Many claim drugs like Ozempic can “end obesity” by reducing appetite (representative)
Sydney:
Hundreds of thousands of people around the world are taking drugs like Ozempic to lose weight. But how much do we really know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Many claim that drugs like Ozempic could “end obesity” by reducing appetite and waist circumference for millions of people around the world.
If we ignore the hype, we’ll find that not only is it untrue, it can also be harmful. Concern about weight, as opposed to health, is a feature of diet culture. This makes the pursuit of thinness more important than other aspects of physical and cultural health.
The popularity of ozone fever is not only rooted in the health and medical fields, but it has also given rise to notions of fat stigma and fatphobia. This may perpetuate fears about obesity and obese people, as well as behaviors that cause harm to people with larger bodies.
Not the first ‘miracle’ weight loss pill
This isn’t the first time we’ve heard that diet pills are going to change the world. Ozempic and its line of GLP-1 mimetic drugs are the latest in a long line of weight loss drugs. At the time, everyone seemed hopeful. But in the long run, none lived up to the hype. Some have even been withdrawn from sale due to serious side effects.
Science is indeed improving, but diet culture also keeps us hopeful about the next miracle cure. As a result, drugs like Ozempic may not have the effects people expect, continuing the cycle of hope and shame.
Ozempic doesn’t work the same for everyone
When we talk about study results using Ozempic, we often focus on the average (also called mean) results or the maximum (or peak) results. So the study might show that people using the drug lost an average of 10.9% of their body weight, but some lost more than 20% and others lost less than 5%.
What we don’t talk about much is that the response is variable. Some people are “non-responders.” This means that not everyone loses an average amount of weight, and some people lose no weight at all. For some people, the side effects outweigh the benefits.
When people take drugs like Ozempic, they can have better blood sugar control by enhancing the release of insulin and lowering levels of another hormone called glucagon.
But the changes in weight loss were greater than the changes in blood sugar control. It’s unclear why, but it may be due to genetic and lifestyle differences, as well as more complex weight regulation.
Treatment needs to be ongoing. what does that mean?
When weight loss drugs do work, they are only effective when taken. This means that in order to maintain weight, people need to take it over the long term. One study found an average weight loss of more than 17% after taking Ozempic for one year, and an average net weight loss of 5.6% more than two years after stopping treatment.
Short-term side effects of drugs like Ozempic include dizziness, nausea, vomiting and other gastrointestinal upset. But because these are new drugs, we simply don’t have data to tell us whether side effects increase as people take them long-term.
We also don’t know if effectiveness will be reduced in the long term. This is called drug tolerance and has been documented with other long-term treatments such as antidepressants and chemotherapy.
Biology is only part of the story
For some, using a GLP-1 mimetic drug like Ozempic will be a validation and authorization. They will feel like their biology has “normalized,” much like blood pressure or cholesterol medications can return people to a “normal” measurement range.
But from a biological perspective, obesity is not just about GLP-1 activity, but also involves many other hormones, physical activity, and even our gut microbes.
Overall, obesity is complex and multifaceted. Obesity is driven by more than just individual biology and choices; it has social, cultural, political, environmental and economic determinants.
A weight-focused approach ignores the rest of the story
A weight-focused approach suggests that leading by thinness means that health will follow. But when it comes to health, changing your appetite is only part of the story.
Obesity often coexists with malnutrition. We try to use statistics to distinguish effects in studies, but focusing solely on the benefits of weight-loss drugs without addressing underlying malnutrition means we are unlikely to see improved health outcomes for everyone who loses weight.
Obesity is not a problem that has nothing to do with people
Even if well-intentioned, the euphoric rhetoric surrounding “ending the obesity epidemic” can hurt people. Obesity does not occur in isolation. This is fat people. The celebration and hype surrounding these weight loss pills may exacerbate harmful fat stigma.
The framing of these drugs as “treatments” reinforces binary views of thin versus fat, healthy versus unhealthy. These are not binary outcomes of good or bad. There is a range of weight and health.
Ironically, while fat people are told they need to lose weight for health, they are also shamed for “cheating” or taking shortcuts through drugs.
Drugs are tools, not panaceas
The development of these drugs is just the beginning, but they are still expensive, and the hype has been followed by shortages. Ultimately, simple solutions cannot solve complex challenges. This is especially true when people are involved, and even more so when there isn’t even an agreement on what the challenge is.
Many organizations and individuals recognize obesity as a disease and believe this framework helps people seek treatment.
Others argue that there is no need to attach a medical label to body shape and argue that it confuses risk factors (factors associated with an increased risk of disease) with the disease itself.
No matter what, two things are always true. Drugs can only be tools, and these tools need to be used in specific circumstances. In order to use these tools ethically, we need to always be mindful of who the app is causing harm to.
Read other articles in The Conversation’s Ozempic series here.
(author:Emma Beckett, Adjunct Senior Lecturer in Nutrition, Dietetics and Food Innovation – UNSW Sydney, School of Health Sciences
(Disclosure Statement:Emma Beckett has received research or consultancy funding from Mars Food, Australian Nutrition Research Centre, NHMRC, ARC, AMP Foundation, Kellogg’s and Newcastle University. She works at FOODiQ Global and is a fat woman.She is a member of nutrition-related committees/working groups or the Australian Academy of Science, the National Health and Medical Research Council and the Nutrition Society of Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
