The Ozempic Era of Weight Loss

from The New York Times I'm Michael. Barbaro this is the daily. [Music]. ozempic and a popular new class of. medications like it are revolutionizing. the medical treatment of obesity and the. way that we think about and talk about. weight. today my colleague Danny Bloom on the. story behind these drugs and the very.

different experiences of two people who. took them. [Music]. Monday September 18th. [Music]. Danny it is very rare to be able to say. the name of a new pharmaceutical drug. and have it immediately mean something. to pretty much everyone but that very.

much seems to be the case with a drug. that you and I are going to be talking. about today ozembic. yeah I mean I've never seen anything. like this in my lifetime where people. are tossing this name around. there is such a cool weight loss. medication in the pipeline that I have. to tell you about it is all over social. media I got my Olympic yesterday I'm. nervous I'm not gonna lie another hockey.

mom she's on it as well she looks. fabulous. it's on tick tock. like you can't go on YouTube or even. watch TV without seeing that really. catchy ozompa commercial Jolo you look. thin thank you ozempi yep. oh great when I look around this room I. can't help but wonder is those epic. right for me. it is absolutely everywhere and it is so. massive that it's something that I am.

thinking about talking to people about. hovering pretty much every day. [Music]. so how do you explain why this drug has. become the subject of so much chatter so. much conversation so many wheels on. Instagram that I watch it one in the. morning. I think it's pretty simple these drugs. are really effective at helping people. lose weight and I should clarify first.

ozembic has become this sort of. shorthand umbrella term for an entire. class of medications but these drugs. come at a really complicated moment in. the medical community and in our culture. well just explain that what do you mean. so we know that doctors are excited. about these drugs because they offer a. potential solution to what they have. long viewed as a Public Health crisis. obesity more than 40 percent of. Americans have obesity and while there's.

an evolving conversation around the link. between health and body size right you. know that you can be metabolically. healthy and in a larger body we also. know that obesity is linked with a. number of really devastating health. conditions cardiovascular disease cancer. risk at the same time we also have an. evolving conversation in our culture. around beauty standards and Body Image. we've had this thin ideal that is deeply. entrenched I think especially in America.

and over the last decade it seemed like. we were starting to finally chip away at. that we had fashion stores start to. offer a wider range of sizes we had. celebrities embrace the body positive. movement and right it's not like this. movement just totally neutralizes the. thin ideal in our culture right but you. have real momentum and then ozempark. walks in and just sort of drops a bomb. into that entire conversation. so Danny what is the backstory of this.

drug ozampic and drugs like it that are. having such an enormous medical and. cultural moment right now. so ozunpeck belongs to this class of. drugs called glp ones that stands for. glucagon like peptide 1 receptor Agonist. doesn't roll off the tongue exactly and. so glp-1 medications start rolling out. in the U.S for diabetes in 2005. and. that's because they're really effective.

at regulating blood sugar and Insulin. but what patients and doctors also. notice is they have this welcome side. effect which is they induce weight loss. and then when pharmaceutical companies. like Nuvo Nordisk the company that makes. ozempic continue to develop and study. these drugs they keep on seeing that. weight loss side effect huh so weight. loss is not what this medicine is at. first designed to do but it is a side. effect that no doubt captures a lot of.

attention right and then in 2017 the FDA. approves ozompic which is this once a. week injectable that people with type 2. diabetes can take and researcher who. study semoglotide the active ingredient. in ozempic find that people who are on. the medication for over a year lose. around 15 percent of their body weight. which is a pretty significant amount of. weight in a not very long period of time. so how do we come to understand why the. drug does that.

so these medications are called glp ones. because they mimic this naturally. occurring hormone that our bodies. release after we have a meal and what. that means is that these medications. make you feel Fuller faster for longer. they slow down the emptying of the. stomach but what they also do is they. target the brain so the parts of your. brain that are hungry that regulate your. appetite these medications directly.

affect that and do we know specifically. how ozempic does that so we don't. totally understand how it works this is. something that a lot of researchers are. working to untangle but this isn't all. that unusual right we have plenty of. medications that are pretty common like. antidepressants that we don't totally. understand just how they affect the. brain and the ways that they do got it. and research has shown that if you stop. taking this medication it stops working.

