Soon, skinny won't be for everyone. (Stefanie Keenan/Getty Images for Baby2Baby)


March 8, 2023   6 mins

If you, a commoner, encountered a feudal lord in the year 1200, the latter would likely be wearing fine armour, carrying a well-polished sword, and riding a horse. Upon seeing these visual cues, you would address him properly, lest he punish you for failing to show proper deference. But as the centuries passed, particularly in the years following the American and French revolutions, this notion of privilege faded; the rich might be a class apart, but at times they might be dressed much like you, even if their apparel was slightly better-made. 

Today, however, the rich are separating themselves in perhaps the most obvious way of all: by perfecting their bodies, rather than what they put on them. The rich are fit and the poor are fat: reams of research confirms that the prevalence of obesity decreases as income increases. In the United States, where 41% of the entire population is obesecompared with 25% in the United Kingdom — it is a rare wealthy person who is morbidly overweight (blimp-sized Illinois governor J.B. Pritzker and portly former New Jersey governor Chris Christie are outliers). Increasingly, the rich in late middle age have come to resemble Jeff Bezos and Sarah Jessica Parker: ripped to shreds and almost certainly “enhanced” with various anti-ageing drugs and techniques, ranging from steroids and growth hormones to Botox injections and liposuction. 

Into this mix comes semaglutide, an antidiabetic medication better known by its trade name Ozempic. Sold by pharmaceutical manufacturer Novo Nordisk, the drug, which reduces food intake by curbing appetite and slowing digestion, was approved by the US Food and Drug Administration to treat obesity in 2021. Since then, celebrities and fitness influencers have routinely shared before-and-after pics captioned with details of their courageous weight-loss journeys, which entailed jabbing themselves with a 1.5ml pen that contains a month’s worth of doses and costs roughly $900 without insurance.

Predictably, stories about Ozempic have proliferated in the tabloids and on social media. Some see the drug as a challenge to the celebrity movement that touts “fat acceptance”, and brought us the “slim-thick” era of curvy female superstars. They argue that Ozempic may work hand-in-hand with the return of the “heroin chic” look of the late Nineties. As interesting as it is to consider where these mixed messages might lead us — to a culture in which poor people are told it’s fabulous to be obese, while the rich get ever thinner and fitter — if this is a conspiracy, it’s not a new one. The rich have lusted after youth, beauty and fitness, in others and themselves, since time immemorial, always keeping the poor as downtrodden as possible while pacifying them with bromides about equality, liberty and fraternity. Ozempic, then, is not simply the key to thinness; those who pay for it are buying even more distance between themselves and the hoi polloi

In short, this appears to be yet another sign that the elite are headed toward some sort of crude transhumanist utopia, complete with gene therapy and designer-baby selection. Some may scoff that this is science fiction, but this future looms: once they’re sufficiently fine-tuned, gene editing tools will likely eradicate heart disease, muscle wasting, neurodegenerative disorders, and other conditions in embryos that are still in utero — but their price will be nothing short of staggering. Similarly expensive gene therapies will enhance the overall performance of already-healthy humans, raising ethical questions about whether these procedures should “improve” a person or merely “fix” a condition. The rich, of course, will leave those debates to the philosophers and pay upfront for the best bodies that their considerable resources can buy. Already, news stories abound of billionaires pursuing immortality, with a few commentators trying to sanitise the pursuit by arguing that the research will somehow benefit even the least of us.   

I have first-hand experience in the big-bucks world of anti-ageing science, and I can state unequivocally that the most compelling benefits are not going to trickle down. In 2017, I worked for a transhumanist medical organisation, producing marketing content related to stem-cell therapy and other forms of anti-ageing medicine. I received several treatments myself, and while I can only speak anecdotally, they significantly relieved decades of aches and pains related to hard training. And these were one-off procedures, not the monthly “Cadillac plan”, which involved steroids, growth hormones, and Botox. Wealthy clients would walk in as untrained, middle-aged slobs and, less than a year later, boast gym-hardened physiques that might take unenhanced trainees a decade to develop. 

