Is our perception of obesity wrong?

British journalist and author, Johann Hari, recently published an opinion piece in the New York Times titled A Year on Ozempic Taught Me We’re Thinking About Obesity All Wrong.


Johann went from 92kgs to 73kgs within a year of starting his Ozempic journey, all the while grappling with a persistent feeling of guilt and immorality, as if his use of Ozempic was somehow cheating the process.


In the US, over 70 percent of individuals struggle with being overweight or obese. A survey indicated that 47 percent of participants expressed willingness to invest in new weight-loss medications. This inclination is understandable considering these medicines facilitate an average weight reduction of 10 to 20 percent, with forthcoming generations of weight loss medications potentially offering a 24 percent decrease, based on clinical trials


However, as the usage of such medications becomes more widespread, society becomes increasingly perplexed, subjecting individuals in the public eye who opt for such treatments to harsh criticism.

Stigma of obesity

One prevailing belief is that obesity is a moral failing. Dating back to the sixth century when Pope Gregory I outlined the seven deadly sins, gluttony was depicted as one of them, often portrayed through grotesque imagery of overweight individuals. According to this perspective, sin demands punishment before one can attain redemption.


The second concept revolves around the notion that we are in a perpetual weight competition with each other. This struggle often involves enduring hunger or committing to intense exercise routines, creating a sense of competition to achieve the ideal slender physique. From this perspective, individuals using medications like Ozempic may be compared to athletes who have used performance-enhancing substances. Those who have managed their weight through conventional methods may feel a sense of frustration, believing, “I’ve put in the hard work to achieve this, while you achieve it with just a weekly injection?”.


In his article, Johann expressed that the surge in reliance on new weight-loss medication stems from being caught in outdated narratives about obesity and the socially acceptable methods for addressing it. However, he sees this trend as an opportunity to break free from the cycle of shame and stigma, and to embrace a more honest narrative.


We have witnessed a dramatic rise in obesity rates, from being uncommon to nearly ubiquitous. 

According to WHO,  worldwide adult obesity has more than doubled since 1990, and adolescent obesity has quadrupled.


This prompts the question: why? And how do these novel weight-loss medications function? The answer, Johann argues, revolves around one word: satiety. Although not frequently discussed in everyday conversation, satiety is a sensation familiar to all, describing the feeling of being satisfied and not desiring more.

On satiety

Johann wrote that the unprecedented rate at which we’ve gained weight can be attributed primarily to significant shifts in our diets, which have profoundly compromised our ability to experience satiety. Fresh, whole foods that were once prepared daily have been swapped out for reheated and heavily processed meals. This transformation in food culture over the span of 30 years across the Western world is alarming.


Scientific evidence supports the notion that the traditional, whole foods consumed by previous generations induce a sense of fullness more rapidly. Conversely, heavily processed, factory-made foods, often containing artificial additives, left him feeling unsatisfied and perpetually hungry. A recent study on the dietary habits of American children revealed that ultraprocessed foods constitute a staggering 67 percent of their daily intake, promoting continuous consumption without achieving satiety.

Why dieting isn’t as easy as it ought to be

Paul Kenny, a neuroscientist at Mount Sinai Hospital in New York, conducted an experiment aimed at understanding why transitioning back to a healthy diet proves challenging. He hypothesised that the American diet might have peculiar effects on our brains and cravings, leading him to design a study


Kenny and his colleague, Paul Johnson, raised rats in a controlled environment, providing them with a nutritious, balanced diet. The rats ate when hungry and stopped when sated, maintaining healthy weights. However, when exposed to an American diet rich in fried bacon, chocolates, and cheesecake, the rats exhibited voracious appetites, quickly becoming obese. 


Shockingly, when the processed food was removed, and the rats were reintroduced to their original diet, they showed little interest, almost rejecting it as food. This behavior mirrors patterns seen in human diets influenced by industrially processed foods, elucidating the need for medications like Ozempic, which enhance feelings of fullness by boosting “satiety hormones,” as explained by scientist Carel le Roux.

In conclusion

Understanding this context highlights how processed and ultra-processed foods create a relentless sense of hunger, while treatments like Ozempic can help alleviate this hunger. Michael Lowe, a psychology professor at Drexel University with four decades of hunger research, views these drugs as addressing an artificial problem spawned by processed foods. However, society tends to attribute the obesity crisis solely to individual moral failure rather than acknowledging the role of the food industry


In Johann’s own words, “I felt like a failure for being fat and was furious with myself for it. Why do we turn our anger inward and not outward at the main cause of the crisis? And by extension, why do we seek to shame people taking Ozempic but not those who, say, take drugs to lower their blood pressure.”

Opinions or facts expressed within the content have been sourced from various news sources. While every effort has been taken to source them accurately, the pharmacy, its owners, staff or other affiliates do not take any responsibility for errors in these sources. Patients should not rely on the facts or opinions in the content to manage their own health, and should seek the advice of an appropriate medical professional. Further, the opinions or facts in the content do not reflect the opinions and beliefs of the pharmacy, its owners, staff or other affiliates. 

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