Ozempic: Navigating the Intersection of Weight Loss and Mental Health

Part 1: Halting progress in body positivity

Content warning: This article contains discussions surrounding weight loss and body image

Image by Aprott on iStock

The body positivity movement, which began in the 1970s, brought forward a new and heart-warming era of learning to love the skin you’re in, promoting self-acceptance and not letting your physical appearance dictate your life. However, after years of progress, the 2024 Met Gala, dubbed by Twitter users as the “Ozempic Olympics”, reminded us that the obsession with thinness reminiscent of the early 2000’s is far from forgotten.

As we marvelled at the celebrities and judged their outfit choices, the smaller bodies which many stars flaunted had a lot of people questioning “who is on Ozempic?”. Originally designed as a treatment for diabetes, Ozempic is now soaring in popularity as the “magic fix” to aid in weight loss, and countless celebrities have been open about taking the medication, boasting about their success in losing weight.

As a PhD student in the field of mental health, and someone with personal experience with an eating disorder, I find the increasing use of this drug alarming. This prompted me to write a series of two articles, of which this is the first, to help people understand the potential benefits of Ozempic while also considering the issues surrounding its popularity and accessibility. In this introductory article, I will discuss what Ozempic is and how it is influencing societal views on body positivity.

What is Ozempic and how does it work?

Ozempic, which is administered by injection, is one of many drugs which contain the active ingredient, semaglutide. This ingredient mimics a natural hormone (a product coming from plant or animal sources) called glucagon-like peptide-1 (GLP-1), which stimulates the body to produce insulin. Therefore, this compound works to lower blood sugar levels, providing beneficial treatment to those suffering from type 2 diabetes. 

However, Ozempic also delays the movement of food through the body, thus allowing people to feel fuller for longer. Further, GLP-1 also works by travelling to the brain and informing it that you are full. Therefore, by mimicking this hormone, Ozempic can make us feel full both physically and mentally. These effects have earned it the nickname ‘the skinny jab’.

Image by Carolina Rudah on iStock

Of course, the original point of this drug was not to make people ‘thinner’ per se, but for people with clinically-significant obesity it can have profound benefits. Aside from being an important treatment for diabetes, it can also lower the risk of cardiovascular disease and help people with obesity get to a healthy weight without the need for stomach surgery. Obesity is associated with a number of health risks, such as stroke, cardiac arrest and sleep apnoea, with many being reversed when weight is lost. Furthermore, bariatric surgery (involves making changes to your digestive system to help you lose weight) can be dangerous and expensive, while Ozempic only requires a simple injection. Based on these facts, the FDA approved that Wegovy injections, which also contain semaglutide, could be prescribed specifically for weight loss in obese patients.

Accessibility of Ozempic and dangerous counterfeits

The biggest concern with the increasing popularity of this drug is that people who do not need it are managing to access it. Indeed, people have been able to bypass face-to-face doctor approval by using online pharmacies, where they can obtain a prescription for Ozempic simply by lying about their Body Mass Index (BMI) (a way to broadly categorize a person based on tissue mass and height). Worryingly, according to an investigation undertaken by the Guardian, some of these pharmacies were even dispatching Ozempic to people who openly declared they were of a healthy weight.

Concerningly, due to the increase in these “off-label” prescriptions for weight loss, there has been a shortage of Ozempic in parts of the US and across the UK. This means that people with diabetes, who need to be taking the drug regularly to control their insulin levels, are not able to access it.

Additionally, due to the shortage in the supply of Ozempic, online black markets have begun to create counterfeit semaglutide “diet kits”. The kits contain needles, along with a white powder and a liquid which are mixed before injection of the drug. A BBC news story even reveals how a young girl bought one of these kits from a seller on Instagram, and after a few weeks of using the drug was taken to A&E due to severe vomiting, throwing up stomach acid, blood and white foam.

Halting the progress of the body positivity movement

The rising use and popularity of these drugs pose threats that go beyond the potential physical dangers of misuse.

For years, we as a society have made significant progress in understanding body positivity and recognising that people come in different shapes and sizes, all of which are beautiful. This diversity is influenced by factors such as genetics, metabolic needs, daily expenditure, lifestyle, financial situation, and more. We've even seen a rise in plus-size influencers advocating for body positivity and normalising body-type variety in the media.

However, the rise in the use of Ozempic has revealed just how fragile this way of thinking really was. Now, we hear stories of celebrities like Boy George, Sharon Osbourne, Oprah Winfrey and Elon Musk who have all openly used the drug for weight loss, with Boy George even stating in his autobiography, Karma, ‘Trust me, anyone who was fat last year and is now skinny is on the wonder drug’.

Image by Jennifer Burk on Unsplash

With so many people starting to use Ozempic and vouching for its efficiency, it perpetuates an unhealthy mindset. Those who are not thin feel pressured to take the drug or risk being judged by society for not doing so. Heavier individuals frequently encounter well-meaning suggestions like 'You should try Ozempic!' from friends and family, which only reinforces the belief that being bigger is not acceptable. The situation is reminiscent of the rise in the popularity of plastic surgery and Botox, where the pursuit of an “ideal” and symmetrical appearance threatens to erode our individuality.

However, the impact of Ozempic on the body positivity movement presents a complex, individualistic scenario. Influencers who have built their following on promoting body positivity may feel conflicted, fearing that taking Ozempic, even for health reasons, could be seen as a betrayal of their plus-size community. It's important to recognise that for many people with health problems in the context of obesity, using Ozempic isn’t solely about appearance; opting for it can be a valid choice to improve one’s health.

Maintaining a balanced perspective is crucial, where health and self-acceptance are intertwined. While Ozempic may offer benefits for weight management and health enhancement in people who are at health risk, its use should be guided by medical considerations, free from societal pressures or expectations. Ultimately, the body positivity movement encourages individuals to feel comfortable and confident in their own skin. If Ozempic becomes widely adopted among those considered healthy by medical standards, there is a risk of undermining the movement's core message of celebrating diversity - as well as exposing healthy people to the risks associated with a powerful medication.

If you would like to read more about Ozempic, head to Part 2, where I discuss the effects that the rising popularity of this drug has on people with eating disorders.