There’s a new $6 billion-dollar industry. Its global market size is expected to increase to $100 billion within the decade. No, it’s not a fancy new app or a revolutionary gadget: it’s weight-loss drugs.
Just a few years ago no one had even heard the word Ozempic. Almost overnight, the drug previously used to treat type 2 diabetes became a household name. Healthcare providers wrote more than 9 million prescriptions for Ozempic and similar drugs in the last three months of 2022 alone. By the end of the decade, 30 million people are predicted to be on it. For comparison, that means that Ozempic is on track to do as well as birth control pills and Prozac—a blockbuster medication.
A little over a year ago we had a fiery debate on Honestly about these revolutionary weight-loss drugs and our cultural understanding of obesity. On one side of the debate, people saw Ozempic as the golden answer we’ve been searching for. After all, obesity is the second biggest cause of cancer. It causes diabetes, and it’s linked to dementia, heart disease, knee and hip problems, arthritis, and high blood pressure, which causes strokes. In short: when you crunch the numbers, drugs like Ozempic seem to be lifesaving.
On the other hand was another argument: Why are we putting millions of people on a powerful new drug when we don’t know the risks? Plus, isn’t this a solution that ignores why we gained so much weight in the first place? In other words: Ozempic is not a cure for obesity; it’s a Band-Aid.
A year later, all of those questions are still up for debate. Our guest today, journalist Johann Hari, has spent the last year trying to find answers, traveling the world investigating weight-loss drugs, and. . . taking them himself.
In his latest book, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs, Johann investigates what we know and what we don’t know about how these drugs work, their risks and benefits, how our food system sets us up to fail, and how movements like “fat pride” and “healthy at any size” have completely altered the conversation.
So on today’s episode: How do these new drugs impact our brains, our guts, and our mood? What are the hidden risks? Are they really a permanent solution to the obesity crisis? Or are they merely a quick fix that do little to address the root causes of obesity? With over 70 percent of Americans today classified as overweight or obese and the average American adult weighing nearly 25 pounds more today than they did in 1960, how did we get here in the first place? And why aren’t we addressing that problem, too?
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What the guest misses during his argument that he doesn’t treat people with medical conditions like high cholesterol as it being their fault is that it generally isn’t. Cancer usually isn’t people’s fault, which is why we feel bad for them. Except in the case of lung cancer because people are assumed to have brought that risk upon themselves if they are a smoker.
The difference between obesity and almost everything else is that obesity is generally within your control. Diet and exercise are the tried and true methods because they work, and failure to do them is most certainly a lack of willpower. I’m sorry to hurt people’s feelings, but if you have been overeating for decades I’m not going to treat you like shit but I’m also not going to pity you and pretend like you’re a victim.
Yes, the food supply can be shit sometimes, and food can be addictive, but that doesn’t let you off the hook for your choices. Even by the authors own admission, he still eats garbage and loses weight so you can’t exclusively blame it on the food supply. Its calories in versus calories out.
To the argument that calorie restriction is a “bad” method of losing weight, what exactly do you think Ozempic is doing for you? It’s not magic. It’s causing you to eat less. It’s making it easier for you to have a calorie restricted diet. It is a medically induced calorie restriction.
Do whatever you’d like people, but don’t come crying in 10 years when this destroys your body more than it was before and pretend like you’ve been duped. Anyone with a brain can see that radical medical interventions always come with side effects. If you choose to ignore them for your own vanity, do it at your own risk.
I have been overweight/obese most of my life. Most recently, I hit a BMI over 50 (and over 300 lbs) about almost two years ago. I was seeing my endocrinologist - who because of my continued gain, my expressed frustration with my inability to lose weight, and the fact that I was pre-diabetic, offered to write me a script for Ozempic. I said yes. After six months, i had lost about 10 lbs, and she upped my dose. By my next six month visit I realized two things - it wasn’t working for me and i absolutely needed to come off it. In that six month period I had gone through an entire family sized bottle of antacid, and lost only another 5 lbs). So we agreed to stop the med, let my system purge it, and readdress writing for a different one in six months time.
Three months after that, I had gained the little weight I had lost back. Unhappy with that, I decided to go back to the one thing that ever had me losing weight. I downloaded an app, and started keeping track of what I ate (following macros). I told the app I wanted to lose 60 lbs. It gave me a target calorie count, and targets for protein, carbs, and fat. Since starting that, I am down nearly 40 lbs (my weight loss was slowed a little by foot surgery that has required me to be much more sedentary than usual). But I focused on what I was eating - and I realized I was eating tons of empty calories, not nearly enough protein and mindless snacking was killing me. Now, 7 months in, I’ve changed the foods I eat significantly, but in a way that I can still do things like enjoy a glass of wine, eat dessert, go to a restaurant, etc.
I’m an anesthesiologist by trade. Ozempic and the like have significantly changed the way I practice. My anesthesia groups are full of anecdotal stories of patients who had been NPO for 2+ days coming in for endoscopy with a stomach full of food. Now, we are asking patients to skip a dose prior to surgery (and we aren’t sure if that is helping) and even if they do, we still treat them differently than a standard patient because of their aspiration risk.
Given all that, I’m overall not a fan of the drug.