#ozempic

Ozempic is not, as many people, including my previous doctor, would say, an appetite suppresant. It is a GLP-1 agonist. The primary function of an agonist is to bind to its respective organic compound to promote secretion of hormones - in this case, insulin. Its presence in the body also decreases glucagon. GLP-1, like most hormones, is complex, and what it does to the body is complex. A side effect of increased GLP-1 activity is reduced appetite.

The reduced appetite is a *side effect* not the purpose, and for people like me who take ozempic to treat for diabetes, it's been life-changingly helpful.

I do not want a world in which ozempic is banned because it's a "weight loss drug" because it's not. I do not appreciate the posts about how serious the side effects are, because it's the safest diabetes medication on the market. I do not consider people posting things with the tag "anti-ozempic" to be my allies, because that reductive view on medicine is the same all or nothing mentality as doctors that refused to treat me for ten years because I was fat.

Has Novo Nordisk done some shitty things regarding advertising and scarcity? Yes they have. Is using ozempic for the sole purpose of weight loss bad? Absolutely. But I think it's really, really important that we stay clear and consistent about why.

I can’t put into words how dispiriting it is to watch all these plus size idols, celebrities, drag queens thin. The body positive movement wasn’t perfect, but we had made some progress. I watched Lizzo dance and flute in front of me and near cried. Watched mid-fat girls flourish in their new comfortable bodies now that they could breathe. Watched plus-size drag queens show they too could be sexy and not just a joke.

But Ozempic and weight loss drugs have snatched people up one by one. For every one there’s some reason it’s justified (oh, they did the work, oh but they might be pre diabetic, oh well they might need it though). Or there’s a celeb who lies about not taking it then admits they have.

And for every one of those, there’s a kid or woman watching who thinks it’s just supposed to be that easy to lose weight. Who thinks there’s something wrong with her if she can’t shed her body.

It’s the understudied weight loss drug of our generation, no different from the pills of before. In 20, 30 years we’ll be talking about all the side effects or failures and it will be a shame.

But that won’t come before a generation of young girls, boys, kids have to endure the big back jokes and Ozempic commercials and the internalization of the idea that skinny is healthy and skinny is what we should be and skinny is what is natural, and all big-boned and bodied girls could be skinny and happier and somehow better tomorrow if they just had the money and the prescription.

Unless you've been living under a rock, you probably already know about people taking the diabetic drug ozempic for weight loss. You've probably heard the debates about the ethics of taking needed drugs away from diabetes patients and maybe even the side effect of "ozempic face." However, there is one side effect of taking these drugs that, in my opinion, people are not being warned about.

If you carefully pay attention to the television ads, you will hear them mention "pancreatitis" as a possible side effect. If you're like me a decade ago, that word probably means nothing to you. Let me warn you, however, it is no minor thing. My husband suffered from chronic pancreatitis for five agonizing years. The pain is beyond comprehension. Doctors who specialize in the pancreas describe it as the worst pain a human can endure. There is no actual cure. Little is understood about the disease, so treatment is difficult. Doctors who understand it are few and far between. It took my husband forever to get diagnosed. He went through multiple surgeries and procedures, but nothing worked. He had to go on an extremely limiting diet. If he varied from it in any way, he would have an attack. The only way to recover from an attack was to not eat at all for days, then slowly add in broth and jello. Did he lose weight? Yes. As a matter of fact, one day he stepped out of the shower, and I burst into tears at the sight of him. He was skin and bones - I could count every rib. Was it worth it to be thin? If you even ask that question, I'm concerned for your mental health.

They couldn't figure out exactly why my husband got pancreatitis. At that time, they thought only alcoholics and drug addicts got pancreatitis. This made it difficult to get compassionate medical care, unfortunately. Now they know that prescription medication (particularly diabetic medication) and high cholesterol can also cause it. Then there is another group - where they just don't know. But you better believe I would hesitate to take any medication that could cause pancreatitis. I would weigh my options carefully to assess if it was worth the risk. In my opinion, weight loss is not worth that risk.