right it's like a Statin or a medication. for blood pressure and so when people go. off these drugs they tend to regain a. lot of the weight and in some cases they. gain even more weight than they had. before they even took the medication and. so because these drugs are newer we. don't have a ton of long-term data right. we just don't know what this medication. does to you after 50 years which in.

theory is how long some people are going. to stay on them. this is something that comes up in. conversations with doctors especially. when people are turning to these. medications who are not obese or they're. not diabetic when people are weighing. the potential costs and benefits of. taking a medication like this there are. a number of open questions especially. when people try to take these drugs for. things they're not officially approved. for interesting so how do we get from. this. approved medicine for diabetes that.

people realize can. result in this meaningful amount of. weight loss for people who take it to. this drug being used out in the world. for That explicit purpose that has. garnered all this attention the idea of. a drug like this as an intentional. weight loss treatment. what people have been taking ozembic for. weight loss for a few years but 2021 is. when things really start to shift.

starting in the summer when the FDA. approves what Govi for weight management. and this is a medication that is really. similar it's a higher concentration of. the same compound that's in ozembic. except this time it's approved for. people who have obesity or who are. overweight and have a number of. different health conditions related to. that and what happens is that there is. so much demand for wagovi there are so. many people who are trying to get their. hands on that drug that then ozempic.

becomes this backup plan and it gets so. prominent that people are seeking out. ozempic because they're not able to get. their hands on mcgovi got it and even. though ozembic isn't really meant for. weight loss the demand for it exists and. it sounds like there are plenty of. doctors who are willing to write a. prescription for it even when the. patient doesn't have diabetes exactly. and most people who take these drugs off. label their insurance company isn't. going to cover a diabetes drug unless.

they have diabetes right so they're. going to end up paying full price out of. pocket which is extremely expensive it's. like around a thousand dollars a month. so in Spring 2022 you're starting to see. these drugs go into shortages demand is. so high that diabetes patients are. really struggling to access ozempic. [Music]. this demand is also fueled. by real swirl girl on social media when. people start talking about which.

celebrities are potentially on ozempic. it becomes this sort of detective game. on Tick Tock where people are pointing. to different prominent figures and. saying you know look it's so and so she. dropped 30 pounds it must be ozembic. that's part of how this drug becomes so. popular and then in the fall of 2022. someone tweets at Elon Musk basically. saying something to the effect of like. hey Elon you're looking really fit these. days what's your secret and he tweets.

wagovi which you know with all things. Elon people become really interested in. this so search results store and this is. the moment it really enters the. mainstream in this way where ozempik has. become a household name. [Music]. right and at this point the conversation. around these drugs is almost exclusively. focused on weight loss rather than its. original purpose diabetes exactly it.

becomes synonymous with losing weight. and this is when these really important. questions come up it moves from being. this sort of tabloid fodder into the. center of what I think is a really vital. discussion about weight and weight loss. and health in our society and we know. that obesity is linked with a number of. really devastating conditions but we've. had this momentum pushing the focus away. from we and instead focusing on one.

making sure people are healthy but then. also making sure that we don't have this. really psychologically damaging emphasis. on people being skinny skinny skinny at. all costs and what happens when we have. more people talking about these. medications taking these medications you. know is that we have the focus being put. squarely back on weight. and this is something that people who. are taking these medications are sort of. wrestling with in real time as they're.

taking a medication that has a. potentially profound impacts on their. health they're also doing this kind of. intellectual gymnastics and thinking. about what it means. and so I've really been interested in. these questions and because these drugs. are so widespread there has been no. shortage of finding people to talk to. who are on these medications. and I talked to two women in particular.

who I think really illustrate what it's. like to Grapple with these challenges. and for both of them they described. these drugs as being life-changing. by in vastly different ways. [Music]. we'll be right back.

so Danny right before the break you were. talking about how many people you have. spoken with who are on these drugs and. are wrestling with what it means to be. on these drugs and you said that two. women in particular stood out to you so. tell us about these women. Wendy hello hi hey so the first one her. name is Wendy Gantt so maybe we could. just start off with the basics like. she's in her 50s she lives in North. Carolina she works as a mental health. counselor well this was last summer yeah.

