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Ozempic has shrunk the American Dream The US has gone off its imperial dinner

Big eaters made America. Damien Meyer/AFP/Getty Images

Big eaters made America. Damien Meyer/AFP/Getty Images


May 14, 2024   7 mins

Much has been made of Ozempic face. The eponymous visage resulting from monthly injections of a weight-dissolving amino acid has generated endless fodder for social media and the tabloids, which have revelled in the grotesqueries of John Goodman, Robbie Williams and the poster child of the gaunt and ghostly look — Sharon Osbourne. There’s nothing quite as stimulating of schadenfreude as the tell-tale sagging of fat-starved skin, a calamity that might be rectified by fillers such as Sculptra and Restylane, by drinking two quarts of water a day, or, God forbid, by eating lunch.

Despite the risk of public shame and the menace of non-reimbursable insurance cost ($1,349 a month for Wegovy and $1,060 a month for Zepbound), steep demand has sent the stock market valuations of Novo Nordisk and Eli Lilly through the stratosphere of the S&P 500. Not since the debut of Viagra has there been such hype in pharma, raising questions as to whether Eli Lilly and Novo Nordisk can produce enough of the magical elixir, as demand outstrips supply.

As competitors flood the field — most recently, Amgen’s MariTide, yet another semaglutide already in Phase 2 trials — Goldman Sachs analysts estimate that by 2030, the market for such drugs will be worth in excess of $100 billion. The lion’s share will be sold in America, where for hundreds of years the seemingly simple alternative — to eat or not to eat — has been a national obsession. Washington Irving, America’s first author whose fame crossed the Atlantic, invested a great deal of his literary capital describing the young republic’s utter lack of proportion when it came to food. His History of New York, published in 1809, asserted that the earliest political leadership of Manhattan was a Dutch “colony of huge feeders”, in which the burgomasters were “generally chosen by weight”. Their chieftains were “the best fed men in the community; feasting lustily on the fat things of the land, and gorging so heartily on oysters and turtles, that in process of time they acquire the activity of the one, the form, the waddle, and the green fat of the other”.

Today, Americans are no less obsessed with weight. Such disses of the Dutch were the Federalist equivalent of present-day body-image disputes over Ozempic, typified by the hysterical row last month over Barbra Streisand’s intervention as to whether or not Melissa McCarthy was shooting up with the serum.

Despite the morass of scientific explainers, confessional essays and philosophical think pieces, all this food freak-out should be filed under “old news”. Americans have been gaining weight for as long as they have been trying to lose it. Indeed, a few hundred miles north of the turtle-gorging Dutch of Manhattan, the Puritans of Massachusetts were gauging their status as chosen people through their gastrointestinal tract, as Samuel Sewall’s noted in a diary entry from 1690: “Mr Torrey is for a fast or at least a fast first. Mr Willard for a Thanksgiving first. Mr Torrey fears lest a Thanksgiving should tend to harden people in their carnal confidence.”

Thus did binge-eating, spiked with self-induced starvation, find its earliest footholds in the land of milk and honey. The great Puritan divine Cotton Mather outlined the toxic paradox when he asked: “Has not my soul as much amiss in it as my stomach?” Mather’s unflinching investigations of depraved digestions came to all-too recognisable conclusions.

In the case of apoplexy, vomits do a deal of good.
In the case of vertigo, vomit.
In the case of hiccups, vomit.
In the case of nightmares, vomit.
In the case of a coma, more vomits …

Bulimarexia, like religious freedom, was native to these shores.

After the colonial period came America’s great expansion, in which the republic’s rampant eating mania — and subsequent dyspepsia — expressed itself in extraordinary feats of consumption. In 1789, the renowned Methodist John Wesley noted cases of “Canine Appetite”, and American frontier literature teems with stories of thunder-swallowing backwoodsmen who devoured buffalo, alligators and rattlesnakes. Davy Crocket’s penchant for eating bears was only matched by his passion for killing the natives. Today, the same sort of digestive blood lust can be observed across social media, which features endless streams depicting the carnivorous habits of modern day meat-eaters and paleo dieters, even though it’s growing ever more clear that the Neanderthals mostly ate roots and leaves.

