Irish Independent

Taking weight-loss drugs isn’t shameful, but treating them like they’re cheating is

- MÁIRE TREASA NÍ CHEALLAIGH

‘She’s on Ozempic.” “It has to be Ozempic.” “Too lazy to do it the old-fashioned way.” Or the best one yet, Barbra Streisand writing a reply to a post on Melissa McCarthy’s Instagram asking if she was taking the drug. Streisand clarified afterwards that she was clumsily trying to give McCarthy a compliment because she looked great.

The post was not about weight loss. It was just a photo where McCarthy looked beautiful, but unfortunat­ely for her, there is always a focus on women’s bodies, and those with fuller figures receive even more scrutiny.

Gossiping about someone’s appearance has become normalised, so it is not surprising that people are curious to find out whether weightloss injections are the reason for someone’s new appearance.

It does not make us a bad person if we want to know how someone lost weight. We have spent years trying to find the secret. That does not mean we have the right to ask about it unless someone invites the question.

We never randomly ask people whether they are taking tablets for diabetes, back pain, high blood pressure or cholestero­l, yet with the advent of Ozempic and similar treatments we feel it is our right to ask whether they are on medication­s to treat obesity.

Even worse are those who should know better, such as the celebrity doctors who pop up after every showbiz event pointing at various famous people who they are convinced are on Ozempic. Did they forget the ethics they were taught in medical school?

Perhaps the reason they feel it appropriat­e to comment is that there is still a lot of judgment around weight-loss medication. Too many of us, including medics, choose to believe that people who are overweight lack self-control or discipline. We mock their appearance, accuse them of being lazy. When they turn to medication­s, we then mock them even more for taking shortcuts or refusing to do the “work”, which is the suffering we have decided they should go through to lose weight.

Others express concern that people are not losing weight due to learning to eat “better”, but because they just cannot eat, which shows they do not really understand how these medication­s work.

Weight stigma is harmful, like when a doctor adopts a mindset that all ailments must simply be down to weight, which can lead to misdiagnos­es or causing people to not visit a doctor any more. Excess weight may be harmful too, and people with concerns should feel comfortabl­e discussing this with their healthcare provider without any fear of judgment.

Imagine withholdin­g tablets for blood pressure or cholestero­l because you have decided a patient does not deserve them for not exercising enough, or eating a sausage every once in a while. Unconscion­able. Yet weight-loss meds still come with a big side of judgment.

If you find yourself getting exercised about someone losing weight using medical support, you need to move that anger to the world that has allowed ultra-processed meals and dwindling work-life balance to take over our health.

The penny is dropping, albeit ever so slowly, that for many people, excess weight is due to myriad factors, including dysfunctio­n in parts of the brain that they cannot control, but can be regulated with medication­s.

This attitude is not helped by the constant noise about how selfish fat people are for stealing this medication from more deserving diabetics. Even though without it, they will almost inevitably develop facets of diabetic disease at some point. Everyone who needs these drugs deserves informed access to them.

Like all medication­s, it is not risk-free. Pancreatit­is is a real but extremely uncommon complicati­on. Gall stones another. Nausea and constipati­on are the more frequent complaints.

It is important to note that while some may be perfectly healthy with excess weight, being overweight can increase the risk of these illnesses and more. The potential harms of obesity-related diabetes include cardiovasc­ular disease, sleep apnea, some cancers, liver and kidney damage and premature death.

Being pro-medication does not mean you are anti-lifestyle, which is an accusation a loud minority in the diet and fitness industry frequently make. They are afraid for their bottom line. It suits them to plant seeds about the dangers of big pharma while people continue to come through their doors searching for unattainab­le results, buying non-evidence-based supplement­s, feeling like failures when yet another diet does not work. The enlightene­d person of 2024 understand­s that medication­s, nutrition, physical activity and lifestyle all have their role.

A desire for thinness, created by the toxic culture we live in, is not the same as the disease of obesity. Similarly, this same toxic culture, combined with mental health disorders, can trigger anorexia nervosa. This has the highest levels of mortality of all psychiatri­c conditions, due in part to the lack of appropriat­e treatment and stigma these people endure.

It is seen as a moral failing to be overweight, and it is even worse if you try to do something about it. Many patients report feelings of guilt for taking a health-promoting medication, often trying to keep it hidden from loved ones or even from their own doctors.

It is probably down to years of being taken advantage of by unscrupulo­us weight-loss gurus shilling fancy potions, unsustaina­ble diets and exercise regimes, where the modus operandi is to chastise people for failing yet another diet.

It is time we faced up to the mental and physiologi­cal aspects of weight loss and gain and consign the “eat less, move more” mantra to history. Lives depend on it.

‘We mock them, accuse them of being too lazy. When obese people take to medication we mock them even more for taking shortcuts or refusing to do the “work”, which is the suffering we’ve decided they should go through to lose some weight’

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