and like so many people she found out. about these drugs on Tick Tock and they. really appealed to her because she had. been struggling with weight for. essentially her entire life. I can remember always being a pudgy kid. I can so she remembers going on her. first diet when she was around 10 years. old and her parents I remember they. offered to pay me. to lose 10 or 20 pounds whatever it was.

but they actually paid her to try to. lose weight I can remember in seventh. grade. um there was a diet going around where. you ate seven grapefruit one day I think. it was seven boiled eggs the next and. maybe like seven bananas or hot dogs. something stupid and she's spent a lot. of her life going through pretty much. every diet you've ever heard of and when. she becomes an adult this sort of goes. from being a mental preoccupation to a.

medical problem. it was a wake-up call for me two years. ago because my cholesterol was just. climbing it was the first time I ever. heard that my liver numbers looked. irregular and the doctor basically says. for the benefit of her health she needs. to lose a significant amount of weight. and she's really frustrated about this. right because she's tried diet and. exercise all the sorts of standard.

medical advice to lose weight and it. hasn't worked for her and then she's. scrolling through Tick Tock one night. women were talking about their Manjaro. Journey you know that's what they would. call them and she sees people talking. about Manjaro which like ozempic is a. medication that is approved for diabetes. but can induce weight loss their story. sounded like my story and so she's. really attached to this idea of a.

medication that can solve this problem. for her right now there's an option I. was like heck yeah this sounds amazing. [Music]. and what she starts to think is you know. why don't I seek this out for myself I. filled everything out online I got. assigned a provider and she sees people. talking about a certain Telehealth. company that can offer them really fast. prescriptions it was less than 24 hours.

I had the prescription submission and. within 24 hours she gets a prescription. for Manjaro I I took my first injection. you know as soon as I got home I could. not could not get that out of the box. fast enough and Jab myself and then. pretty much as soon as she takes that. first injection she feels different I. woke up the next morning. and my first priority was not going. downstairs and making myself a breakfast. you know that that Loop of have a good.

breakfast have a big breakfast and then. what are you gonna have and to not have. that food chatter on Loop. is really freeing she told me that it. was like this switch just went off in. her brain it was a sense of relief and I. thought wow I don't care about food. and I just want about my day. what exactly is she describing as. happened to her relationship to food.

when she starts taking this drug is. there something people bring up to me a. lot is this concept of food noise right. this like constant low-level chatter in. the back of your brain that's like what. am I gonna eat next what's my snack. when's breakfast when's all this and for. her all of that just shut off it's the. first time in my life that I've ever. felt normal. she didn't have that sort of rumination. in her brain anymore I kept saying this.

must be what skinny people feel like. this must be how normal people's brains. work and for her she was like oh this is. what a healthy relationship to food. actually presents us. foreign it reminds me a little bit of. how people who take anti-anxiety. medication describe the noise of doubt. and worry in their heads the volume of. that just suddenly going down and by the.

way I'm one of those people I take. Lexapro so that's a familiar concept. she's saying that a kind of Uninvited. Guest in her head is going away. yeah I think that's a really good. comparison and for Wendy you know. without that sort of constant voice she. was able to listen and sort of adhere to. some of the guidance that doctors have. been giving her for her entire life I've. always tried to make sure okay I get. this amount of steps I'm going to move. my body I'm going to do this I'm going. to do that and stay active but in the.

past you know it didn't have an impact. on my white. and now it does I try to so she's more. able to exercise she's able to make. those healthy food choices it's not as. hard to want to eat vegetables or to. balance your meals as it was a year ago. and what actually happens to her weight. when she's on this medication so she. loses a ton of weight since last year. beginning the medication I've lost 40. pounds and she loses about 20 of her.

body weight my arthritis is way better. my knees don't hurt my plantar fasciitis. and my right foot is gone she feels. better if this medication just quelled. the food noise part for me forever I. would be a happy camper even if I didn't. lose another pound. so this was like a case study in why. this new class of drugs is so popular. right now Wendy is somebody who.