The organisation’s telos was the stuff of nightmares: the acquisition of a yacht to serve as a floating hospital so that various procedures that are illegal in North America could be performed in international waters; or the same-day infusion of stem cells harvested from a delivery of rich clients’ babies. Although peer-reviewed research has shown no difference between using frozen and freshly-harvested stem cells, there was marketing value in promising clients the freshest ingredients possible. It allowed for a considerable markup in the price of the procedure. It wasn’t the “these vampires want to drink baby blood” of conspiracy-nut ramblings — but it did resemble them. 

So, when I see discussions of Ozempic’s social impact, I don’t think about plus-sized singer Lizzo and skeletal commentator Ann Coulter trading barbs about the ideal female physique. That sort of chatter is all a sideshow for the general public; the rich clients doping themselves to remain forever young do not much care about how the poor and middle class choose to identify (be it fat or fit) as long as few have the money to identify as rich. Without truly high-end gene editing that might enable skeletal and organ reconfiguration — still a way off, though one never knows — the rich are limited to the basic shape and size of their natal bodies. But being able to invest tens of thousands of dollars per annum in upkeep will nevertheless produce an optimised body utterly unlike that of the poor American.

The culture of fitness influencers and body performers is downstream of this. Their bodies represent an investment that will yield riches, which can in turn be reinvested in the upkeep of those bodies. They are selling you a picture of health that doubles as a picture of wealth, often lying about just how much they spend on effective drugs. In the marketing of bodies, deception is the key to the kingdom. You might, for example, promote your Ozempic transformation on TikTok while failing to mention the $6,000 “micro-liposuction” procedure you’ve used to improve problem areas, because you’re sponsored by an online clinic that writes prescriptions for the drug. Or you might fail to mention your Ozempic and steroid use completely, touting instead a diet that is far less effective in the absence of all these chemical crutches, but tied to prepared meals and meal-replacement shakes you’re being paid to promote

As a lifelong strength athlete, I have toiled in filthy gyms and basements to maintain my own physical condition. I would like to say that remaining “natural” or practising intense physical discipline offers some intrinsic reward. Unfortunately, it does not; it is a hard-to-follow path made more tortuous in my case by my stubborn unwillingness to take any effective shortcuts (even though the stem cell injections I received worked like a charm). But a resistance to emptying my wallet, and an aversion to some of the side effects from these drugs — cancerous tumours in the case of Ozempic — has hindered my route to body optimisation.

For me, glorifying the “natural” in and of itself, then, is little better than writing some trite ode to manual labour. There are loads of people, nearly all of them poor and sick, whose bodies are relatively resistant to weight loss. For them, the simplicity of the Ozempic jab — as opposed to the creation of a stomach pouch via laparoscopic gastric bypass surgery — might offer an improved quality of life in much the same way that cheaper insulin and other band-aids help ease the pains associated with sedentary, unhealthy lifestyles.

But the rhetorical appeal of this medicine — that it will produce gains that will “trickle down” from the upper classes to the masses — is an old lie. Time is a thief, stealing each passing minute from us, but as money proves able to purchase ever-increasing amounts of it, it will be disproportionately hoarded by those rich people who are already proficient at squirrelling away their money. Whether by violent nature or scientific nurture, the body is merely something to be overcome. And if you’ve the money to opt for the latter, why wouldn’t you?

In the meantime, those of us doomed to remain mere humans can only watch this process unfold while the rich become superhuman. Consigned to increasingly rare “normal” bodies that are both temples and tombs, the middle class must study this journey from the sidelines, watching on as a vast array of battered, bloated and ruined bodies are left in the wake of a transhumanist train that goes in only one direction


Oliver Bateman is a historian and journalist based in Pittsburgh. He blogs, vlogs, and podcasts at his Substack, Oliver Bateman Does the Work

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