Debating Ozempic: A Lifelong Battle with Body Image and the Allure of Quick Fixes
Trigger Warning
When I was six, I went to gymnastics. An older girl looked at me and asked me ‘Are you pregnant?’ pointing to my stomach. When I was nine, my father said to me in the car that no boy would ever like me if I didn’t lose weight. When I turned 11, my mum gave me a protein shake to take to school for the first time instead of a normal lunch. ‘It fills you up all day – you don’t have to eat again until the evening.’
Every evening I would sneak into the kitchen and eat my brothers’ leftovers – cold. If I got caught, there was trouble. Why did I have to empty the fridge? ‘Drink a glass of water, you’re just thirsty’. The next day, I was given bitter drops to alleviate the craving for sweets. At night I lay in bed hoping to get sick so that I could be artificially nourished. It makes you lose weight – I’d seen that on television. Or a broken jaw. There was a young woman who had broken her jaw, which had been wired shut. She lost 50 kilos. I was 12.
I was 12 and apparently fat – and nobody was allowed to know that.
On the first school trip in the sixth form, I didn’t eat anything during the day. How could I? You can’t see fat people eating. Because when fat people eat, they don’t do it for, well, survival reasons. It’s because they’re fat. The fat girl who eats. What else would she do? Fat people always eat.
When I did my A-levels at 18, I went to the gym every day, still didn’t eat anything, chain-smoked cigarettes and went out partying in the evening. ‘I don’t eat anything before going out, it makes me look bloated and I get drunk quicker’. I would sneak into the kitchen at night.
At university, I left the gym behind and discovered calorie counting. Did you know that oatmeal has 372 kcal per 100 g? Combine that with around 100 ml of oat milk and we’re already at 472 kcal. That keeps me going until the afternoon (I didn’t). Cigarettes reduce the feeling of hunger. Drinking plenty of water does too, as we know. Funny little tablets that satisfy hunger and low-calorie shakes that keep you full all day long became my companions. And also the constant questions in my head: what food is ‘safe’ for me and is this person now watching me eat? To this day, I can’t eat in front of strangers.
My relationship with eating was complicated right from the start, as you can easily see. When I moved out, our relationship got better – not good, but less stressful. I was no longer afraid of the supermarket, of being seen at the checkout with sweet drinks and more than almonds and sultanas. However, I still prefer my food cold. I wonder where that comes from.
And I thought I was on the right track. Until I heard about Ozempic. Believe me when I say that I have already tried every remedy, tablet and drop. Even at the age of 26. And when the first TikTok about Ozempic ran on my For You page in a continuous loop, I fell down a rabbit hole.
Ozempic was originally developed for diabetes patients. However, the drug is making headlines around the world as a safe and easy way to lose weight. In addition, the high-dose variant Wegovy, which was explicitly developed for severely overweight people, is in great demand worldwide. In Germany, too, there are repeated supply bottlenecks.
Because it is also available over the counter. It costs quite the money – but you can order the miracle cure to your home for just under €300.
The weight loss injections are on course for success. In 2023, the medication was not only named scientific breakthrough of the year by the renowned Science magazine. Novo Nordisk is now the most valuable company on the stock exchange in Europe due to its slimming injections alone. However, doctors warn against misuse of the medication.
The active ingredient contained in both Ozempic and Wegovy promotes the release of insulin in the body and makes you feel full quickly. In people with type 2 diabetes, the body’s cells no longer respond well to the hormone insulin. This is a problem because insulin is a key messenger in energy metabolism. It comes into play when food is digested and a lot of sugar passes from the intestine into the blood.
Semaglutide helps here in various ways, namely by mimicking the effect of an intestinal hormone (GLP-1). This ensures that the pancreas releases more insulin. And only after eating, when the blood sugar level is high and insulin is actually needed. There is therefore little risk of the patient suffering from hypoglycemia (a condition in which your blood sugar level is lower than the standard range), as can happen with some other diabetes medications.
The medication also acts centrally in the brain by signaling as a brain messenger that enough has been eaten. Patients feel less appetite, eat less and then lose weight significantly. Anyone taking semaglutide must inject the drug once a week, for example into the abdominal fat.
It is important to note that the weight loss of ten to 15 per cent possible according to studies really only applies to people with obesity – it will be significantly less for slimmer people.
The drug is not entirely new. Similar active ingredients have been used in diabetes therapy for some time – but none have been as effective as semaglutide. And the authorisation of the active ingredient explicitly for weight loss is new.
Similar diabetes drugs are also being tested for the treatment of other diseases, such as Parkinson’s disease.
It’s impossible to escape the soaring popularity of Ozempic and similar drugs these days—daily headlines, celebrity “success” stories, and apparent ease in procuring prescriptions abound. But the cumulative effect of all of this has many (including me) worried about how this might affect eating disorders. This makes sense—even for those without eating disorders, these drugs can feel both triggering and enticing. After all, research tells us about 90% of women are dissatisfied with their bodies. This sounds like a quick fix.
Then, I started hearing reports—first anecdotal, then published—that some doctors were prescribing weight loss drugs like Ozempic to their patients with eating disorders. As in, to help treat them.
As a woman who had suffered from eating disorders on and off for much of my own life—I thought I must have misunderstood. Yes, we as a society are in the midst of Ozempic Fever—and by “fever,” I’m referring to excitement, rather than a possible side effect of the drug (which it is).
Truth be told, if Ozempic was introduced when I was growing up, I probably would’ve been eager to get my hands on some myself. I lusted after those dry, unappetizing Weight Watchers pastries because I craved the feeling of eating chocolate without immediately feeling guilty afterward. I felt the disappointment in my mother’s gaze whenever she bought me clothes where the tag had double digits. I longed for a weight loss version of a get-rich-quick scheme to make the numbers go back down. Just 15 years ago, you’d be hard-pressed to find any dissenting voices concerned about these weight loss fads to make the impressionable masses shrink instantly.
The long-term side effects of GLP-1’s are not yet known. But the harms of eating disorders are: eating disorders have one of the highest mortality rates of any mental illness (second only to opioid overdose). People with eating disorders are more likely to attempt suicide, and during COVID-19, emergency room visits and inpatient admissions for eating disorders at pediatric hospitals skyrocketed, particularly for young women. According to the CDC, emergency room visits for 12-17 year old girls who suffer from eating disorders doubled during the pandemic. Those numbers, as shown by recent studies, have not returned to pre-pandemic levels.
An even greater concern is that the gaps in comprehensive care for eating disorders invite experimental, potentially harmful treatments and leave patients vulnerable. GLP-1’s may seem like a short-term “fix”, but they won’t graze the deeper issues nor will they diminish the eating disorder crisis.
Dangerous diets and surgeries are bought and sold in pursuit of self-love. How else do we explain the willingness to create scarcity of a potentially life-saving medication in pursuit of vanity? Fatphobia is already inherently ableist, but watching the indifference towards making a drug (that is meant to assist with the very disease that makes society scorn fat people) be made inaccessible to those who need it in real time has further underlined the fact that fake concerns for public health is nothing more than a tactic meant to disappear anyone that they deem undesirable. For self-love in no way discourages the suffering of others.
I count myself both lucky and unlucky that I am not easily swayed by idle affirmations. Of course, in my journey, I have been seduced by the adorable illustrations with positive platitudes attached to them that amount to some version of “love yourself.” But that was never enough to sway me. Why should I love myself when the world treats fat people like second-class citizens? Why should I love myself instead of trying harder to be a version of myself that the rest of the world would encourage me to love?