struggled with weight literally her. entire life and from what she says this. is the first treatment that is made of. measurable difference for her her weight. her health but I'm curious how Wendy. feels about these larger as you call. them intellectual gymnastic questions. about self-acceptance and body. positivity and what it means to now have. a drug that solves this problem for her. in a way that never existed before is.

she grappling with any of that so for. Wendy they this is the simple part I. think people like me who have struggled. for years and years and years who and. who have never been offered you know. help from a medication like this you. feel really judged. and you also don't always feel like your. beliefs before she had this medication. that was when things were complicated. all of the mental churning of figuring. out what to eat and all of the. self-blame of her entire life that was.

when things got really thorny but once. she was able to access this medication. then it was really the best case. scenario for her the weight was a. medical problem her doctor had warned. her about it and she had a really. effective solution. but that's definitely not the case for. everyone I talked to about these. medications and for the second woman I. spoke with things got a lot Messier. so tell us about the second woman you. spoke with. so her name is Renata lavac Savi hello.

how's it going okay and she's in her. mid-30s she lives in New Jersey and at. first her story looks pretty similar to. Wendy's and one of those type of people. who would exercise rigorously control. what I was eating when I was eating. she's someone who has sort of. Desperately tried to lose weight for a. lot of her life either I'm losing my. mind or this isn't working like this is. not possible she sort of felt like she. was going crazy because she was putting. in all this effort and not seeing any.

results. and so she went to her endocrinologist. and she got diagnosed with PCOS it. stands for polycystic ovarian syndrome. it's a hormonal condition and it makes. it really difficult to lose weight if. you're overweight with PCOS you can have. some pretty serious health complications. and so after she gets this diagnosis she. goes to see a nutritionist and she ends. up with someone who specializes in. intuitive eating which is it's this.

philosophy of focusing on foods that. make you feel better I ever sounded so. kind of like woo-woo and like I don't. even think about what you eat. how is that going to help you with. anything but it really made more sense. that it's about taking the time to. actually appreciate how your body is. feeling before and after eating. different types of food and so she still. is keeping an eye on her health but she. stops dieting and she stops moralizing.

using food as good or bad I had no. longer been like weighing myself daily. or being obsessive over but instead. trying to look at other measures of. Health such as how I felt my energy. levels rather than the number on the. scale and she says that she reaches this. really healthy place with food with her. body she's at peace and that's something. that's come with a lot of work for her. [Music]. but then she goes to a doctor's.

appointment. again I didn't bring it up I didn't say. hey Doc I really need something to help. me lose weight what can I do like she on. her own brought up so she's new. medications her doctor says look there's. a drug called ozombic and it can help. you lose weight we're willing to take. the chance that if this is gonna. be beneficial for me in some ways that. maybe I can't see then I'll I'll give it. a shot so unlike Wendy Renata is not. somebody who is seeking out these drugs. she takes the advice of her doctor who.

is the one who raises it seriously and. decides to go on it exactly and she. feels the effects of these drugs almost. immediately I remember that day I was. like okay this is it give the medication. this is your last morale you better have. a great big meal and so I had a nice big. dinner and. um about 10 minutes afterwards I took. the injection. and within an hour I felt more bloated.

and full than I have in my entire life. and I was like what is happening what is. this and I just felt so sick so nauseous. she had this sense of like this is in my. system now and I have to ride this out. whatever it is and So eventually she. feels a little bit better she digests. her dinner but that nausea stays with. her this sort of like low level. queasiness that never really goes away.

well what exactly is happening here I. remember you describing these drugs. function as slowing down the digestive. system so is that what happens here. basically she ate a meal and it just. took a really long time to digest yeah I. mean this is pretty much par for the. course with these medications right it. takes longer for food to leave your. stomach and so a lot of people have.

nausea especially when they're first. starting to take these medications. feeling like the food is like right. there well you can't see me but I'm. putting my hands in my throat you know. like right at your throat but for Renata. it's really severe like her house got. messy because she was worried if she. bent over to pick something off the. floor she would throw up on the spot I. definitely had a hard time eating. anything that was protein Rich because. it's.

