Most folk are familiar with the 'Ozempic Fad' that has swept the Western World. Originally, the drug was developed to treat type 2 diabetes. Diabetes Mellitus can be split into two distinct conditions. Type 1 diabetes is usually detected in childhood, and it is mostly caused by an autoimmune condition that attacks pancreatic tissue. Insulin is manufactured in the pancreas, specifically in cells called the Islets of Langerhans. Once these cells are lost, the individual can no longer regulate carbohydrate metabolism, and the patient requires a controlled insulin-injection regimen to regulate blood glucose levels. Type 2 diabetes usually occurs in adulthood and has a strong correlation with obesity. Generally, the condition is less severe than type 1, as patients still produce insulin but not enough to fully regulate carbohydrate metabolism. This form of the condition can usually be controlled with diet alone or with non-insulin medication.
Ozempic was first introduced in 2017. Unlike previous diabetic medications, Ozempic affects the 'Satiation Complex': it stops people from overeating by triggering a feeling of fullness early in the eating process. Thus, the drug is designed to help people eat less, which in turn helps maintain healthy blood sugar levels. As a result, it can lead to weight loss, and since 2021, doctors have begun prescribing the drug for weight loss in none diabetic individuals. The drug has other therapeutic actions, which I will briefly consider below.
Science Stuff
This is my chance to awaken the latent biochemist training I endured many years ago. The ghosts of pathways past come before my vision: glycolysis, Krebs cycle, beta-oxidation, and others parade in an endless array, crowding my senses with monotonous languor.
Anyway, Ozempic is classed as a glucagon-like peptide-1 (GLP-1) receptor agonist. For clarity, an agonist is a chemical that interacts with a receptor to elicit a biological response. The drug has several effects on the body. It acts on the hypothalamus in the brain and signals early satiety, preventing overeating and snacking between meals. In addition, it stimulates insulin production in the pancreas, helping convert glucose to energy and reducing blood sugar levels. It slows the passage of food from the stomach to the small intestine. Again, this delays the pangs of hunger by extending the satiety reflex. Finally, Ozempic suppresses glucagon, a hormone responsible for releasing glucose, and therefore helps regulate overall blood sugar. On the face of it, Ozempic appears to be an ideal drug for treating diabetes, as it acts on multiple systems, working in concert to maintain blood glucose levels within clinically prescribed limits. Enough biochemistry.
Like all medications, there are side effects. As expected, the most common involve the stomach and alimentary tract. Not all are affected, and in most cases symptoms are modest and usually decrease over time. The most commonly associated symptoms include nausea, constipation and diarrhoea. I suspect the last two symptoms are mutually exclusive in any given individual.
It didn't take long for rich celebrities to catch on to Ozempic's involvement in weight loss. Because the celebrity 'lifestyle' is associated with being thin, it seemed like an effortless way to lose weight. The drug was particularly appealing to those fat, rich bastards who lacked the discipline and willpower to rein in their gluttony. Or perhaps they were too intellectually disadvantaged to appreciate the metabolic reality: if calorific input exceeds calorific expenditure, then the excess is converted to adipose tissue. It is true that, due to a myriad of factors, folk differ in their metabolic 'burn rate', and some appear gifted in this regard. We can all recall a friend or acquaintance who is imbued with the mystical property of gluttony without associated fat deposition. My wife is of this ilk. She can scarf down calories akimbo without consequences. She has always been so disposed and struggles to maintain a healthy weight as she ages, due to constraints of appetite- is this a gift or a curse? My story is a tad different. I, due to my intellectual and mental disposition, have the blight of obsessive behaviour(s). Under this umbrella hide several behavioural compulsions that guide my daily routine; they are legion. I have a horror of weight gain that is clearly, to the 'sane' individual, abnormal.
As we age, weight gain is a reality for most folks. We also experience a necessary decline in physical activity as age-related conditions take their toll. By three score and ten, there are few of us left who haven't felt the lash of medical maladies that limit activity. Whether your aged health status and fate are due to 'luck', genetics, or overindulgence, your final health 'barometer' is a remorseless, and often sad, reality.
It has become clear that taking Ozempic as a weight loss aid rather than for therapeutic reasons is not without consequences over and above the known side effects. And there is little doubt that folk can lose a considerable amount of weight whilst taking the drug. However, the weight loss is not exclusively due to fat loss, as 40% of the weight involves protein, or specifically muscle. This explains the development of the 'Ozempic Face'. Together with rapid fat loss from the face, there is also muscle reduction. The result is a hollow, gaunt look, and the overall effect is a loss of a healthy and youthful visage. It has become noticeable that certain celebs who have been partaking of the drug for its rapid slimming action have developed unhealthy-looking 'aspects' that have become indelibly inscribed upon their faces. The drug's effect on dietary intake requires a lifelong application. Once the drug is stopped, and unless other measures are taken to either restrict calorie intake or undertake an appropriate exercise regimen, the weight is likely to return. Furthermore, as we age, our ability to replace lost muscle decreases, and older participants will find that the gaunt look remains even as they become fat.
Tis a sad reflection of modern society that a sure way to become thin, without willpower or work, is by taking a pill. It is also true that if you want to become exceedingly wealthy, just design a drug that guarantees weight loss. Celebrities are under immense pressure to maintain their physical attractiveness, and part of that journey is staying thin. And let's be clear, this is not the same as maintaining a healthy weight for a designated age. Couple this with the self-selecting trait of narcissism, and we are no longer lingering in the territory of maintaing a healthy weight but in the wasteland of an eating disorder.
