By now, you’ve all likely heard much of the buzz surrounding the drugs Ozempic, Wegovy, and others like them, which are now being widely prescribed for weight loss. I’ve been deeply troubled by this for quite some time, and recently I watched a webinar from the Center for Body Trust, titled “Let’s Talk About Weight Loss Injectables,” with in-depth dialogues surrounding these issues. Today I am offering a very condensed synopsis of some of the points in the webinar and how they support my criticisms of these medications as tools for weight loss. I highly recommend watching the webinar, which is still available for purchase on a sliding scale if you would like to dive deeper.
A big thank you to Hilary Kinavey and Dana Sturtevant of the Center for Body Trust, as well as panelists Sirius Bonner, Ragen Chastain, Lisa DuBreuil, and Marianne McCormick.
—
1. These are diabetes drugs – not weight loss drugs. The dosages at which they are prescribed in order to have the intended effect on weight are obscene: double, even triple, what is recommended for diabetes. There are virtually no long-term studies at these dosages, which means we don’t even really know whether it’s safe or not three, five, or ten years down the line – a major issue, considering many will be taking these drugs for the rest of their lives.
Even if there were no health risks – even if there’d been decades worth of thorough testing and research to suggest these dosages are perfectly safe – the issue still stands that these drugs are intended for diabetes, and that the uptick in demand for the purposes of weight loss means that diabetic people who rely on these medications to stay alive now struggle to access them. Some diabetics report unsolicited pressure from healthcare providers to increase their dosage for the “added benefit” of weight loss. Further, a look at the history of the greedy pharmaceutical giants behind these drugs – namely, Eli Lilly and Novo Nordisk – shows us that when demand goes up, so does price, making them even harder to get for those who truly need them.
2. The decision to take these drugs is not an informed one. Even if doctors are giving their patients all the available information and people are using these medications willingly and as directed, the fact remains that anti-fatness is the reason they are being prescribed for weight loss in the first place. Using these drugs in this way is inherently skewed in favor of weight stigma and thus cannot be considered an objective and informed decision. The harmful impacts of anti-fatness are very real and deeply impact the lives of fat people, and any decisions made under the heavy burden of weight stigma can only be considered as having been made under duress.
Additionally, most people are told they will need to keep using these drugs for life in order to keep their weight off. Studies are showing, however, that weight regain is highly probable after prolonged use, even when still taking the drug. When this happens, other medications are likely to be added into the mix, bringing with them a whole new slew of side effects. The data is unmistakable: cessation of these drugs will cause the weight to come back, making the maintenance of any kind of weight loss (if even possible) an ever-complicating life sentence – which is likely not what patients are aware they’re signing up for.
3. The use of these drugs for weight loss is rooted in weight stigma and anti-fatness. Developers and proponents of Ozempic, Wegovy, and their ilk aren’t shy about stating their intentions to eradicate fatness. In order to accept that fatness should be eradicated, of course, we must first believe that fat people should not exist. This is the crux of anti-fatness: the idea that there is a certain point at which bodies stop being acceptable. In order to champion weight-loss injectables, one must believe that to be true.
Moreover, as I have heard pointed out by NAAFA’s Tigress Osborn, fatness as something that can be medicated away only opens the floodgates for increasing discrimination and oppression against those who choose not to, or cannot, take these drugs. Weight stigma already kills. Fatness is already largely seen as a choice in mainstream diet culture. These problems, in a world where fatness can be eradicated with medication, will only increase in severity.
—
These are only three of the many, many reasons that I, and so many other care providers, sense inherent danger in the current iteration of the weight loss drug boom. We’ve seen this before; many have likened it to the opioid epidemic and the lack of caution that was exercised leading up to it. This scenario may be even more chilling, in fact, given who is most likely to be harmed. While the opioid epidemic was very clearly a massive problem, medical professionals and society at large will likely not show the same readiness to admit their mistake when it comes to weight loss injectables, for one simple reason: in a society of anti-fatness, we don’t care when fat people die. Instead, we justify it by blaming their weight – the very thing they were so desperate to address in the first place. It’s a downward – and deadly – spiral that both fuels and feeds off of anti-fatness and weight stigma.
Instead of trying to eradicate fatness and fat people, healthcare providers need to focus on eradicating bias. This is the underlying message of the webinar mentioned above, which I highly recommend purchasing if you are able. I am not an affiliate of the webinar, and I do not receive any compensation for referrals – I just believe deeply in its message and feel everyone should see it!
Lastly, I’m hosting an online overview training on March 29: “Eating Disorders Treatment: Applying a Social Justice Lens for Healing and Liberation.” It’s intended to provide a foundational understanding for care providers of the ways in which oppressive systems not only perpetuate eating disorders but also inform the way they are diagnosed and treated and thus disproportionately harm marginalized patients. For more information and to register, click here.