My concern has been heightened seeing the Hers commercials for these drugs (under different names, but rest assured, it is the same thing). These commercials brag that you can get these drugs from Hers with just a simple virtual call, no questions asked. I wonder if people are fully aware of the risks of these drugs. I also wonder if we even know all of the risks yet. I also fear that the culture around these drugs could develop into an us vs. them mentality. That if it's so easy to be thin, why wouldn't you be? And some are getting dangerously thin on these drugs.

I know some diabetics who are on these drugs, and necessarily so. They tell me that it causes nausea when they eat. That's why they don't eat much. Again, that doesn't sound like a pleasant way to live. If you need it to regulate your blood sugar, that's one thing. But if you don't? Why would you do this to yourself?

My husband is now healed of pancreatitis. It was a miracle. You may not believe in that sort of thing, but I'm telling you, there is no other explanation. We had exhausted every medical solution, then the pandemic hit. We were concerned because hospitals were only taking life or death cases. What if he had a bad attack and needed an iv of pain meds? What would we do? Weeks passed - no pain. A month passed - no pain. Six weeks passed - no pain. He decided to grill a steak - something he hadn't been able to even take a nibble of in 5 years. I watched him take a bite, holding my breath. Nothing. He ate the whole thing. No pain. Five years later, still no pain. The doctors can't explain it, either.

Is the overwhelming social pressure for fat people to lose weight a deeply damaging form of institutional and cultural stigmatization, and do we need to work as a society to dismantle fatphobia wherever we encounter it? Absolutely.

Is the way to do this to restrict the body autonomy of individual fat people by banning elective medications in the name of preventing some sort of "opt-in eugenics", because said fat people are too stupid to make correct decisions? Because societal pressure means that people who want to lose weight need to be protected from their own choices? Because we're all too stupid to realize that we'd be better off the way you'd prefer us rather than to be the active decision makers in our own lives? No. Also I'm going to punch you in the face.

I see people implying that giving people an "easy option" to lose weight instead of forcing more people to sit in the stigma of fatphobia will entrench fatphobic attitudes. And maybe it will! But you don't get to force individuals to suffer worse discrimination by limiting their autonomy in the hope that it might make your political goals easier to obtain. That's just the worst kind of accelerationism. It's an argument with the same shape as, "well, maybe it'd be good if the fascists started murdering minorities, maybe then people would wise up sooner and revolt". Volunteering other people to be in any sort of firing line is not woke!

And this is not to even speak about the very real and vigorously medically validated benefits that weight loss can have in many (not all! But absolutely many!) cases. Which are constantly dismissed and downplayed, because people are too afraid to make the actual important point of fat liberation - which is a pro-body-autonomy point! - that it is not anybody else's business if somebody is fat, even if that fatness is "unhealthy" to them! But people aren't brave enough to argue on that alone a lot of the time, so people downplay the medical realities of fatness/thinness (which are complicated, but it seems absolutely true that there are negative medical consequences of carrying more weight outside of just the institutional biases of the medical field) for political convenience to their cause, which is another persistent bugbear of mine.

But anyway, the opposite is also true, which is that, 1. in an absolutist sense, people should be able to modify their bodies however they want, 2. including to make themselves thinner, for whatever reason but 3. including to escape social stigma, if they so wish. And if you care about body autonomy you should be willing to go to bat for that, instead of trying to restrict access to therapies because you personally wish they wouldn't, or because the fact that there's a medication that reduces weight complicates your personal liberation narrative.

There are some asterixes I could add to the above, but I hate having to qualify everything I say, so I'll be bullish about it.

Anyway, GLP-1 agonists totally changed my life, in a complicated way but one that was absolutely my choice, and whether you believe that I made a right choice or wrong one it is none of your business either way, and you should be supporting my right to self-determine.