The Disordered Culture of Ozempic

In the brain of someone with an eating disorder, consuming just “one and a half meals a day,” “a few French Fries at lunch,” or realizing that “I take a couple of bites and I’m full” might represent success. The same claims are also attributable to reviews from happy Ozempic customers who spoke with The Cut, The New York Times, and Insider. The popular media’s failure to challenge narratives surrounding the usage of drugs like Ozempic for weight loss reinforces harmful messages about food, body image, and health.

For those unfamiliar, Ozempic is a self-injectable form of semaglutide which mimics the GLP-1 hormone that’s released in response to eating and signals fullness. Ozempic was designed to treat type 2 diabetes. Recently, however, it — along with its injectable counterpart Wegovy and oral semaglutide Rybelsus — has blown up as the latest weight-loss solution. In New York City, I can’t take the subway or turn on the TV without seeing an Ozempic ad.

The drug has created a new, expedited pathway to weight loss. The problem is that the demand and discussions surrounding Ozempic fail to consider health implications for everyone exposed to the now ubiquitous messaging around it.

While reading the thoughts about food described by Ozempic users, I realized how eerily similar they were to thoughts I’d experienced at various points in the course of my debilitating eating disorder.

Actress and Ozempic user “Allison” shared with The Cut that the drug makes her “not as hungry, which makes her not as anxious.” For people with anorexia, the ability to refrain from eating also reduces the anxiety that’s associated with their high levels of serotonin. Carrie Arnold writes in the Atlantic. “[They] are able to continue starving even while food is plentiful.” They, like Ozempic users, find food “less rewarding.”

What sets Ozempic and eating disorders apart from other weight loss mechanisms is that shared effect of decreasing anxiety by increasing a person’s ability to restrict food. Ozempic’s active ingredient affects the areas in the brain responsible for appetite regulation and also causes the stomach to empty more slowly.

This process also leads to another sensation I recognized, but this time from later in recovery. I noticed a decrease in “food noise”, described by others as the respite from constant thoughts about cravings, less rumination on whether to eat, and a decrease in negotiations about what others might think about my food choices.

With anorexia, weight gain enables people “to tackle the obsessive thoughts, fears and worries.”¹ The brain requires nourishment to function optimally. This is made exceptionally clear by the lower rates of relapse amongst eating disorder patients who maintain a higher weight in recovery.

With Ozempic, it’s the drug and, therefore, the weight loss that is connected to the silencing of food noise. So the drug rewards users for the same biological process that prolonged my anorexia, but then also relieves the spiraling thoughts I had to seek recovery to begin managing.

You get the restriction without the rumination. Sounds like a win-win? The probem is that Ozempic can incite malnutrition. Most reporting on the consequences of drugs like Ozempic has centered on negative physical side effects and weight regain. While significant, that narrative leaves out the disordered thoughts that would likely also be regained upon stopping the drug. Having deprived their brains and bodies of the nourishment needed to function optimally, users could be left totally unequipped to deal with the returning thought spirals that were masked by the drugs.

The celebration of drugs helping users to specifically eat less sounds innocuous enough amongst other conversations of what foods to eat, times to eat (or wait to eat), and how much to exercise to lose weight. Recent commercials for Wegovy (Ozempic’s semaglutide sister drug approved for weight loss) tout its ability to reduce patients’ appetites. Television advertisements for Mounjaro, another diabetes drug being prescribed off-label for weight loss, unapologetically proclaim that it can “help decrease how much food you eat.” So despite some strides being made in the media’s slow embracing of body diversity, the messaging remains clear: eating less is better.

Fortunately, organizations are working to dismantle the fatphobic norms that pervade our social discourse about body size. Emerging from the foundations of the 1970s Fat Underground movement and Black Feminist Theory, the Association for Size Diversity and Health’s (ASDAH) Health At Every Size® (HAES) principles and the Center For Body Trust are decoupling thinness from notions of health, virtue, and beauty. In doing so, they create space to challenge the celebratory culture of eating less.

Semaglutides don’t appear to be going anywhere, and therefore, the language being used to advertise them is unlikely to vanish any time soon. My hope for the time being is that before we share, post about, or publish Ozempic users’ experiences, we take a deeper look at the words being used, their roots, and their potential impact on others. Doing so could help ensure that we prioritize wellbeing rather than a singular, problematic definition of bodily perfection.

¹Carrie Arnold, Decoding Anorexia: How Breakthroughs in Science Offer Hope for Eating Disorders (New York, NY: Routledge, 2013).