This is about Ozempic and whether/why it amounts to “cheating” to achieve a weightloss result, and “aesthetic culture”, and moral failure, and self-control, and all manner of other related things that just happen to be all tangled up together in my own experience of life as an American woman carrying “a few extra pounds” (more than a few, unfortunately), viewed through the lens of my own experience(s). I’m providing this wee summary to more easily allow you to simply move on if the topic lacks interest for you, personally. 😉

…You could just watch South Park “The End of Obesity”…

When Ozempic became “a thing” in the news (early in 2022), it was mostly due to celebrity endorsements for weightloss and shortages having developed because it had become commonplace for people who are not diabetic to be prescribed a GLP-1 (which is what Ozempic is) for the sole purpose of losing weight. I’m not criticizing – whether you’re grossly obese, or just a few pounds over your “ideal weight”, we live in a world that puts a lot of emotional effort into blaming and shaming “fat” people, and puts a ton of emphasis on “thin is beautiful”. Thin sells products. So do feelings of guilt, shame, and envy. The conversation in the media immediately began swirling around who should have these GLP-1 drugs available to them, and why, and the 100% ridiculous (and unaffordable) cost of them to individuals (and insurers). Celebrities whose transformative weightloss was a topic of discussion were picked to pieces over did they use a GLP-1 or lose weight “the right way”? (Who decides that? It probably shouldn’t be a matter of public opinion.) The articles about terrible side effects followed. What I found interesting at the time was that the first GLP-1 approved for treating type 2 diabetes was approved in 2005. No fanfare. No media hype. No alarming back-and-forth about side effects. All that developed much later – after it was clear that GLP-1s could “cause weightloss” as a side effect, and they became popularly prescribed off label by GPs to clients who could afford them in spite of the offensively high retail price (long before insurers would cover them for weightloss).

…2005… They were in use for decades without any remarkable controversy. Safely. Huh.

When I started thinking about them and whether I might benefit from them, myself, I was only aware of them because of the media hype to do with weightloss, and that was where my own interest was centered. In spite of my type 2 diabetes, a GLP-1 hadn’t really been discussed. To be fair, I was not “open to” the diabetes diagnosis, in spite of serious difficulty managing my blood sugar (it seemed to clear up any time I corrected my diet by more or less eliminating sugars, and got my weight down a bit).

At one point, faced with quality of life and health threatening weight, and my difficulty managing it, (and my Mother’s similar challenges) I got serious with myself and managed to shed almost 150 lbs over about 18 mos. Over time, in part due to stress, in part due to health and mobility challenges of various sorts, I gained some of that back (and I’m not at my ideal weight). I lost a lot of it, again, then gained it back, again. It’s been a challenge and it’s a serious health concern. But – I did lose all that weight, without a GLP-1, or medical intervention of any sort. It is possible for many people (and for some people it just isn’t). I say this because my thinking on weight, weight management, and various medical options regarding weight management are built on my own experience, and are nuanced.

My thinking evolved over time, and I tried a lot of things to manage my weight when it became a problem. I was self-critical and hard on myself after I gained weight in my 30s. I wasn’t overweight “all my life”. I was healthy, fit, and a “curvy muscular” woman when I was in the Army. I was faced with a culture of “fat phobia” that tended to promote an unhealthy leanness that I could never catch up to with my muscles and curves. Emotionally, that was hard on me. I struggled to see my own youthful beauty. Society’s messaging was harsh and unyielding. Be thin. Non-negotiably, thin was “pretty”. Thin was “sexy”. I even achieved thin for awhile – it wasn’t healthy for me to be a size 0 at 5 foot 6 inches tall.

I’m bouncing around a bit here, sorry. The tl;dr is that I was “coached” over a lifetime that my weight was my own to manage, that the acceptable beauty standard was “thin” – preferably like a pre-teen girl – and that failing to achieve that standard was most likely a moral failure or a lack of effort on my part.

We each walk our own hard mile. I know I can (possibly) lose the extra weight I’m carrying, with a serious reduction in calories and an equally serious increase in exercise. That’s the basic deal; eat less and exercise, right? I’m also quite human. Mobility issues and disabilities often make exercise difficult or complicated (no jumping rope on this f*ed up ankle, I’m just saying – I’ve got limitations). Other medications prescribed for chronic medical issues can change the efficiency of my metabolism (or rob me of my will and energy). Food and great dining are truly among life’s most profound sensuous pleasures, and it can be difficult to say no to some treat. That’s just real. “Emotional eating”? Another challenge. The cost of healthy calories? Yet another consideration. Losing unhealthy weight is not universally easy.

I decided against Ozempic for losing weight, figuring I’ve lost weight before, I’ll just keep at it, you know? The side effects sounded pretty terrible, too. And the expense?! Nope. Not worth it.

