Whenever I think of weight-loss drugs, I think of Darren Aronofsky’s harrowing Requiem for a Dream. In the film, a middle-aged woman uses amphetamines to try and quickly lose weight for an appearance on a game show. In her desperation, she ups her dosage but soon develops psychosis, hallucinating that she is being attacked by her refrigerator and openly mocked by the TV host. It’s desperately sad, and a warning about how easily a well-intentioned decision can turn into a full-blown addiction.
Semaglutide drugs which suppress appetite, such as Ozempic and Wegovy, are a long way from the unregulated speed abused in the film. Yet pharmacists are right to call for tougher regulation around the online sale of weight-loss jabs and pills. The easy accessibility of these drugs, and the aggressive advertising used to promote them, means that they risk becoming a lifestyle product rather than a regulated medicine. Instead of helping diabetes patients or those who need to lose weight for life-saving surgeries, they are being used as a quick fix for the otherwise healthy to get “beach-body” ready or, worse, enabling those with eating disorders.
Buying these drugs is shockingly simple. For example, there are dozens of providers selling Wegovy, where all you need to do is fill out an online questionnaire. For most, there is no verification process to check whether the customer is lying about their height, weight and BMI. Some sites such as Superdrug Online Doctor may ask customers to upload photos as evidence, but these can be easily edited or the numbers on the scales staged. Given the well-documented side effects, some of which can be incredibly serious (such as pancreatitis), it seems baffling that anyone can access these drugs without clinical supervision or even a face-to-face consultation.
What is most frightening — other than the potential for those with eating disorders to worsen their self-harm — is how, if taking the drug becomes normalised by the slim and healthy, this will pervert people’s body image and self-esteem even further. Botox and fillers have become so commonplace that, in some circles, people fear they will appear strange if they haven’t indulged — and unless people are honest about their “tweakments”, it’s easy to feel embarrassment or shame that they are seemingly ageing faster than their peers.
The same may happen with weight-loss jabs. It might become all too easy to see these drugs as just another form of “self-care”, something you do before a wedding or after pregnancy or just because. I had a baby four months ago, and as I discuss the pressure to “bounce back” with other mums, I can see how tempting it might be to take something that is not only proven to work but is seemingly so straightforward — with none of the self-discipline of dieting or the invasiveness of a tummy tuck needed. Yet I can also see how normalising the drug could lead to toxic, paranoid mind games, such as female friends growing suspicious when one says she doesn’t feel like eating dinner or the all-consuming self-comparison when wondering if someone has dropped a dress size through willpower or a private prescription.
These drugs can be marvellous, but they are not a magic bullet. They do nothing to address the root causes of obesity, they only work by dysregulating our very delicate digestive systems, and they do not give patients any behavioural or psychological skills to help with their eating habits. They are also not necessarily a long-term solution: on average, patients regain two-thirds of their weight loss 12 months after stopping the drug. All these factors exacerbate the risk of becoming dependent on the drug, and its openness to abuse: they should therefore not be as easy to buy as something off Amazon.
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SubscribeA miserabalist piece from a third rate hack.
You could have just said that it was uninformative – and contained very little insight. Strange that UnHerd thought it was up to its normal high standard.
He might just as easily have said it’s “written by a woman”.
Or an English teacher
I think being a woman does give an insight into this that a man wouldn’t have. Women are in an arms race for status which men barely understand. It has been ramped up by social media, plastic surgery, Botox, ozempic and the rest. Women increasingly feel they must use these in order to retain or boost their status.
But it’s a treadmill. The more they spend, the more they do, the more other women do the same to keep up, with no real end in sight. As soon as a woman pauses and reflects she realises all women would be better off if none of this was around.
I’ve read about a wonder product which when taken in sufficient quantities helps promote fullness, reduce appetite, fight inflammation and many other health conditions and only cost a few pounds for a months supply. They’re called vegetables.
Some hand waving in this article.
Why shouldn’t people be able to buy a treatment that helps them to lose weight easily (or for that matter smooth away their lines and wrinkles)? The side effect mentioned – pancreatitis – is very rare. Most people tolerate the drugs well and see benefits immediately. There doesn’t seem to be any reason why people cannot maintain a healthy weight and a slim figure indefinitely using these drugs. The price will drop massively over time as market mechanisms do their thing.
I personally think it is a wonderful thing that after humans solved the problem of feeding everyone well (starting with the agricultural revolution in the 19thC and culminating with the Green Revolution of the 1970s) we have now found an effective way to deal with the side-effect of super-abundant, cheap food: obesity.
The benefits of capitalism are never ending but neither is the temptation of people, like the author, to wreck progress through state interference. Clearly the pharmacists in this story are just a pressure group trying to maintain their control over the market rather than letting online players have a slice of the action. Same old story!
Absolutely – next there will be a drug to make people happy all the time without lifting a finger, or having any reason whatever to actually be happy. Even the homeless will be happy.
But again there will be the naysayers who think we should have to make an effort to be happy rather than just taking a pill. They always hold up progress and capitalism.
There are indeed drugs to make miserable people happy – SSRIs – and they have been very valuable and have helped millions of people with depression. Thank God for profit-driven technical innovation. The usual alternative – “talking cures” delivered by psychologists, psycho-analysts etc – are notoriously ineffective and generally a complete waste of money.
Many people are naturally happy – probably more of them than are naturally slim – and not in need of drugs. But those that need them should be able to get them.
Homeless people are almost always suffering from acute mental illnesses or drug and/or alcohol addiction. If drugs were available to help with these things (and some people think that GLP1 Agonists are helpful with addictions) that would be a good thing.
I don’t agree, being overweight or obese is not ‘otherwise healthy’ it’s unhealthy and increases the likelihood of a wide range of diseases. Demanding doctors only prescribe these face to face is also a double standard when NHS GPs and other doctors routinely prescribe following only a telephone call – I can’t remember when I last saw my GP face to face.
All the evidence so far show how effective they are and they should be encouraged
Does it really make it “not a lifestyle drug” because you have to go to a doc for it?
I’m a doc here in Canada. I don’t prescribe GLP-1 antagonists, but my colleagues give them out like candy. 3/4 of my patients are overweight or obese here in NS, and many of the others are flobby and would like to lose some subcutaneous fat.
I joke that any of my patients who come within a half-mile of an internist come away with a prescription for Ozempic in their pocket over the last 2-3 years.
Personally, I think people who take these drugs are guinea pigs. Fine. Is it better or worse that docs give the drugs the imprimateur of “safe and effective”?