A Patient for Life

We need to talk about the new obesity drugs that are all the rage right now – apparently pharmacies can’t keep them on the shelves.  Any prescription medication ‘flying off the shelf’ is cause for concern in my book, but these drugs in particular should give you pause.

Ozempic and the rest of the drugs in this class mimic the action of a particular hormone that activates the part of the brain that regulates appetite, and indirectly influences reward sensations and impulse control.  Put simply, they make you want to eat less because they trick your brain into feeling fuller sooner or less hungry in the first place.

Okay, fair enough – that is actually a pretty well-established strategy for losing weight. It’s the same reason old-timers would tell you to fill up on fiber and to drink lots of water – that keeps you feeling full on relatively few calories so you aren’t tempted to clean out your refrigerator when a simple salad might be more appropriate.  But that’s not the modern way, I know.  A pill for every ill.

There was an article in the Wall Street Journal a couple weeks ago heralding these drugs as “transforming the world’s understanding of obesity.”  And herein lies the problem.

You have to read the article several times to understand what is actually being said – it’s like so much of the health-related information we’ve been presented with over the last few years, in that a kernel of truth is absolutely there, but it is wrapped up inside all kinds of nonsense and presented as settled, unquestionable fact.  Even the language is changed in a way that assumes one particular (obvious!) point of view, to dissent only proves your ignorance/intolerance/-ism of the day. 

Case in point:  the article begins by explaining the role our brains play in keeping weight off (true), and how it is difficult for some people to lose weight and maintain that loss (also true).  Then it goes on to quote a doctor associated with a virtual weight-loss clinic as saying, “This is not about willpower or personal choice…this is about your brain driving behaviors.”  Um, okay.  EVERYTHING is your brain driving behavior, that’s how it works – your brain drives your behavior – it’s the definition of personal choice:  you use your brain to decide whether or not you do a thing, often overriding your initial impulse. 

This is a set-up.  If you’re not careful, you start to agree with this preposterous assertion – “oh, my BRAIN decides, I have no control over it.”  And from there, it’s not much of a stretch at all to buy the rest of what they’re selling.  Chiefly that obesity, which affects 42% of adults in the U.S., is a disease that has nothing at all to do with the choices a person makes.  People “have obesity,” the author repeats multiple times, which is something that must be “treated for the rest of their lives.”  In fact, we’re told that “if a patient stops taking the medication...people regain weight.”

This should horrify you, because it is another case of a disease being created in order to sell a drug.  They even tell us that we have to take it forever, that there is zero chance of recovering from this ‘disease,’ and still we lap it up. 

It’s almost comical because the various doctors quoted have a hard time selling it – they’ve resorted to blaming food, saying “for some people, high-calorie foods are especially problematic,” and are “hard to put down.”  LOL, no kidding.  Don’t worry though, because when patients take this drug, they “feel less hungry and fill up more quickly – sometimes after one slice of pizza when they once ate the whole pie.”  That sure sounds like a personal choice to me.

Oh and by the way, they’re coming for you in particular.  “Women gain weight during pregnancy and menopause,” they tell us - two excellent target markets. Lots of buying power there.

In the last week I’ve already seen two articles in major media outlets telling shocking stories about how difficult it is for women just like you to get these life-saving drugs.  This of course is how you whip the public into a frenzy – tell them how Big Bad Corporations are blocking your access to Things You Can’t Live Without.  Sound familiar? It should, because something very similar happened last year around HRT.  All the media hype created a scream-fest that just about every minor female celebrity and the women who love them eagerly amplified, and before you knew it every single doctor on earth whipped out the prescription pad, no questions asked; and pharmacies everywhere tripled their orders to meet the demand.

Here's what you should consider: that first woman’s sad story about not being able to get the weight loss drug that were saving her life?  It wasn’t an example of a situation so widespread that it was impossible for anyone to ignore, it was pitched to the networks and major publications by agencies representing the manufacturers of the drugs in question – a calculated part of multi-million-dollar marketing campaigns.

Have you heard that saying that people always tell you exactly who they are, you just have to listen?  Well, so do pharmaceutical companies in their marketing messages.

Here’s the bottom line: we don’t need to transform our understanding of obesity – we already know what causes it.  It’s a complicated metabolic process, but it definitely isn’t Twinkies and Doritos conspiring with Pizza Hut and Netflix to force feed us 6,000 calories a day while we are chained to our sofas.  We DO have choices, including whether or not we will be a victim and a patient for life. 

We must guard against these messages – this corrupted language - that pervades popular culture and convinces us that we have no agency over our health outcomes.  It is a lie perpetuated by the makers of these drugs to keep you coming back for more.  Don’t fall for it.