Ozempic Fever

Free Ozempic from the NHS? *Amy Winehouse Voice* What kind of fuckery is this?

God, I wish I’d never heard the name Ozempic.

It is so difficult to have any kind of conversation about body image at the moment without hearing its name. I was actually chatting with my friend the other day about how hopeless this all feels because of how pervasive Ozempic and Wegovy seem to be at the moment. We even both talked about how on some level we’ve mentally prepared for an eventuality where we may end up having it prescribed to us. Inevitably, the rise of semaglutides for weight loss while we witness the return of ‘thin is in’ as a beauty standard was going to create a perfect storm for our body image issues. 

I want to pre-empt this post by clarifying that I am looking at Ozempic from the perspective of someone who works in the body image space, and how it is being used as a weight loss drug rather than its usefulness as a medication for diabetes. I am not a doctor and I’m not qualified to comment on its effectiveness for diabetes from a medical perspective. It even sounds like Wegovy and the like are effective treatments for diabetes (i.e., what they were originally meant to be used for). However, to ignore the repercussions of the normalisation of this medication would be doing the field I am in and the field that I love a disservice. Indeed, the sheer popularity of semaglutides for weight loss has caused a shortage, meaning that those with diabetes who require the medication have had difficulty trying to obtain it because people are more interested in their own weight loss than the repercussions that this could have on those that actually need it. 

So why am I talking about this now? Not only because Ozempic is currently inescapable and haunts my every waking moment, but also because last week, Keir Starmer and Wes Streeting have announced that there may be an initiative to prescribe fat folks with Ozempic in order to help them lose weight, re-enter the workforce and ‘put less pressure on the NHS’. 

Whilst we have known that the UK government has scapegoated fat people for the downfall of the NHS for years now, this tactic feels brand new and more insidious. Considering that Ozempic users are at risk of stomach paralysis, sight loss and pancreatitis, it feels quite hypocritical to say that prescribing this to people will reduce the strain on the NHS. This could even exacerbate it. But hey! At least your waist looks snatched and you can work in the office again! That’s more important than a wave of people being rushed to hospital with Ozempic-related side effects, right? 

This is the oxymoronic nature of anti-fatness. It emphasises the link between thinness and health and how weight loss and being slim are automatically ‘healthy’, and yet will encourage destructive methods that risk your health in order to achieve thinness. Anti-fatness prioritises the aesthetic of health that it has constructed over actual health itself. We’ve seen this over the centuries - it wasn’t that long ago that tapeworms and arsenic were both recommended weight loss treatments. 

What is also problematic is that the NHS still heavily relies on BMI to ‘diagnose obesity’, despite the fact that BMI has been widely criticised as a tool for understanding peoples’ health. So, this means that we could be entering into a situation whereby people who are out of work and do not adhere to the guidelines of an arbitrary measure from 1832 will be prescribed something that could put their health at risk, just so they could potentially become a more productive member of society through the eyes of capitalism. Our bodies are more than just tools for production, work and profit, and yet this scheme prioritising profitability and the workforce over our wellbeing is tacitly asserting this message that our worth, our ability to work and our body size are all intrinsically linked. 

This potential scheme, at its root, has the idea that fatness is a personal failing, rather than an inherent part of body diversity. People are fat for any number of reasons, and that in itself is not a problem, even though it has been problematised for so long. For example, weight gain is a side effect of many antidepressants and SSRIs. I have many friends who are thankfully still on this planet thanks to SSRIs, and I am forever wincing when I hear people make comments about peoples’ weights after they have started taking antidepressants - usually veiled comments about someone looking ‘....well’, while emphasising the ellipsis. But what’s the alternative to these people? Thin and dead? When anti-fatness conflates thinness with wellness, we start doing the same, so even if someone is making wonderful, life changing recoveries, that’s not celebrated because weight gain may be a by-product. Our priorities are all wrong.

