Everybody’s Talking About Mounjaro, Ozempic…

Despite what my insta feeds me, I try not to pay too much attention to the latest diet fads and weight loss movements. Believe me, I have dabbled in my fair share.

In my twenties, I lost almost two stone by eating Weight Watchers tiny microwave lasagnas and being very hungry most of the time. I was horrified when the same diet didn’t work for me during my thirties. Since hitting my forties, I have tried to realise that a healthy mix of well-balanced nutrition, exercise and learning to love yourself is the way forward… if only it was that easy, particularly the last part.

But there’s a new kid in town. Well, new on my radar anyway. It seems I suddenly cannot escape the conversation surrounding Mounjaro, Ozempic and all their GLP-1 competitors. For those living with obesity, according to Dr Laura Falvey, a SCOPE-certified medical doctor in obesity management, “These medications are revolutionary.” But I don’t know anybody who is living with obesity and been prescribed GLP-1 receptor agonists, only those who have decided to fill in a questionnaire and buy the drug online to shift a bit of excess weight. When I’ve asked with intrigue what it’s like, I’ve been told that it “takes the chatter away from thinking about food all the time.”

This made me a little uncomfortable. I love food. I love chattering about food.

“So when I go to a restaurant,” one user told me, “I might only feel like a starter.”

Now I don’t know if this is where my own problems lie, but if I’m going to a restaurant I think about what starter I’m going to have all day, alongside the main. I jump online to have a nosy at the menu, my mouth watering in anticipation. Going out for food has always been up there with my favourite things to do. I was never in the “eating is cheating” camp and would happily go for a slap up meal before hitting the clubs in my teens and twenties. These days, eating out can send me into a food coma which is generally welcomed. Is it wrong to get giddy about food? I mean all types of food too, not just the unhealthy stuff. Sure, I love a burger and loaded fries but I have also been known to go a bit bananas over what Ottolenghi can do with an aubergine. I’m not sure I want to change my love of food.

Still, this doesn’t mean I am in love with my body.

I can’t escape counting calories. I try to be, shall we say, mindful of what I eat. If I don’t hit my daily steps target I get frustrated and wish I hadn’t snacked on that slice of toast. I fall into rabbit holes of watching influencers harp on about protein goals and how this is my sign to start doing wall pilates. I try hard to love the weight I can’t shift around my middle, telling myself that I grew babies in there and it’s magical and beautiful and… But I was teenager of the 90s. I remember Chris Evans telling Posh Spice to stand on the scales in front of a live audience to see if she had shed her baby weight. As wrong as it so clearly was, I can’t un-think the thin thoughts.

So after years of dieting and mental battles with how I see myself, is injecting myself once a month going to be the way forward? Is Mounjaro about to become the new norm in weight loss? Will those of us who choose to continue eating three meals a day become the plus-size of the next generation? Are we about to see humans shrink in size, the heroin-chic of the 90s making a comeback? Or is it ethically wrong to use - or perhaps, misuse - a drug which is administered for chronic illness?

It sounds simple; one injection once a week. But the side effects are common and unpleasant, such as nausea, vomiting, diarrhoea, heartburn, constipation…no wonder the users don’t fancy eating. Mounjaro's manufacturer, Eli Lilly, even lists acute pancreatitis as a serious side effect. Plus, there is the stigma of it being a quick fix which shames those who are living with obesity.

On The Healthtech Podcast with Dr James Somauroo, Dr Falvey explains that obesity is not a choice, so why is treatment still controversial? “Obesity needs to be reframed,” she says. “Obesity isn’t a behaviour…like smoking. Its a chronic illness. Symptoms include eating a lot, but we see this and people form judgements.” Stigma has become highly internalised by patients and Dr Falvey often hears patients say things like, Oh, I just need to sort myself out… and this mindset and fear of judgment hinders seeking help and accessing services available to them. Many who live with obesity are highly motivated to lose weight and put much effort into wellness and wellbeing. They have tried diet after diet and struggle with their metabolism, so why shouldn’t medical treatment be administered to assist?

But Mounjaro, Ozempic… it’s not a cure, rather medication to treat a chronic condition alongside wraparound care and professional guidance from clinicians and dieticians. Now that it is available to buy online, many are using the injections for body images purposes to get “beach body ready” before a holiday. There is not enough data to prove how effective this is going to be long term and what the side effects might be, especially since selling drugs privately makes it a money-making business, not an all-round care provider. It’s impossible to create clear statistics.

There is also the ethical argument. Those who can afford it are buying the drugs and losing 20% of their body weight, but what about those who really need the medical support? Dr Falvey explains, “Part of a good obesity intervention is about understanding why the patient has developed obesity. Do they have an underlying psychological cause that GLP-1s will not address?” Its not a case of prescribing the drug and off you go, it’s much more complex.

Another big question. Is this a forever drug? Once you start, is there no going back? If you’re buying Mounjaro from an Instagram ad, once your money runs out you might pile on the pounds without the tools in place to continue this lifestyle. There are always going to be the haters too, those who think this form of weight loss is cheating. I worked my butt off in the gym and you just stabbed your own thigh! It’s not fair! I’ve restricted my calories for years and buying a diabetics drug makes you skinny?! But we must be careful to pass judgement. Everybody has their own personal relationship with food and their body. All reasons might be valid. Taking medication for a condition is not cheating. It’s perhaps too early to understand if and how people are abusing this.

I don’t have a strong opinion on this yet. I only know my own insecurities and struggles with body image, food and everything etched onto my brain from growing up being told that skinny meant beautiful. When I see someone looking and feeling amazing because they tried Mounjaro, I am going to be intrigued. I also want to understand the science behind it and whether this is something that should be left alone as a medically prescribed drug. Or maybe we will all be injecting ourselves in the future and eating less…Stranger things have happened.