harder to digest and therefore made me. feel sicker yeah. so throughout all of that was there any. point in which you actually had an. appetite appetite. oh I don't know if I ever felt hungry. there were times where I felt less. nauseous and like eating didn't sound. disgusting. you know if you don't eat for too long. you can actually get nauseous so what. she ends up doing is actually setting a. bunch of alarms to try to remind herself.

when to eat the morning would be me. trying to force myself to eat something. to lower my nausea so that later in the. day I could have a little more. but I didn't have anything or didn't. have enough then the nausea would just. get worse or worse or worse or worse and. then you know what's the last thing you. want to do when you're nauseous eat. right so then it becomes like a cycle. that you can't break out of. so given all of this it sounds awful. does she stop taking this drug. no and even when she feels really.

fatigued even when she starts having. really low energy she keeps taking the. medication that it just became like a. I'm putting so much effort into like. surviving each week that it felt like. the longer you do something the more. invested you become it was sort of a. sunk cost well I'm not gonna quit now. you know I don't know. so she kept seeing her nutritionist and. I was explaining to her how I was just.

exhaust she was sleeping over 10 hours. and still feeling really tired and the. nutritionist basically said that bernata. might be malnourished. essentially this medicine is making her. eat so little that she's not getting. enough nourishment exactly she has so. little appetite that she's just not. consuming enough nutrients all of it. felt very. bizarre I'm still overweight.

oh and I only had lost eight pounds four. months even after taking this medicine. somehow now both overweight and. non-nurse like how does that work this. really throws her for a loop because for. her whole life she's basically been told. that if anything she's over nourished. right she's overweight and now she's on. this medication to do something about. that and she's not getting enough. nutrients it was just hard to reconcile.

that with how I know I look yeah. foreign. I want to be clear that malnourishment. is really rare right like we're talking. about an extreme outcome there are side. effects that happen more commonly with. these medications Nuvo Nordisk the. company that makes ozembic tends to cite. nausea and diarrhea vomiting all those. icky things but these are the sort of. risk and benefit trade-offs that people. make when they're deciding to take the.

medication or deciding if they want to. stay on it are the side effects worth. the results and so Renata just plans to. bring this up with her doctor at her. next checkup but she expects that her. doctor is going to say stay the course. and continue but no her reaction was. this is appalling this is clearly not a. good trick for you let's stop this. medicine immediately and for her it's. sort of a worst case scenario because.

she she goes off the medication she. actually starts gaining some of the. weight she lost back and this and entire. relationship with food that she's come. to such a delicate equilibrium about it. has gotten super complicated over the. course of taking this medication well. just explain that what do you mean so. because you had to go through all this. effort to remind herself to eat she was. thinking about food all the time I mean. all day long what am I getting to my. next month do I have the food can I.

prepare it now what am I going to buy if. I go somewhere will they have something. I can eat right it became having to be. obsessed with food in order to survive. in order to be able to eat enough food. to like live every day and she had done. so much work to get to a place where she. didn't have that sort of mental. negotiation and I made a lot of. psychological mental progress on how I. valued myself being independent of my. weight trying to separate the focus of. food.

as being something that nourishes me and. provides me with the energy I need. versus good and bad not looking at the. scale I had done a lot of work mentally. to get away from that type of toxic. environment that's so focused on on. weight equal and beauty. and it felt as if by starting the. Olympic as if I was kind of being untrue. to that like and now I'm taking a. shortcut to lose weight because. apparently I do care about weight you. know like it felt like I was undoing a.

lot of the mental work I had been doing. to de-emphasize weight. so Danny we are left with two very. different accounts of what it's like to. be on these new drugs in their earliest. days but what seems undeniable is that. whether these drugs work as they seem to. have for Wendy or whether they have not. worked and had terrible side effects as. they did with Renata that these drugs. are going to be changing our.

relationship to weight both medically. and culturally yeah I think they speak. to a really Monumental shift because for. so long right we've viewed obesity as a. sort of moral failing I think a lot of. our culture speaks to this idea of you. know thinness is a virtue it is. something to strive for and if someone. has excess weight that is their fault. and what these medications do is they. basically offer an acknowledgment of.

