On the morality of Ozempic
Obesity is a major problem.
It is currently the leading preventable cause of death worldwide. In 2022, 2.5 billion adults were overweight, and more than 1 billion people were obese. Predictions suggest that more than half the world's population will be obese or overweight by 2035. The cost of this is predicted to amount to $4 trillion annually. Currently, it is predicted that being overweight costs people in the UK £98 billion annually, with £19 billion of that being to the NHS.
There is a thriving industry based around losing weight; the number of gurus who promise that this diet or this food are a dime a dozen. There is seemingly no easy pill.
Yet early last year, Novo Nordisk, a Danish pharmaceutical company, announced what can only be described as a miracle drug. You have probably heard of it, Ozempic.
Ozempic is the brand name for semaglutide. Semaglutide is a type of medication known as a GLP-1 receptor agonist. They were originally developed for type 2 diabetes and work by mimicking a naturally occurring hormone known as GLP-1.
The hormone is responsible for triggering insulin release from your pancreas. It also has the effect of increasing your satiety and preventing excess glucose from entering the bloodstream.
After its approval for type 2 diabetes, there were multiple studies run on semaglutide that found a significant reduction in body weight versus placebo. The studies also found that after stopping the medication, patients would regain roughly two-thirds of their original weight loss within a year.
This is because semaglutide works by making your brain think you are satiated, i.e., you are full, and your appetite is therefore suppressed. It also has the effect of slowing down food in your digestive system and prevents wide swings in blood sugar, therefore making you feel less hungry.
But regardless of how, the fact of the matter is, Ozempic works.
On average, those who take Ozempic lose 20% of their initial weight over 18 months. For someone who is obese, this represents a considerable drop in weight and a large change in quality of life.
Part of why I called Ozempic ‘a miracle drug’ is because it has uses far beyond weight loss. People who take it report they no longer crave cigarettes or alcohol. Those who were compulsive shoppers have found they haven't felt as compelled. The drug could also cut the risk of dementia in half according to a recent study by the University of Oxford.
It could reduce the risk of Parkinson's, encephalitis, and even just general cognitive decline measurable by memory loss. And it may help protect against kidney disease and heart attacks. This is actually beyond just the loss of weight; the drug itself has effects on the incidence of these diseases.
If these claims are proven true, Ozempic could truly be a miracle drug.
Recently reported by The Times, at least 500,000 people in the UK are taking the drug privately as you can’t get it on the NHS just for weight loss. The cost is roughly £200 a month. The value of Ozempic was so large that in May of this year, Novo Nordisk—the patent holder—had a market value higher than that of Denmark's economy (the country they were founded in). Novo's growth single-handedly kept Denmark out of a recession in 2023. Therefore there is big money to be made in the drug.
Of course, Ozempic raises moral questions. Firstly, the drug has significant side effects for some; these include nausea, vomiting, diarrhoea, stomach pain, and constipation. Are suffering those side effects worth the cost of reducing weight for what some might see as vanity?
Consider the number of young women who feel pressured to lose weight. Women are socialised into an ever growing list of expectations around their appearance—society is driving women to adhere to unachievable ideals. This is further perpetuated by socialised inter-sex competition where women compete and judge each other into being as skinny as possible.
Furthermore, the influence of class on women cannot be missed. Being overweight has associations with poverty, as being skinny implies you have the income to buy healthier food and the leisure time to exercise. As Arnold says, "a well-built physique is a status symbol. It reflects that you worked hard for it; no money can buy it." Yet, for most women, a well-built physique typically means being skinny, therefore with Ozempic, you can now buy it. Thus raising questions around the potential expectations of young women to adhere to ‘heroin chic’ standards.
The other issue is that if you rely on Ozempic for weight loss, the moment you stop, you will regain the weight. This is because permanent weight loss comes from diet and lifestyle changes—combined with the willpower to stick to it when you don't want to.
This is where, as a 24-year-old man—who has multiple times lost and regained weight over a range of 20kg—it would be very easy for me to be puritanical about losing weight.
I could echo the Telegraph commenters who I often read—just so I can stay on the pulse of 70-year-old conservative men with nothing better to do—that say that the drug is just a way for Big Pharma to make money and you just need to pull yourself up by the bootstraps and eat less because in my day…
But I don’t think that is very fair; obviously, there are people who could, with a bit more movement and a slightly changed diet, change their life without the need for medication. One of the 70-year-olds, on the pulse of society, commented, Ozempic was simply "more tablets for healthy people."
But the reality is losing weight is hard; it takes a conscious choice to realise what you are doing and how you are living is not working. This is the same for someone like myself who lost 14kgs early this year and someone who needs to lose 50kgs. Yet, every case has extenuating circumstances.
I, as a relatively healthy 24-year-old, simply increased my steps (aided by the GE) and ate less—this was aided by my almost autistic desire for precision, as I weigh almost everything I eat (I promise this is not an eating disorder, I just like to know the exact numbers).
This would work for most people in their 20s, but the moment you age into your 30s, 40s, 50s, your body slows down, and it becomes much harder physiologically, mentally, and socially to lose weight.
This is, of course, much more true for someone who is obese. Excessive fat crashes your hormones and makes it much harder to lose weight. It is also very easy to be trapped by the quantity of weight you have to lose. Say for example you want to lose, 50kgs. The usual recommendation for losing weight is about half a kg a week, which would take 100 weeks; for most, this would be impossible to stick to and would lead to bad habits like crash diets and binge eating. All of which would leave you at best in the same place or more likely much worse off.
So, I’m not sure it’s really fair to be so puritanically against Ozempic when it is proven to work. Of course, Its important for someone to change their habits, but if they can use Ozempic to kick start that process, why should that be a negative?
On a societal level, I think they are truly a marvel; obesity is an enormous drag on the state, and the cost of prescribing these drugs is a pittance in comparison to the money saved.