Ozempic has opened the door to what every psychiatrist will recognise as the danger zone of behaviour: the return of the repressed. And what have we repressed? The fact that in the beginning, the boundaries of consumption had been smashed. The fact that, here, it was finally possible to eat anything. In 1609, Henry Hudson sat down with some upstate Wappingers for a solemn feast of fatted dog. A bit farther south, the Lenapes were kind enough to share their raccoon and lynx, which they gobbled raw. Food publicity filled the 19th-century press with outrageous accounts of primordial American foodstuffs: out in the sticks there were caribou and antelope, epic beets the size of cedar stumps and corn that grew so fast its percussion killed a hog. Markets in New York City, Cleveland and throughout Iowa offered black-bear steaks and panther chops as late as 1832, and bison, elk, reindeer and moose remained available far into the 19th century.

The story of westward expansion was a romance of superhuman ingestions and prodigious wastes. Davy Crockett’s threat to “eat any man opposed to Jackson” did not land him in jail for threatened manslaughter, but in Congress. And Crockett was not alone. Liver-Eating Johnson hunted down and consumed Crow Indians. Mark Twain’s Mississippi raftsman ate “a bushel of rattlesnakes and a dead body”. The recipe for cowboy sonofabitch stew included everything from beef brains to beef liver, tongue, heart and bones. America in its 19th-century imperialist prime was an insatiable power that viewed the entire continent, if not the world, as its manifest dinner.

Then the frontier closed. The physical limits of continental expansion had been reached, so the stomach, given no other recourse, became a transcendent object of adoration. “The stomach-sac”, the American poet Walt Whitman proclaimed, “food, drink, pulse, digestion…”

“O I say these are not the parts and poems of the Body only, but of the Soul,
O I say now these are the Soul!”

The end of the American stomach’s will to political power meant a number of other curtailments, too, most clearly articulated by the 19th-century American diet guru, Catherine Beecher, when she noted that “it is the opinion of most medical men, that intemperance in eating is one of the most fruitful of all causes of disease and death”. Followed by her profound observation that “it is possible to put much more into the stomach than can be digested. To guide and regulate in this matter, the sensation called hunger is provided.”

Indeed. A “sensation called hunger”.

Thus did American eating mania crash into a new derangement: the diet. At the height of America’s literary renaissance, when Emerson, Thoreau, Dickinson and Whitman were furiously scribbling curricular content for the next century’s American Literature courses, neither Walden nor Moby Dick could boast sales anywhere near Sylvester Graham’s edition of Discourses on a Sober and Temperate Life. “Few things are more deceptive to children or adults, than soft lazy dishes,” Graham declared. “This is a universal rule.”

In 1838, the famous vegetarian (and author of more than 100 books) Dr William Andrus Alcott railed against ginger, fennel, cardamom, nutmeg and coriander, declaring that molasses and sauces were indecent “drugs”. He worshipped “pure, plain, unperverted pudding”. And he inspired a terror of mince pie, which might actually consist of a dozen or so ingredients, and thus would “stupify our immortal souls”.

Meanwhile, the founder of Seventh-Day Adventism, America’s “Prophetess of Health”, Ellen Harmon White, sought God through her plant-based diet. In her wake, America’s diet culture has continued the tradition of eating as a way to pursue both spiritual and capitalist perfection, from Joran Rubin’s recent The Maker’s Diet (that implores disciples to eat what Jesus ate) to the latest from Park Avenue’s “top diet doctor”, Jana Klauer: How the Rich Get Thin. Not to mention the long history of American cookbooks wooing audience by trumpeting themselves as quasi-spiritual tomes: The Sauce Bible, The Smoothies Bible, The Bread Bible, and The Pie and Pastry Bible. Linking sanctity and thinness had long been a fixture of the American psyche, most recently demonstrated by participants in a recent survey of 260 Latter Day Saint BYU students, who judged that “smaller-bodied females” were, as a rule, “more moral than larger-bodied females”.

