November 28, 2023

The United States of Ozempic

For a while it was a secret that only the A-listers were in on. Now, however, Ozempic – the diabetes drug that is being used off-label as an appetite suppressant – is everywhere. Ads for the medication are ubiquitous on US TV screens, videos of people documenting their Ozempic use are all over TikTok, and people like Elon Musk are loudly singing its praises. So many people are now popping Ozempic, Wegovy and other appetite-suppressing medications, that the effect is reportedly being felt in grocery aisles across America.

“We definitely … do see a slight pullback in overall basket,” John Furner, Walmart’s CEO, said in an interview Wednesday about the impact on food shopping among people taking the drug. “Just less units, slightly less calories.”

If you’ve wondering (as I briefly was) whether it might be astronomical food inflation, and the fact that a loaf of bread now costs a gazillion dollars, that is to blame for the shift in grocery habits, it isn’t. Walmart has access to detailed enough (anonymized) data that they can compare shopping habits among people taking Ozempic and people who aren’t.

Walmart isn’t the only company looking carefully at whether the increased use of drugs like Ozempic will take a bite out of their business. Morgan Stanley put out a recent white paper on how these drugs could reshape the “food ecosystem” and found that they might make Americans’ consumption of soda, baked goods and salty snacks might be around 3% lower. The CEO of Kellanova, the maker of Pringles and Cheez-Its, also recently told Bloomberg that it’s looking carefully at how the trend might impact its company and is ready to “mitigate” if necessary. Mitigate? You’ve got to wonder how they’re going to do that. Are they going to make snacks so tasty that even Ozempic – which triggers “a chemical repugnance to food itself” – won’t stop you reaching for more?

While Ozempic is clearly popular, is it actually safe? While it’s hard to precisely quantify the risks it’s definitely not risk-free. Research published on Thursday in the Journal of the American Medical Association found that people who take GLP-1 agonists (as this class of drugs is known) for weight loss may be at an increased risk of severe stomach problems. “Although rare, the incidence of these adverse events can happen,” the lead author of the study told NBC. “People should know what they’re getting into.”

Even if physical side effects were non-existent, how healthy is America’s renewed love affair with popping weight loss pills? While some people may be taking them for medically valid reasons, you can certainly see how they might be abused and the trend is worrying eating disorder experts. “We just add another tool to the stockpile of ways to self-destruct with an eating disorder,” one doctor told Jezebel.

More broadly, the love affair with these drugs signals a cultural shift away from body positivity and a return to an obsession with thinness. “Ozempic has won, body positivity has lost,” Rachel Pick wrote in the Guardian in June. “For a while, it seemed the cultural conversation about size and fatness was limping along some sort of vaguely progressive track … The tone of the discourse around dieting and weight loss had shifted, and there was a growing attitude on social media of self-acceptance.” Now however, after a brief period where body positivity was cool, Pick writes that “the Ozempic moment neatly lays bare exactly how much our society still hates fatness and fat people, and the extreme measures people who are already physically healthy are willing to put themselves through to be just that much leaner”.

Want to know just how much society hates fatness, particularly when it comes to women? You’re economically penalized for it. For women a low BMI comes with a high ROI. “The upper estimates of the wage premium for a woman being thin are so significant that she might find it almost as valuable to lose weight as she would to gain additional education,” the Economist has noted. “The wage premium for getting a master’s degree is around 18% which is only 1.8 times the premium a fat woman could, in theory, earn by losing around 65lbs.”

The upshot of all this? Drugs like Ozempic are only going to get more popular. It’s not (just) vanity that’s driving their use, it’s economics, it’s the whole structure of society. And that is a tough pill to swallow.

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