Does The Rise Of Ozempic Mean The End Of Body Positivity?

In November 2022, the New York Post even put the message in a headline: “Bye Bye booty,” it read, “Heroin chic is back.” Then rumours started to circulate that Kardashian (and others – names such as Adele and Rebel Wilson have been tossed around) had been assisted in their “weight loss journey” by a new drug called Ozempic.

Ozempic is the brand name of a new drug called semaglutide, originally developed in the 2010s for the treatment of Type 2 diabetes. Soon, diabetics using it reported significant weight loss as a side-effect.

Ozempic seemed to interfere with the brain’s hunger cravings, and to slow digestion, keeping people using it feeling fuller for longer. The drug was approved for weight loss and re-released under a new name: Wegovy. Suddenly, the new wonder-drug was everywhere.

All of Hollywood was using it on the sly, it was reported, while publicly proclaiming their newly svelte figures were down to genetics and personal rectitude.

Far better to be an Angel of Wellness (think Jennifer Aniston and her daily salad, or Gwyneth and her irritating smoothies), than to be a mortal human who will happily take injections to shed unwanted fat.

Before long, its use filtered down to the masses.“My Ozempic journey” testimonials proliferated on Tik-Tok. There was an explosion in media coverage about the new drugs, and a corresponding worldwide shortage of semaglutide.

In early 2022, the shortage reached Australia, when “off-label” prescriptions of Ozempic for weight loss meant diabetics who needed the drug were going without, according to the Therapeutic Goods Administration.

Over a year later, GPs say they are constantly fielding requests for the drugs from patients, and not just those who are clinically overweight or obese.

All this rapacious hunger for thin-ness, at whatever cost (the drugs are expensive, often come with debilitating side-effects, and their long-term effects are unknown) has taken some by surprise.

Because aren’t we past all that?

It’s been three decades since Naomi Wolf published The Beauty Myth, and since Kate Moss brought “heroin chic” mainstream by starring in the 1993 ad campaign for Calvin Klein’s “Obsession” perfume.

Haven’t we moved beyond the worship of thin women, and the inverse denigration of women whose bodies don’t meet that ideal?

Many of us have been heartened by the dawn of the “Health at Every Size” and body-neutrality movements in recent years. It has become common to see women of different sizes and bodies on runways, even high-fashion ones.

In January this year, body-positivity activist Taryn Brumfitt won Australian of the Year for her work promoting normal female bodies. But it appears body positivity has been dropped like a carb-heavy hot potato in the face of these new drugs.

Those who have owned up to taking the drugs report a miraculous feeling of constant satiety. They are able to go hours without food. They don’t want to binge on anything. They eat modestly. The weight drops off. Even British TV personality and Meghan Markle-troll Jeremy Clarkson has written about taking Ozempic. He called it “magic”.

But apart from the celebrities, there have been accounts from ordinary people who describe the drugs as life-changing

Dr Zali Yager is the co-founder, with Australian of the Year Taryn Brumfitt, of the Embrace Collective, a health charity that distributes positive body image resources.

She is horrified by the glorification of Ozempic. “The diet and fitness industries have always been huge,” she says. “But there’s never been this much money behind a well-orchestrated PR campaign that is coming at people and changing their minds about the fact that we are all just fine in a range of different-sized bodies.”

Celebrities are turning up on social media suddenly thinner and the ultra-thin model has returned to the runway – something noted sorrowfully by British Vogue editor Edward Enninful this week, when he wrote on Instagram that this season’s runways had shown “so many limited versions of womanhood, it felt like we were slipping back… the reality of so many women around the world… ignored.”

“All of it contributes to conversations about what we ‘should’ look like in order to fit in and be accepted,” Dr Yager says. “This conversation around ‘thin is in’ is damaging in and of itself.”

Some overweight and obese people who use the drug have felt guilt for “selling out” the body positivity movement. How can we claim to love ourselves at any size, when we leap at the chance to use a drug which allows us to shrink, and quickly? But the physical and psychological benefits enjoyed by people prescribed these drugs are evident.

While it’s true that people with higher than “normal” BMIs can be healthy, the medical evidence is undeniable – people with high BMIs are at greater risk for heart disease, high blood pressure, type 2 diabetes, breathing problems including sleep apnea, some muscle-skeletal conditions and certain cancers.

People who are overweight or obese also have higher death rates than others.

Any GP will tell you, they frequently see overweight and obese patients who despair of their inability to lose weight to lower these risks – people who try every diet and every fitness fad, only to fail. Or, if they manage to lose a few kilograms, it comes back on.

The cycle is demoralising and can lead to depression and social anxiety. Why should such people not benefit from an innovative new drug that can treat their obesity for what it is – a clinical condition, not a moral failure?

As one formerly obese young woman told Vox, after losing a significant amount of weight using these drugs, the realisation that it was not her fault – that she could never out-diet the complex interplay between her hormones, her genetics and her environment – was incredibly freeing.

“Being on these medicines, I was like, ‘Jesus Christ, I didn’t need to have any guilt around this,” she told Vox. “I didn’t need to have any big feelings around it.”

There are also strong social and economic arguments in favour of the drugs, particularly given we face a worsening global obesity epidemic. The World Health Organisation estimates more than one billion people have obesity worldwide, including children. Obesity costs taxpayers through elevated health costs, and it costs individuals who face stigma and discrimination because they look a certain way.

“[The drugs’] biggest beneficiaries will be not celebrities in Los Angeles or Miami but billions of ordinary people around the world whose weight has made them unhealthy,” the Economist editorialised in March.

The American Academy of Pediatrics seems to agree – it recently changed its guidelines for treating obese and overweight youngsters, to include the prescription of semaglutide to children. Semaglutide has just been approved for routine use in Britain’s National Health Service.

But – and this is a huge but – the drugs can only be a force for good if there is equal access to them.

Obesity is associated with under-privilege, meaning the people who most need these medications can least afford them. Just as the longer-term effects of the drugs are unknown, so are the wider spread social implications.

As these drugs continue to be developed and improved, will they be marketed to ordinary people who want to lose a few kilos for a wedding, or to fit into a dress, Kardashian-style?

Will people give up on the health benefits of exercise if they don’t feel they need it to maintain their figure?

More intriguingly, will thin-ness lose its social cache if it’s available to the masses?

Will we be forced to acknowledge that a slender figure owes as much to chemistry as it does to self-discipline and “eating clean”?

Will larger-bodied people still be featured on magazine covers and in advertising campaigns, or will we declare that fashion over?

It could be that before too long, weight loss injections are as common as blood pressure meds. Let’s hope the drugs lead to positive health outcomes for the people who need them, and that they are not used to promote another “trend” which commodifies women’s bodies and traps us in self-criticism.

Because I think we all agree: we are exhausted by that.

Most women are not in need of clinical treatment; they are in need of a world that accepts and even celebrates them, the way they really look, just as they are.

They deserve to live without the constant background noise of body negativity and criticism that society imposes on them, and which they impose on themselves.

They deserve, in other words, to be free.