The American desire to discipline the dysfunctional stomach would soon be subverted into another instantly recognisable tradition: the fad diet. The evangelist John Wesley advised those who suffered from scurvy to “live on turnips for a month”. Dr Alcott’s associate, Samuel Larned, decided to subsist for one year on nothing but crackers. The next year, he ate nothing but apples. America introduced the milk diet, the turtle diet, grapefruit, bone broth, the infamous cabbage soup diet of the Fifties and the Nineties classic 12-step eating recovery programme, “The Love-Powered Diet”.

But the American stomach would not be so easily deterred from its voracious rounds, typified by what would prove to be a pivotal year in the history of eating. In 1997, when George and Richard Shea founded the International Federation of Competitive Eating (since re-branded as Major League Eating), which over the past quarter century has sponsored hundreds of eating contests — featuring gorgers of everything from jalapeños to buffalo wings, oysters to doughnut, pancakes to sushi, bologna to straight mayonnaise — not to mention the greatest triumph of American consumption, the Nathan’s Famous Fourth of July International Hot Dog Eating Contest. The professional gurgitator would be the final incarnation of the digestive imperialists, the grotesque and stunted descendants of industrialists, frontiersmen, and founders.

“The American identity, no longer confined by the twin poles of feast and famine, might seize the moment to define itself anew.”

The dream of consuming everything might have been disciplined to a 12-minute eating contest, but it would not die. As the dimensions of American ambition contracted from mountains and valleys to the virtual horizons of the smartphone, it was, perhaps, inevitable that the fate of American eating would at long last devolve into yet another triumph of technology, the unsexy and unsavory glucagon-type agonist — and thus where we find ourselves today, stuck between the glories of Ozempic and the horrors of Ozempic face.

Novo and Lilly and Amgen come at the end of a long line of American diet history, whose gurus might have been surprised to learn the side effects of not eating, as monthly doses of Nordisk peptides have been known to cause nausea, diarrhea, vomiting, flatulence, constipation, fatigue, not to mention an increased risk of vision changes, kidney problems, gall bladder disease, hypoglycemia and pancreatitis. Such are minor inconveniences in light of the true American dream: the nirvana of bodily perfection. A shot of pure poison is a small price to pay for a glimmering mirage of health and wealth on Facebook, even if the sagging, haggard, fat-starved face has now been joined by Ozempic butt and boobs.

Will there be no more July 4th hot dog eating contest? No more avocado shortages on Super Bowl Sunday? No more gastroporn on Reelz? Can we finally foresee the tragic death of the foodie? Will there be no more food fads, food taboos, food fetishes and paranoias regarding what would or would not pass the holy threshold of our lips? There is much to mourn.

And, perhaps, something to celebrate. Ozempic may toll the death knell for America’s age-old mania of stuffing everything into our imperial systems, a delusion that dates back to our famished origins, when out of the howling wilderness appeared the grim shadows of natives bearing the makings of the first Thanksgiving. The American identity, no longer confined by the twin poles of feast and famine, might seize the moment to define itself anew.


Frederick Kaufman is a contributing editor at Harper’s magazine and a professor of English and Journalism at the College of Staten Island. He is the author of Bet the Farm: How Food Stopped Being Food.

FredericKaufman

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J Bryant
J Bryant
6 days ago

This was a really enjoyable essay, fun and informative.
I feel cheated. Each year I gain a little more weight, although I’m a fairly moderate eater. I must bear the consequences while enjoying little of the sin.
Next time someone says, “Oh, you’ve gained weight,” I’d love to reply, like the early leaders of Manhattan, “Aye, last night I had twenty oysters and a turtle for dinner!”

Bret Larson
Bret Larson
6 days ago
Reply to  J Bryant

Butcher smaller turtles?

Martin M
Martin M
6 days ago
Reply to  J Bryant

I like the Indian take on things. In India, if you put on a bit of weight, people say “You’re looking prosperous”.

Sayantani G
Sayantani G
5 days ago
Reply to  Martin M

Sadly now in emulation of the West, ” size zero” is the new fad!