In ignoring this, this scheme puts a plaster on a deep, structural wound - people are miserable. The UK has never been more sad and more stressed. The cost of living, witnessing a livestreamed genocide the UK is funding, the job market being totally bizarre plus so many other factors are contributing to why people aren’t working. Weight loss and going back to work does not fix any of these things.

Beyond this haphazard and quite frankly, deeply worrying scheme from Keir, Wes and co, I feel like I am witnessing the normalisation of this medication for weight loss in real time. It is EVERYWHERE. Whoever does Ozempic’s PR has really done the thing - though I really, sincerely hope they are losing sleep as we speak. I recently saw a midsize (ICYMI, midsize is a term used to describe those UK size 12-16 who are scared of the plus size label because of the implications of the term ‘plus size’) influencer make a statement about their decision to take the medication, how putting out a statement weighed heavily on their heart, but ultimately felt it was the only thing they could do to improve their relationship with their body and food. I’m sure they’re not the only one who has started doing the same thing.

I have the utmost compassion for those who feel like they’re at their wits end with their bodies. So much of my body image coaching work is seeing first hand just how difficult people find it to come home to their bodies. So, when a miracle drug is marketed that promises weight loss, i.e., the thing that society puts on a pedestal as being The Ultimate Goal, of course people are going to be tempted to take it, or get it prescribed. It all makes sense. What we need to get better at in body image spaces is being able to hold space for multiple things at once. For example, we can hold space and compassion for those who feel the pressure to lose weight and seek out ways to do so, especially when for many, losing weight in a fatphobic world is what will help people gain access and resources (Vinny Welsby of @fierce.fatty - pronouns they/them - wrote about this so well in their most recent post on Ozempic - please follow them, they’re brilliant). We can also hold space for the fact that it sucks that people feel or ‘give in to’ this pressure, that anti-fatness prevails and people don’t seem to want to fight against it, even though unlearning anti-fatness would solve most peoples’ body image issues.

What also worries me in this context is that bodily autonomy is being used as a ‘get out of jail free card’. As in, ‘I am choosing to do x to my body but it’s my body, my choice so you can’t critique it’. Of course, whatever you do with your body is your choice. However, bodily autonomy still exists within a context where anti-fatness exists. When making choices about your body, they are still informed by all the forces at play that tell us how we should feel and relate to our bodies. So even if it is your body, your choice, that doesn’t remove you from the societal context that you find yourself situated within, and the pressures that surround you.

I have always said that body image work is an inside job. How you feel about your body is so much about how you feel about yourself, and improving your relationship with your body means improving your relationship with yourself. Because, if you build a positive body image on the back of your body looking a certain way or being a certain size, that can be thrown through a loop when (not if, when) your body changes. Blanket prescribing Ozempic to make people lose weight will not solve any kind of body image issue, as this treats the symptom (wanting to lose weight) not the cause (anti-fatness).

All this is to say that this Ozempic mess is showing us how our collective body image is in dire straits. Why is it that even though we’ve seen the rise of positive body image content over the past few years, that peoples’ body image is worse than ever? If this kind of content was so effective at improving body image, why are so many people, including those who have built platforms on self love and self acceptance, falling victim to this trend? And what the hell can we do to bring people back from the brink, considering that the pressure to be thin is becoming more and more intensified, and in some cases, being backed by our governments? It is clear that we do not have good enough resources for people to heal their body image issues, and even if they did have those resources, the world around them continues to reinforce everything they’re trying to unlearn. How do we win? 

I have had so many conversations about this with people recently, which is a great signifier that this is weighing heavily on peoples’ minds. Whilst these issues are not solvable overnight (even though Ozempic is marketing itself as being the answer to that quandary), what is key is that we keep talking about it. Keep challenging your own anti-fatness as well as others’. In our own worlds and communities, we have more influence than we think. So keep speaking up. And please know, this intensified pressure isn’t just you; you’re not alone in this. 

Show your body some extra compassion and care in the wake of all this, and hopefully from there, you can make that body compassion a part of your routine. That is one of the many ways we can resist.