like this is a chronic condition this is. a disease and what do we treat diseases. with medication and so from one. perspective these medications are a way. to take morality out of the equation. right because as with mental health the. availability of a treatment says to the. world this is out of any one person's. control and it requires a medical. intervention exactly but on the other. hand you sort of have this other thorny.

issue of like if you can treat obesity. with a medication and everyone knows you. have that option right let's say in. theory then what happens when you elect. not to take a medication like this. what happens when you don't want to deal. with the side effects or you can't. tolerate them and you're left in a. larger body in a world where. increasingly that is becoming almost an. option and so I asked both of these. women if having this medication becoming.

more and more available does it sort of. emphasize these expectations around. being thin does it undermine the. progress that fought positivity has made. huh. that's an interesting perspective. um for Wendy she's not really worried. about the stigma around weight getting. worse what my hope is is that medical. professionals who are the ones on the. front lines with individuals that they.

can be more educated about what all the. options are so that a person can make a. decision based on informed consent. whether you want to take the meds or you. don't want to take a med to her the real. problem would be someone who has. struggled with their weight not having. an option to access treatment now that. there's one that's finally available. not everyone who is psychotic wants to. take an antipsychotic drug not everyone. who wants to be in recovery wants to be.

an abstinence you know typically there's. a reason why someone makes the choices. they make. but for Renata she's very worried about. the stigma this creates I just hope that. people don't view it as why are you. still fat when everybody else is just. taking ozympic and losing the weight. that's something I think about like. whether it will cause people to be even. more judgmental of others she is worried. that what happened to her that this.

piece she worked so hard to create with. her body and with her relationship to. food that's going to get disrupted on a. larger scale and what Renata saw. firsthand is these medications they. don't work for everyone it's more. complicated there are side effects there. are other considerations but if people. don't understand that maybe there will. be a new layer of stigma around being in. a larger body and what you're describing. and what we're not and when you're.

describing are ultimately questions of. psychology and culture and they're going. to play out over a long period of time. but my sense is that the companies that. make these drugs. are focused on the huge Market that now. exists for them regardless of how they. are going to fundamentally as you said. monumentally change our expectations and. our conversation around weight yeah the. Pharma industry is barreling forward.

with this there are dozens of these. drugs that are in development there are. pill forms of ozembic on the horizon. there are experimental drugs that are. even more powerful I mean it's like the. entire goal post for what researchers. and doctors consider to be successful. weight loss that has all shifted and. what doctors have told me is what we're. seeing now is the kind of weight loss. that they wouldn't have dreamed of 10. years ago now that's a given.

and so more of these drugs are going to. be approved pretty soon for weight. management specifically and these. medications are being studied Beyond. weight loss there's data that's. trickling out about whether they're. protective against cardiovascular issues. whether these medications can treat. addictions and I don't think we're going. to be able to put the genie back in the. bottle after this it's only going to go.

broader from here. foreign. thank you very much we appreciate it. thanks for having me. [Music]. [Music].

we'll be right back. here's what else you need to another day. in a closely watched impeachment trial. the controversial Attorney General of. Texas Ken Paxton was acquitted by fellow. Republicans over the weekend the trial. was a test of Republican Party Loyalty. and whether in the hyper partisan era of. Donald Trump Republican lawmakers would. be willing to use the impeachment. process to oust one of their own from.

office. Paxton a trump Ally was impeached in May. by the republican-controlled Texas house. over allegations that he repeatedly. abused his office to help a Texas real. estate investor who in turn allegedly. paid for Paxton's home to be remodeled. and for Paxton's mistress to get a job. but on Saturday Republicans in the Texas. Senate narrowly acquitted Paxton amid. intense pressure from National. conservatives including threats to run.

primary challenges against any. Republican senator who supported. Paxton's impeachment. today's episode was produced by Nina. Feldman and Alex Stern with help from. Luke vanderbloop and Shannon Lim it was. edited by Lexi diao fact checked by. Susan Lee contains original music by. Marion Lozano rowani misto Diane Wong. and Alicia baitu and was engineered by. Alyssa Moxley our theme music is by Jim.

brunberg and Ben Landsberg of Wonderland. [Music]. that's it for the daily I'm Michael. Morrow see you tomorrow. [Music].