Steve Jolly
Steve Jolly
4 days ago
Reply to  Sayantani G

For the life of me I don’t understand why the whole world decided to try to emulate us Americans. I suppose everyone follows the lead dog, but a more sober examination of America would reveal it has a history almost unique among nations and civilizations. This entire article links American eating habits pretty well with the abundance and freedom of America’s establishment and westward expansion, which occurred exactly once and is unlikely to ever occur again.

Last edited 4 days ago by Steve Jolly
Adam Grant
Adam Grant
3 days ago
Reply to  Steve Jolly

The growth of the suburbs in the 1950’s effectively added a lot of space that America filled with kids – the baby boom generation.

Graham Stull
Graham Stull
5 days ago
Reply to  J Bryant

Just came back from a visit to the States. My goodness, the food!
The ice cream got me the most. Pleasant roadside ice cream vendor. Rural New England. We look at the sizes. Cup: 1 (enormous) scoop, Mini-kiddie: 2 (enormous) scoops, Kiddie: 3 (enormous) scoops; Small: 4 (enormous) scoops; Large 5 (enormous) scoops.
Holy cow! We shared a cup among two people. But the Kiddie portion is what the kids were ordering. So much fat and sugar!

Dumetrius
Dumetrius
5 days ago
Reply to  Graham Stull

They have this thing called a Monte Cristo sandwich which is deepfriend and full of turkey and whatever passes as bacon in America. It has about three sorts of cheese, stuck together with the bacon and turkey with injections of further cheesy goop, and for reasons unknown to me, a layer of raspberry jam.

The Calorie Count of Monte Cristo must be stratospheric.

Alex Lekas
Alex Lekas
5 days ago
Reply to  Dumetrius

And it is delicious. The trick is to not eat one more than a couple of times per year.

Dumetrius
Dumetrius
5 days ago
Reply to  Alex Lekas

If I am honest, it was the blandest thing I ate on my visit, and there was a lot of bland food.

Only tasted of salt and sugar.

Ian McKinney
Ian McKinney
5 days ago
Reply to  Dumetrius

Where might own find such a thing? What store? In the interest of science of course.

Dumetrius
Dumetrius
4 days ago
Reply to  Ian McKinney

They’re popular among people in Portland who wear berets, I know that. But I believe they started in California.

They’re not hard to spot . . . look for a mound of deep-fried cheese-encased bread, about a foot high.

UnHerd Reader
UnHerd Reader
5 days ago
Reply to  Dumetrius

I haven’t had one in 40 years, but yum!

Lancashire Lad
Lancashire Lad
6 days ago

From fastest gun to fastest food

From Wild West to Wild Waist

From East to West, to eat to waste

From North and South, to fork and mouth

Alex Lekas
Alex Lekas
5 days ago

The epitome of the first-world problem. Imagine a society in which obesity is a bona fide health concern. Our problem is not diets; there are a million of those. It’s lifestyles. Constantly eating garbage with little to no activity leads to an obvious conclusion, one that surprises nobody.
Put down the phone, put down the game console, and step away from the laptop. Go outside for a few minutes. Let the sun shine on you. Soak up some vitamin D. Move about a little. Find some form of activity. Make it one that you enjoy so that you keep doing it.
If the gym is not your thing, save your money. But do something. Anything that involves elevating your heart rate, breaking the occasional sweat, and getting the blood to circulate a bit faster.
There is nothing wrong with being a foodie. Or visiting the occasional buffet. Or even a hot dog eating contest. But the last two are occasional things, not constants. And eating is among life’s pleasures. Even in countries where obesity is not commonplace.

Clare Knight
Clare Knight
5 days ago
Reply to  Alex Lekas

That’s unsolicited advice that we didn’t need because it’s so obvious. However, there are many folk for whom exercise is prohibitive, like those with degenerative arthritis.

Chuck Burns
Chuck Burns
5 days ago

The comment that Neanderthals ate mostly roots and leaves is completely incorrect. Neanderthal was omnivorous but primarily ate meat when it was available. Remember the Neanderthal lived mostly during cold eras and not so much in the temperate times. They lived in the cold and had large brains so required a lot of calories from fat and protein. There probably weren’t any over weight Neanderthals.

