The past several decades’ worth of anti-obesity medication development produced multiple drugs for weight loss, and now the newest weight-loss drugs are on the horizon: Ozempic, Wegovy, and Mounjaro. They mimic the glucagon-like peptide-1 (GLP-1) hormone that produces insulin and suppresses blood sugar, helping create satiety and thus suppress appetite. Danish pharmaceutical company Novo Nordisk and its most promising product Ozempic (semaglutide), a diabetes treatment drug, have been under the public eye for the past year, met with both anticipation and scrutiny. People have started to question whether these drugs could be the catalyst to shift society’s views regarding obesity from an individual moral failing to a biological dysfunction that calls for medical intervention, or exacerbates the reputation of obesity through potential abuse behind cosmetic motives.

There was a time when women’s menopause used to be viewed as a deficiency disease instead of a natural stage of aging. Hormone replacement therapy (HRT) for declining estrogen was advised and administered for women undergoing menopause due to such a conception, but when it turned out that this treatment was correlated with higher risks of breast cancer and dementia, medical specialists finally accepted menopause as a part of natural aging. As such, medical interventions shape and influence conceptions of disease and illness. How can the new anti-obesity drugs be contextualized within the discourse on obesity?

The Deeply Moralized Chronic Disease

Obesity is one of the deeply moralized chronic diseases, best exemplified by the widespread stigma about obesity that labels fat people “lazy” or lacking willpower and discipline. The association of obesity with moral failing and fault of character has a long history as harmful prejudice; A 2022 University College London (UCL) study by Anastasias Kalea et al. revealed that a significant amount of health professionals believed their obese patients to be “lazy” and “lack[ing] self-control.” Professor Jang Jaebong (College of Pharmacy) suggests, however, that the recent development of the weight-loss drugs and the public attention they have received are an indicator of heightened public health awareness of obesity as a disease, coupled with increased risk for other chronic diseases like diabetes, heart and liver problems, cancer, and even joint pain. Moreover, administration of antiobesity drugs as treatment may further help familiarize the public with the pathophysiological mechanisms of obesity that certain groups of people with particular characteristics are most vulnerable to.

According to Cleveland Clinic, the newest anti-obesity drugs help people combat the “biological pathways” that lead to obesity, including “appetite, satiety, cravings, and thoughts about food.” The first generation of weight-loss drugs developed in the 1930s to 1960s, and they were stimulants that would act on parts of the brain that speed up metabolism. However, the anti-obesity drugs that have more recently surfaced in the market target the simulated hormones that regulate feelings of fullness, such as the GLP-1, amylin, and glucose-dependent insulinotropic peptide (GIP). The imbalance between calories consumed and burned via exercise is just one general cause of obesity. Unlike popular belief, decades of research have established that lifestyle changes were only effective in weight loss for a very small number of people. The causes of obesity are myriad, including environment, genetics, underlying health conditions, chronic stress, or a combination of some, thus, as Professor Jang further comments, the targeting of appetite suppression is just one of many possible approaches to help achieve weight loss.

Limitations of Anti-Obesity Drugs

Although drugs like Ozempic have been mostly approved for prescriptive use, limitations and risks are also to be noted with caution: the scientific journal Nature reports that the side effects include nausea, diarrhea, constipation, and more. Because Ozempic works by manipulating the brain’s acceptance of the quantity of food that a person consumes, malnutrition or disordered eating has been observed as side effects. The New York Times reported further that “no standard nutritional guidelines” have yet been set for patients who have been prescribed antiobesity medications. These are to be considered more thoroughly as the medication becomes more common. Additionally, Nature mentioned that the side effect of lean body mass accounted for 40 percent of the weight that patients lost in one study, and getting off the drugs once they have taken them may result in the risk of regaining weight easily.

Furthermore, disentangling the culture of shame and stigma surrounding obesity may not be as quick or straightforward as some may hope; some people are using weight loss drugs for dieting purposes, the practice of which is being met with valid criticism. Celebrities like the Kardashian family were rumored to have used Ozempic for cosmetic weight loss purposes, and experts worry that such drugs may stigmatize obesity even further. According to the New York Times, these drugs also tend to induce shame in users due to the perception that the medications are merely an “easy way out” of obesity, which highlights the need for a clear distinction between clinical obesity and normal weight fluctuations.

While the anti-obesity medications have great potential to treat and raise awareness of overweight individuals who are genetically predisposed, it is also important that the drugs do not overshadow the social determinants of obesity, including poverty that could tangibly limit access to healthy foods, which requires structural, epidemiological aid and expertise. According to the book An Anthropology of Biomedicine (2010), medicalization contributes to “masking significant historical, social, and political variables that contribute to illness and distress” – applying biomedicine at the expense of overlooking multivarious causation.

Medicine can easily give a false impression that there exists a standard human body and thus a standard solution. These new weight-loss drugs may help people not to fall hook, line, and sinker in the widespread moralized narrative of obesity, but it should also be clear that the drugs like Ozempic and Wegovy cannot be the panacea to the treatment or stigma of obesity, either. Professor Jang comments that medicine developers are continuing to research what target protein or signals in the body can be controlled for more broader reach. “In this field, we talk about targets – finding new targets to treat obesity will continue to be studied,” Jang said.