What’s the Deal with Ozempic, the “Breakthrough” Diabetes and Weight-Loss Drug?
In the last several months, semaglutide, a drug originally developed to help manage type 2 diabetes, has been in the news for its “breakthrough” weight loss abilities. This video from Vox is a good overview of what the drug does and the interest & controversy around it.
Both Ozempic and Wegovy, Ozempic’s counterpart approved specifically for weight loss by the FDA, are brand names of a drug called semaglutide. Semaglutide is one of several drugs that mimics a crucial digestive hormone called glucagon-like peptide 1, or GLP-1. It amplifies a process our bodies perform naturally.
GLP-1 is released in our intestines when we eat, and there are receptors for the hormone in cells all over the body. In the pancreas, GLP-1 promotes the production of insulin and suppresses the production of glucagon. This helps insulin-resistant bodies, like those with type 2 diabetes or obesity, manage blood sugar levels. In the stomach, GLP-1 slows gastric emptying, extending the feeling of being full. In the brain, GLP-1 suppresses appetite, which also promotes satiety and curbs hunger, so we eat less.
Jia Tolentino wrote a long piece about semaglutide for the New Yorker this week: Will Ozempic Change How We Think About Being Fat and Being Thin?
But, as I kept reminding Ozempic-curious friends, these medications were designed for chronic conditions, obesity and diabetes. For people who are dealing with those conditions, Ozempic appears to create a path toward a healthy relationship to food. For those who aren’t, it might function more like an injectable eating disorder. As the side effects make clear, it’s not a casual thing to drastically alter your body’s metabolic process, and there is no large-scale data about the safety of these drugs when taken by people who are mainly interested in treating another chronic condition, the desire to be thin.
Julia Belluz wrote a piece for Vox on Obesity in the age of Ozempic and Eric Topol wrote about The New Obesity Breakthrough Drugs.
Update: In the shuffle of the last few months, I’d missed reading Paul Ford’s piece about “the post-hunger age”, A New Drug Switched Off My Appetite. What’s Left?
I can see my anxiety mirrored in the wave of reactions starting to appear — op-eds, TV segments, people explaining why it’s good, actually, that the vast majority of those using this drug lose a quarter of their body weight. On social media, fat activists are pointing out that our lives were worthy even without this drug. The wave of opinion will not crest for years.
And that’s fair because this is new — not just the drug, but the idea of the drug. There’s no API or software to download, but this is nonetheless a technology that will reorder society. I have been the living embodiment of the deadly sin of gluttony, judged as greedy and weak since I was 10 years old-and now the sin is washed away. Baptism by injection. But I have no more virtue than I did a few months ago. I just prefer broccoli to gloopy chicken. Is this who I am?
Even outside the context of drugs, I find the tension between accepting who you are versus trying to change some behavior you find unappealing is challenging to navigate — it’s something that comes up in therapy a lot. (thx, anil)
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