Peter Dawson
Peter Dawson
5 days ago

This is what your really need to know:
https://www.everydayhealth.com/diabetes/every-ozempic-side-effect-explained/
You take it for the rest of your life to keep the lard off and suffer for it.
Far better to just stop eating Ultra Processed Food with all sorts of chemical additives and only eat food that is minimally processed and has only two or three ingredients at most.

Peter Dawson
Peter Dawson
5 days ago
Reply to  Peter Dawson

PS It is authorised for use in the USA – but not the EU where it is manufactured – hence the big push to offload it across the ocean.

Clare Knight
Clare Knight
5 days ago
Reply to  Peter Dawson

Semaglutide has been used by diabetics for many years with little problem. It saves lives.

Norfolk Sceptic
Norfolk Sceptic
5 days ago

It’s worth investigating the keto diet: it’s especially for those, like me, that gained a couple of pounds each year for 15 years. That was two stone that I didn’t have.

Though it’s not for everyone, it worked for me, someone who is active but not pursuing a highly energetic sport. I am back to my weight that I had before. There’s plenty of literature and videos on it.

The diet is based on the Biochemistry of the human body, so there’s no set diet, though the aim is to keep Carbohydrate intake below a level so the body utilises fat properly. This needs some medical knowledge to understand all the ramifications of the changes, especially if underlying issues are already present. There are other aspects, like regular exercise, that can be very beneficial, and enjoyable, especially when there’s some improvement.

So seek medical advice, but beware there’s also an intriguing history, with Ancel Keys and his cherry picking of data for a low fat diet, to which parts of the NHS appear wedded.

Gary Taylor
Gary Taylor
5 days ago

Yep that’s the longer term answer, but I found a one month course of Wegovy was enough of a crutch to get off the carbs and sugar and get into ketosis.

Heidi M
Heidi M
5 days ago

Hey now, don’t do Davy Crockett dirty like that. Much of his political career life he spent fighting Jackson on the forced removal of Native Americans. While as a young man he was in the army during some of the unrest with native tribes, he was noted to have had distaste for it. He was never known for going out and killing natives on the regular (surprising perhaps given several members of his family were killed by them).

Y Chromosome
Y Chromosome
5 days ago
Reply to  Heidi M

Good on you, Heidi. Fred was virtue-signaling, at the expense of historical accuracy.

Paul Rodolf
Paul Rodolf
5 days ago

I once lost a fair amount of weight and when I ran across an Australian friend I hadn’t seen in months he asked if I had “…suffered a puncture?”

Tyler Durden
Tyler Durden
5 days ago

I took those jabs for over a year having developed type 2 diabetes during the pandemic in Spain. They had an authoritarian 2-month lockdown where you could be fined for walking the neighbour’s dog if your IDs didn’t match. It pushed me over the edge and I had to start taking daily insulin injections.
So the skinny drug meant a once-a-week jab on top of the pills. And another 160 euro a month. My medical costs in Spain were coming to over 350 euro a month including private insurance.
The jab worked instantly and I lost 12kg in 2 months. Then it tailed off and at least 5 kilos returned when I lost discipline over food. I levelled off though thanks to a fair bit of sport as well as regular exercise.
Now I take the pill version of the gluatides and the Spanish health service covers that where they won’t pay for Ozempic. But that drug and eventually its equivalent jab dried up in Spain due to over-demand elsewhere; the pharmacies just couldn’t guarantee the supply chain and like an addict, I really needed the insulin from it.
But unlike insulin, sticking it in my belly felt really toxic. The pills feel a little odd too; I would not recommend either for the non-diabetic over the long term. Better to become type 2 than developed a terminal liver or kidney condition.

Sayantani G
Sayantani G
5 days ago
Reply to  Tyler Durden

Entirely agree. Was given the drug for a galloping case of diabetes, but the side effects are very disturbing.
Nothing to beat good old fashioned methods of weight control- good diet, exercise and least stress.
It’s a different matter that most high pressured jobs nowadays create conditions quite the reverse-which is why short term solutions like Ozempic are being resorted to.

