I said, ‘No, thank you!’” It was the third time I had refused my endocrinologist’s prescription in five minutes. “I’ll still put it on your file; that way it’ll be there if you change your mind,” she curtly replied.
I’d read a lot about Ozempic, an injectable semaglutide intended to treat type 2 diabetes but now increasingly used by celebrities for one of its principal side-effects: rapid weight loss. But I had no clue how easy it was for a lay person like me to obtain the drug for the sole purpose of shedding extra pounds. I didn’t even have to ask my doctor about it.
I should have known; medical fat-phobia is an all too common reality fat people — myself included at 5’11’’, 275 pounds — have to contend with pretty much any time we set foot in a doctor’s office. How many times have I seen a physician and been recommended (or ordered) to lose weight, regardless of the nature of my symptoms? Chronic migraines? “Lose weight!” Painful stomach cramps? “Lose weight!” Debilitating anxiety? “LOSE WEIGHT!”
Three years ago, I had my thyroid removed because two nodules in my throat had grown to the size of grapefruits — the largest my surgeon had ever seen, he later told me — which had started hindering my breathing. This happened because my GP had taken too long to diagnose the issue, blaming the growths on my weight. (The surgeon later confirmed weight had nothing to do with it and, had my throat been examined sooner, I could have been given medication to shrink the nodules. Which means I’d still have a thyroid today and wouldn’t need to take an ever-fluctuating dose of Synthroid, a man-made hormone, for the rest of my life.)
Over the years, I’ve heard many infuriating stories of people being patronized by their doctors or receiving the wrong diagnosis or treatment.
So I wasn’t surprised to have my doctor push Ozempic on me. News about this revolutionary medicine that curbs your appetite and makes you quickly drop dress sizes is everywhere: in ads, on TikTok, on the front page of New York magazine, even onstage at the Oscars. “Everybody looks so great. When I look around this room, I can’t help but wonder if Ozempic is right for me,” joked Jimmy Kimmel, the ceremony’s host.
But Ozempic is only approved by Health Canada for the treatment of type 2 diabetes, not for weight loss. The dosage for the two are quite different; you need almost double the amount of injections for weight loss as you do for blood sugar management. Side effects can include nausea, diarrhea, digestive issues and, in more extreme cases, vomiting, extreme fatigue or even lethargy and depression.
Ozempic also often isn’t covered by insurance plans when it’s used off-label, as in the case of weight loss. According to Karine Gravel, a registered dietitian with a PhD in nutrition, “Depending on the prescribed dose, costs can vary between $250 and $500 a month — that’s huge! Those costs are for life, because once you stop taking Ozempic, the weight returns.” Gravel called it a Band-Aid solution. “It works on the surface, temporarily. It’s often presented as this miracle remedy, when, in instances of negative body image or a difficult relationship with food, it doesn’t actually fix anything and can even raise patients’ risk of developing an eating disorder.”
That’s what happened to Alexandra*. She started taking Ozempic in February 2021 on the advice of her doctor to manage her diabetes and — as an added “bonus” — lose some weight. “Within weeks, I experienced nausea, stomach pains, intense fatigue, but most alarmingly, I was having bulimic episodes, relapsing into an eating disorder I’d spent years recovering from,” said Alexandra, who gained 20 pounds while on Ozempic. “My doctor’s response? Hike up the dose.”
By that point, Alexandra said the medication made her so tired — on top of causing vomiting, diarrhea and even fainting spells — that she spent four out of seven days in bed. “I ended up having to go on sick leave. Strangely, I kept putting on weight despite the higher dose. After a few months, I decided to go off the medication so I could get my health, energy and life back.”
Amélie* can relate: she takes Ozempic to control her diabetes. “It works pretty well for that, but the adjustment process is really hard,” she said. “I’ve been on it for nearly two years and I’m still dealing with significant side-effects like exhaustion, constipation, diarrhea, gastric reflux, dehydration. Meanwhile, I’ve only lost about 12 pounds — not exactly the kind of extreme transformation you see on TikTok.”
Dr. Benoît Arsenault, a researcher at the Quebec Heart and Lung Institute and associate professor at Laval University’s faculty of medicine, said that Ozempic can help people when prescribed correctly. “Ozempic can be beneficial for people with type 2 diabetes and for people of all sizes who suffer from cardiometabolic diseases [like insulin resistance and non-alcoholic fatty liver disease.] Where I take issue with this drug is when it’s prescribed to people who are overweight but have no cardiometabolic issues whatsoever.”
Before I went to see my doctor, my mind was made up about Ozempic. I’m healthy — and I have the test results to prove it. I refuse to fall prey to yet another alluring weight loss promise that, in the best case scenario, would make me yo-yo back to where I started.
“Psychologically, gaining the weight back, which is pretty much inevitable, and having struggles with body image and eating return once people stop taking Ozempic can be really distressing,” said Dr. Stéphanie Léonard, a psychologist who specializes in the treatment of eating disorders. “It can bring back a lot of past pain and trauma.”
I have a feeling we’re only seeing the beginning of this kind of medication becoming more popular — especially in the wake of WeightWatchers making headlines for acquiring Sequence, a weight-loss management telehealth company known for facilitating access to drugs like Ozempic. But I won’t be participating. Despite society trying to convince me that I should feel otherwise, I actually like my body. After 38 years, I’ve more than had it with playing the diet game — or rather, having the diet industry play me.
*last name withheld.
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