical labels to body types to argue it confuses risk factors (things associated with an increased risk of disease) with the disease itself.
Regardless, two things will always remain true. Drugs can only be tools, and those tools must be used in a certain context. To use these tools ethically, we must remain aware of who this application is harming along the way.
Emma Beckett is an adjunct senior lecturer in nutrition, dietetics and food innovation, School of Health Sciences, at the University of New South Wales in Sydney.
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