Clare Knight
Clare Knight
5 days ago
Reply to  Tyler Durden

It doesn’t have to be that way. There are lots of benefits including heart health and mood.

Michael K
Michael K
5 days ago

All you need to know is the number 3600.
That number of calories equates to about one pound of body weight.
Burn 3600 calories more than you eat and you’ll lose a pound. Eat 3600 more than you burn and you’ll gain a pound.

Everything else is just marketing hype based on targeting people who lack the necessary self control – or believe they do.

Allison Barrows
Allison Barrows
5 days ago

Interesting that of the three people cited as horrific Ozempic Face examples, two are Brits.

Clare Knight
Clare Knight
5 days ago

Why is it interesting? They both live in America and are Americanized.

Doug Bodde
Doug Bodde
5 days ago

Is this an AI generated effort of cultured, historical, topical writing on American food habits? It is bizarre and won’t hold me as a subscriber.

Point of Information
Point of Information
5 days ago

“The evangelist John Wesley advised those who suffered from scurvy to “live on turnips for a month”.”

To be fair this is just primitive medicine, not dieting, and probably would cure scurvy – caused by a lack of vitamin C – although it might introduce other problems due to lack of variety.

Thomas Wagner
Thomas Wagner
5 days ago

One of the problems I can foresee is that after ten days of nothing but turnips scurvy might seem preferable.

Andrew Henrick
Andrew Henrick
5 days ago

I have no idea if this headline article has a point. Perhaps the author was trying to convey his distaste for consumerism: grotesque waste in food with grotesque waste in words. I don’t know, maybe you can emote your way into a faux temperance through disgust. But it will remain a fake temperance that has no connection to life. For that you at least need a point.

Benedict Waterson
Benedict Waterson
5 days ago

I don’t think the ‘Smoothies Bible’ etc. is meant as quasi spiritual just because it has the word Bible in it. Bible here is a synonym for something like ‘definitive compendium’

Ian McKinney
Ian McKinney
5 days ago

Surely this headline should have been “Imperial DIET”!

laurence scaduto
laurence scaduto
5 days ago

Great essay. Thanks. I had no idea my Fellow Americans were such gluttons all along. I fear I’ve been shirking my Patriotic Duty! Looks like I’ve got some catching up to do.

Andrew Horsman
Andrew Horsman
6 days ago

The drugs don’t work, they just make it worse.

This is an excerpt from the UK PM’s “speech on security” yesterday:

“… you can see the opportunity too in healthcare, giving people longer, healthier lives. In Denmark, NovoNordisk created the Ozempic drug which is not only helping to tackle chronic disease globally, but singlehandedly grew Denmark’s entire economy last year.“

And the political class wonders why they are losing the public’s trust!

Douglas Redmayne
Douglas Redmayne
6 days ago
Reply to  Andrew Horsman

Not true. Studies are revealing that they are effective. You have a negative psychology.

Ryan K
Ryan K
5 days ago

what was Europe consuming in the 19th century. Aside from raw raccoon of American Indians what were the Africans consuming? It’s a joke that the Chinese eat anything. Maybe all the restrictions of kosher eating kept Jews in Eastern Europe alive apart from the pogroms.

roberta grapperhaus
roberta grapperhaus
5 days ago

“Not since the debut of Viagra has there been such hype in pharma…” Hello? Have you already forgotten about the repeated Covid jabs,MANDATED by law? Love everyone’s selective memories.

Ken Bowman
Ken Bowman
5 days ago

When I was pushing up towards 80 years old I thought it was time to upsize and we moved from a 2 story house to one on 3 floors. For the last 12 years I have been averaging about 10 flights of stairs ascended per day. Surely that must have kept my weight down. Using the 3600 kcal to 1lb weight conversion given I find that all that stair climbing over 12 years means that I am about 5 lb lighter than If I had moved to a bungalow. Give me another 20 years and it will be a stone.

Primary Teacher
Primary Teacher
18 hours ago

Far too many words. The author is suffering from a surfeit of words.