My blood sugar was still an issue. I was also struggling with other health concerns, including chronic fatigue, irregular (high) blood pressure, fairly ordinary middle-age stuff like that. My doctor was insistant this time; my diabetes needed to be managed. We tried this, we tried that, I eventually ended up on metformin (common), which immediately reduced my quality of life with near-daily diarrhea that had the potential to force me to stop going out on the trail for long walks. It was problematic. That’s how I ended up giving a GLP-1 a try – for my diabetes. (That I refused to acknowledge for far too long, and now deal with the consequences of that stupidity.)

Within 60 days, my blood sugar stabilized – normal. Then my blood pressure. I felt somehow younger and more energetic, too. Weird. Yes, I also lost the near-constant focus on food, eating, meals, sweets – in fact, meal planning to cook meals for my family became almost impossible for awhile. lol I just wasn’t thinking about that. Huh. Wild. I did lose some weight. Quite a bit, actually. Then – relatively recently – on a stable dose that serves me well with few side effects (and those I do experience are manageable) – my weightloss stalled completely. I still get all the other benefits, but a new reality unfolded; for those of us who take a GLP-1 for diabetes, there may not be quite so much aggressive weightloss coming quite so easily. There are still verbs involved. I still need to do an appropriate amount of healthy exercise (human primates need exercise, that’s just part of what we are as creatures). I still have to manage my calories. Frustrated with my lack of weightloss, and watching my Traveling Partner manage his post-injury weight gain (and closing in on his goal weight quite efficiently) I finally put the pieces together…

…I can be a little slow sometimes…

It’s the calories. I’m still eating calories that support the weight I am right now. I started on the GLP-1, reduced my caloric intake as a byproduct of starting on that medication and losing interest in grazing, snacking, sweets, and impulse eating, and lost weight until I got down to the weight supported by the calories I’m actually consuming. Well… that’s fucking obvious. LOL So… now I have to reduce my caloric intake down to the quantity that will support my goal weight. Of course. Nothing to see here. So ordinary it is almost not worth mentioning.

You know what is worth mentioning? It’s just mean to be shitty to people because of their weight. It’s definitely rude and inappropriate to comment on it. You know what else is worth mentioning? It’s also not your fucking business how someone is managing their weight, their health, or even what their personal aesthetic is. Do you think someone is “fat”? Well, okay, you have an opinion. Let it go. If nothing else, just shut up about it. It’s most likely not your concern, at all. Is taking a GLP-1 “cheating” if the only reason someone takes it is to lose weight? I’m not sure that’s anyone else’s business in the first place. It’s inappropriate to be taking it for vanity weight loss if there are shortages that prevent people who need it for their health and wellness from getting it. Still not your business (or mine) who is taking it and why. Like any other medical question, that should be a conversation between patients, doctors, and caregivers. (And it would be nice if we could all take a wee step back and stop hassling each other over appearances.)

Taking Ozempic has changed my life a lot. My poor impulse control, for example, just generally (a byproduct of head trauma and brain damage) is now notably improved (like, just not a problem), which was an unexpected bonus. I’m not distracted by the thought of food or thinking about the next meal, which means I can more easily focus on what I’m doing. I have more energy, which means I get more done – including the exercise I need to be healthy. My health concerns are mostly well-managed – and this has also resulted in being able to discontinue several other medications, which means my body isn’t having to process all those other drugs. My quality of life has improved, and sure, I lost some weight. There are still verbs involved. I still have to watch what I eat, still have to get healthy exercise and take care of myself. It’s not a fucking magic trick, it’s just a treatment for a medical condition.

So, here I am, 16 months after starting on a GLP-1, still human. Still working, walking, and being. My results vary. I still have to practice healthy practices. Still have to eat right and exercise. Ozempic isn’t a cheat code to perfect health, or achieving my ideal weight – it’s just a medication. It does have serious side effects, which seem to be more of a problem for consumers taking larger doses solely for weight loss, than for people taking it to manage their diabetes (something to consider). For me, the side effects have been mild, and limited, and tend to be easily managed by eating a healthy diet that maximizes plant fiber, protein, and includes plenty of water. I supplement my magnesium. I make a point to drink a yogurt beverage with reliably good quality active cultures (several varieties). I feel good on this GLP-1; it changed several “small things” and has had big results (for me). It’s not for everyone, I’m sure.

One day at a time, one step at a time, I walk my own path. You’re walking yours. Neither of us actually have the time to waste on criticizing other people’s choices with regard to personal aesthetic or health, wellness, or beauty. There’s too much to do in life to waste it on interfering in other people’s business, isn’t there? I hear that clock ticking in the background (here in the office, it is a literal ticking clock that I hear). It’s already time to begin again…