Lead image by Justin Katigbak/Disabled And Here
By Fady Shanouda and Michael Orsini
This article is republished from The Conversation under a Creative Commons licence. All photos provided by The Conversation from various sources.
Fady Shanouda is an assistant professor of critical disability studies at Carleton University.
The headlines squeal with delight: Latest wonder drug will “cure” obesity.
We’ve encountered these headlines before. Time and again, dubious and ineffective solutions for obesity gain prominence. Pills, tonics, elixirs, Zumba, Noom and now Ozempic.
The latest wonder drug is a semaglutide drug invented to help diabetics regulate blood glucose levels, but has the notable side-effect of severe weight loss — for which it is prescribed off-label. It has been heralded by many to culminate in the elimination of fat bodies.
The fatphobia that undergirds such a proclamation isn’t new.
What makes this moment different from the others, however, is the dangerous rhetoric in which it is lodged. This rhetoric elevates the banal and commonplace fat-shaming that fat people must endure and resist to an unprecedented level.
Even before this, fat people have been seen as having disposable lives not worth saving. For example, during the height of the COVID-19 pandemic amid fears of bed shortages for COVID patients, the Ontario government drew up draft triage protocols that prioritized people assumed to be more likely to survive COVID-19.
The move sparked an outcry from hundreds of organizations, led by ARCH Disability Law Centre. Given the history of discrimination experienced by fat people in environments that are supposed to provide care, fat communities also mobilized globally to sound an alarm about the potential for discrimination against them.
Fat-haters
Following news of Ozempic’s ability to help its users lose weight, it did not take long for fat-haters to surface.
Two weeks ago, National Post columnist Barbara Kay proclaimed the death of obesity politics (a.k.a. the fat liberation movement). The arrival of these drugs, she wrote, will lead to the conquering of obesity once and for all, putting an end to fat activism.
Ozempic is being likened to what eyeglasses are to near- or far-sighted people. But, its promise of a fat-free future is unsustainable.
It is steeped in fat-hatred that could further damage our relationships to our bodies and food.
The language of the ‘miracle cure’
Let’s start with language.
The language used around Ozempic is about ending the so called “obesity epidemic.” The very description is laced with the idea of eradicating fat people.
First, Ozempic does not cure obesity. Certain users of the drug have lost significant weight, but they will need to take this costly medication in perpetuity.
If you come off the drug or if the drug changes, you will, just like 97 per cent of all dieters, gain that weight back and more.
Also, restricting or suppressing caloric intake — or your body’s natural urges — is dangerous. These urges can come back with a vengeance after being quieted down for so long in the form of the ghrelin hormone, which increases one’s appetite.
Ozempic could drop one from the requisite weight associated with the danger zones of obesity or morbid obesity. Yet, in a world marked by scientific uncertainty, the promise of “a cure” as a magic elixir is the ultimate expression of science vanquishing the bad enemy.
Then there is the other ‘O’ word: Obesity
Obesity talk pervades society.
The latest news is that medications to address obesity, like Ozempic and other semaglutide drugs at higher doses, are transforming health as we know it.
Governments are intent on stamping out obesity. Individuals are exhorted to do everything in their power to avoid becoming or being “obese.” This, even though the measure of obesity, the Body Mass Index (BMI), is widely regarded as a flawed measure of health.
Pressure is mounting for governments to provide these medications as part of a universal basket of health care. Social media is abuzz with Ozempic talk and the hashtag #Ozempic has garnered a staggering 1.2 billion views on TikTok.
@RemiBader/Instagram
Distorted picture of side-effects
The crusaders are half right. Ozempic is indeed transforming how we understand health.
The bad news is that it paints a grossly distorted picture of patients whose lives will be purportedly transformed if only they could shed that weight. While initial concerns were expressed that these injections are for diabetes only and should not be used strictly for weight loss, those concerns seem to have dissipated. Ozempic manufacturer Novo Nordisk is warning a shortage of the drug is expected in Canada.
One notable side-effect of Ozempic is reportedly suicidal ideation. However, when you are in the midst of an obesity epidemic, side-effects are, well, secondary.
The message in the marketing of Ozempic
What other messages can we read from the marketing of Ozempic as a weight-loss drug? Highly visible ads have appeared in such places as the exterior of Toronto streetcars and behind home plate at Blue Jays games, drawing criticism from some doctors and medical ethics experts.
Journalist Rachel Pick argued recently in the Guardian that the use of these drugs for weight loss encourages a myopic view of self: “It does not ask us to work on how we regard and treat others, it only asks us to feel better about ourselves. It is purely self-love, with an emphasis on the ‘self’: the ultimate exercise in navel-gazing.”
Obesity biopolitics: selling ‘fat-free futures’
Drugs such as Ozempic can be understood as a form of “pre-emptive obesity biopolitics,” a term used by United Kingdom geographer, Bethan Evans, to describe policy interventions that seek in the present to prevent fat futures.
Noom, the cognitive behavioural therapy-powered weight-loss company, has similar aspirations of helping what they call pre-chronic patients, candidates in waiting.
All of these approaches seek to create new markets of anxious consumers obsessed with their weight. Everyone can hop on the bandwagon that tramples over fat people in the pursuit of wealth and market share, even if it means pushing unrealistic and unattainable beauty and size ideals.
Although Post columnist Kay was quick to celebrate the so-called end of “obesity politics” occasioned by the arrival of Ozempic, perhaps we are instead witnessing the dawn of a politics engaged in contesting fatphobia and fat hatred in all of its forms.
A future without fat is a dystopian aspiration. And it’s one that fails to acknowledge the essential role fat plays in our bodies and in the body politic.
This is an updated version of an article originally published on Aug. 20, 2023. It clarifies the usage and marketing of Ozempic.
Monday, August 21, 2023 in The Conversation
Share: Twitter, Facebook
