It’s the jab that everyone wants, but few are willing to admit they use. Ozempic and the class of semaglutide drugs created to treat diabetes have taken a world obsessed with thinness by storm. Hollywood celebrities and influencers have, in recent months, made Ozempic a household name for its powerful weight-loss effects. The trend begs the question: is this a game-changer for those who struggle to lose weight or is it a dangerous fad that feeds into society’s already unrealistic body image expectations?
Giles Yeo, professor of molecular neuroendocrinology at the University of Cambridge, is a world-leading expert on obesity and weight loss. He stresses on looking at why people gain weight and find it difficult to lose it in the first place. “You have people that are really skinny, and they feel morally superior. They’re just genetically lucky. Therefore, the chances of them ever getting fat are so low,” he states. He elaborates that the active ingredient in Ozempic induces satiety by mimicking a naturally occurring gut hormone called GLP- 1, which signals to your body that you have eaten, and prepares it to use the energy that comes from food. This activates a feeling of being full, which suppresses appetite, thus working for weight loss. For most, GLP-1 levels drop off a few minutes after meals and can be even lower in people with obesity. This could be from reduced production of GLP- 1, or increased breakdown. “All we’re doing here is making a small tweak to increase one hormone in your body,” furthers Yeo. “This should tell you that being overweight or obese is not some moral failure. It’s a simple hormonal imbalance. Your hormones are not adjusted to an environment where there’s an abundance of food.”
Despite the costly nature of these weekly injectables – at around AED 1 700 per month – as well as side effects that can include nausea, vomiting, and diarrhea, soaring demand has caused a global shortage for these prescription drugs. Yeo says the benefits of weight loss (anywhere between 10% and 22% of body weight) for those who are chronically overweight or obese are many-fold: “Obesity rarely in and of itself kills you. It can be debilitating to certain people, but what kills you are the whole host of other diseases that are associated with obesity: heart disease, high cholesterol, high blood pressure. And so, as body weight decreases, you therefore improve a whole spectrum of other illnesses in the process.”
Much of the insatiable demand for these drugs has been fueled by celebrities like Elon Musk and Chelsea Handler admitting to taking them for weight loss, although few others have made public confessions. Many such as the Kardashians, however, have been suspected of being on Ozempic after flaunting sudden and extreme weight loss, prompting the likes of Jimmy Kimmel to muse, “When I look around at this room I can’t help but wonder, ‘Is Ozempic right for me?’” when he opened the 2023 Academy Awards. The celebrity obsession has led to a worldwide shortage of the drugs, with many diabetics expressing anger at being unable to find the doses they need to medicate for their condition. One such user, Angel Bryant Stewart, tweeted angrily at Elon Musk: “Can’t find my diabetes medication, I need my Ozempic 2 mg pen!!! What’s the problem with this? I will not have any more after I use my last injection tomorrow! This should be a Priority for U.”
Cosmetic surgeon and anti-aging specialist Doctor Neetu Nirdosh says, “Ozempic has become a most wanted weight loss drug from my celebrity patients and others alike in London and the UAE. What I would warn people against, is using it as a fad. Generally, I’d reserve it for patients who genuinely find weight loss a challenge and need a boost. This is not a quick fix to a size zero supermodel body. It is a drug that must be prescribed to patients with caution.” Dr Katia El Sibai, consultant endocrinologist, says there has been a rise in the number of people who are overweight and obese in recent years, with the UAE ranking high in the prevalence of obesity in the region. She says the pressure to lose weight comes from a need to improve self and body image, as well as avoiding the social stigma that comes with obesity. She says women are under particular pressure resulting from weight fluctuations due to pregnancy, perimenopause, and menopause.
The psychological impact of these drugs worries experts. Dr Rim Mahmoud, health psychologist at The Lighthouse Arabia, says the Ozempic trend “reinforces the notion that a certain body type is desirable or acceptable, which can contribute to self-esteem issues and negative body image particularly for individuals who do not fit this standard. The focus on achieving weight loss through medication carries the idea that thinness is synonymous with beauty.” She furthers, “The idea that health and beauty are solely determined by a certain weight or body size can be extremely psychologically damaging and can contribute to eating disorders such as binge eating, purging, and restrictive eating.”
However, for many, treatments like these can be life changing. Margaret, a 37-year-old beauty industry executive, takes Mounjaro, an injectable that works similarly to Ozempic. After a lifetime of struggling with her weight, she lost 38kg through hypnosis and healthy lifestyle changes, but during a very difficult Covid period, she gained 20kg back and has struggled to lose it since. “I live a very healthy life, I train four-five times a week, and I train hard, but as you get older, the weight becomes harder to shift. I still have my battles with food, and so when a friend of mine told me she went on Ozempic, I couldn’t believe it. She dropped five kilos in the first week, and she could just eat whatever she wanted, but in small portions. And I thought, well, this is for me. Literally the next day, I called up the doctor and asked her to put me on it.” She considers that negative attitudes towards those who need treatments for weight loss are simply another form of fat shaming: “I feel like anything that helps someone is great when they really need it. What I hate on social media is when they say, ‘Oh did she really lose weight or is she just on Ozempic?’ If that’s what she needed to help her, why is that a problem?” Margaret has frequently seen firsthand the judgment that comes with being overweight, especially in a place that values image as much as Dubai: “Skinny privilege is real. I do F45 high intensity training, and I often come first, second, or third in a class of 30 people. I’m super fit, but I’m probably one of the fattest people in that room. The expectation is always that the skinny person is healthier than me.”
Dr Nirdosh advises against a heavy reliance on these drugs long term and warns that they can have a boomerang effect: “The danger lies with people believing this is a miracle weight-loss cure. But the moment they stop taking it, the weight piles back on at an accelerated rate. ‘Ozempic face’ is also a side effect, where the loss of adipose tissue can deeply affect middle-aged women and make them look older. Balance is key.”
While it’s still too early to know what the long-term implications of these drugs are, doctors warn of the dangers of self-medicating without supervision, with some reports of severe side effects including aggravated symptoms of anxiety and depression and a possible cancer link. But Professor Yeo and others see them as a powerful tool that will become a more accepted part of weight management within a healthy lifestyle. Global demand for these medications is only set to rise as more companies race into the market with enhanced versions. Trials are currently underway for drugs that could have positive indications for not only weight loss but for dementia and heart disease as well.
Originally published in the May 2023 issue of Vogue Arabia