Why Using Ozempic Is Like Putting on a Gas Mask
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Why Using Ozempic Is Like Putting on a Gas Mask
There’s nothing intrinsically wrong with it, except that it does nothing to cure the real problem
Thursday posts are normally for paid subscribers only. However, due to the sheer importance of what we’re talking about here, we’re making this piece free for everyone.
This recent piece from the New York Times, about the new weight loss drugs like Ozempic, really rubbed me the wrong way. Let’s suppose there were a safe drug that promoted weight loss through reduced appetite. (It’s not entirely clear that that has really happened, but of course everyone’s acting as if it is.) That could remove a strong argument against changing the ways and types of food that we produce, market, and eat.
And that is a bad thing, because agriculture as currently organized is terrible for the environment, for the use of land and other resources, for climate change, animal welfare, human labor, and more. And it’s still far from clear that eating ultra-processed food (UPF) – which now comprises the majority of calories eaten by Americans – isn’t bad for you for reasons other than weight gain. Yes, the new drugs may make people less likely to gain and even more likely to lose weight, and may even protect against diabetes, but do they slow the rate of diet-related cancers? Unlikely.
It’s like someone hitting you in the head with a hammer and then feeding you a painkiller. Or, more nuanced, it’s like “We’ve found a way to end fossil fuels’ contribution to climate change.” Well, great. But what about the other ill effects of fossil fuels? What about the other causes and effects of climate change? All this would sound like is permission to drive gas-guzzlers. And all Ozempic sounds like is permission to keep marketing junk food: “We’ve taken the harm out of it.” But of course that’s not true, and it’s yet another in the long list of our plainly seeing the cause of a harmful disease or condition or syndrome or crisis and, instead of addressing that cause, we attempt to pick off the symptoms and “cure” them, one by one.
Obesity can cause disease, but obesity isn’t a disease. If anything, it’s a social disorder, one brought about by the force-feeding of Americans (and others) with “food” that’s really closer to the dictionary definition of poison: It makes you sick, not well. You don’t need to be obese to get diabetes, or cancer, or heart disease.
The root causes of all of this are, undeniably, really really really hard to address. Because in this system, corporations make money both ways: by seeding the causes of diseases — and charging for them — and then selling the so-called cures. The whole system needs reforming if we want food that’s healthy, fair, green, and affordable for all.
That last bears emphasis, because it’s likely that Ozempic and the other anti-diabetes weight loss drugs will be available only to people with the best health insurance, thus increasing even further the health disparities between rich and poor.
There’s so much wrong here, and it’s so awful to see the near-infinite positive publicity. (In the midst of an anti-vaccination movement, no less!)
To sanity-check myself on some of the outrage I’m feeling, I reached out to David Katz, my co-author on How to Eat and among the country’s best-informed and sanest medical authorities. His immediate response was, “It’s just like ignoring the sources of air pollution because we can market gas masks that work quite well.” (You can read a more detailed analysis of this whole issue by David here.) We have a big problem, a social problem, and our reaction is to devise a drug that addresses some of the effects of the problem in some of our bodies. That doesn’t even sound like an adult reaction, does it?
I’m not sure – I’m not equipped to know, although it could well be that no one is at this point – whether there’s actually anything wrong with using Ozempic as a treatment, any more than there’s anything wrong with taking ibuprofen for chronic headaches or, for that matter, donning the gas masks. I just worry that it’s yet another distraction from the real problem.
As David said to me a couple of weeks ago, “If I believed we could hold two ideas in our minds at once — (1) it might be good to help people attenuate their appetites/cravings; and (2) we still need to direct the bulk of our efforts to fixing the production of food, the supply side, the marketing, etc. — then I would be far more enthusiastic about the drugs. But I don't believe that — I believe the drugs will provide cover for business as usual on the supply side.”
In short: We’re solving for symptoms while belittling or ignoring causes.
Why Using Ozempic Is Like Putting on a Gas Mask
I do agree that ozempic and the like do not address the root cause of obesity, but this particular post would make sense if obesity were caused solely by eating 'bad' foods - but it is much more complex than that. Yes, ultra-processed foods seem to be the culprit in many if not most cases but plenty of people achieve obesity on eating 'good' foods - just too much of them due to physiological issues or stress or cluelessness . The sad truth is that obesity due to UPF is most likely to afflict people in poverty who live in food deserts and can only easily obtain ultra-processed foods - those people are not likely to take ozempic because they can't afford it. So this particular post is really getting at people with first-world problems. I would also point out that Ozempic makes a difference for people whose 'set points' are messed up which can originate with hormone imbalances. All that said, the existence of Ozempic must not be allowed to turn into a "get-out-of-jail-free card' - which is what I think is your main point
What I continually see missed in this debate are 2 things:
— Some people take meds, like SSRIs, that cause weight gain beyond the individual’s control; others have malfunctioning hormones that can be difficult to control
— Some people have disabilities that do not permit even the least bit of decent exercise, and they really struggle with weight
There are a lot of health benefits, and using these drugs ethically is not “cheating”.
I think the bad air vs gas mask analogy is a bad one, because as an individual I have one vote — and if the winner supports ignoring the Clean Air Act, there’s precious little I can do about it directly.
I have great insurance, but I’m not a diabetic so my insurance wouldn’t pay for these meds. Docs can prescribe off-label, but that’s the individual’s choice. Or, I can self pay. Regardless, nothing at all like the politics surrounding the CAA.
I’m wondering most of all why my weight/weight loss is anyone else’s business at the micro level, and why anyone is telling me how to live my life. You all seem to think that 150M Americans are going to jump on the Ozempic bandwagon and disrupt our economy and way of life, but that kind of sky-is-falling (and the stunningly ugly comments made about those who do choose to explore these meds) are completely unhelpful.
And yes, I vote Blue.