There’s nothing intrinsically wrong with it, except that it does nothing to cure the real problem
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This recent piece from the New York Times, about the new weight loss drugs like Ozempic, really rubbed me the wrong way. Let’s suppose there were a safe drug that promoted weight loss through reduced appetite. (It’s not entirely clear that that has really happened, but of course everyone’s acting as if it is.) That could remove a strong argument against changing the ways and types of food that we produce, market, and eat.
And that is a bad thing, because agriculture as currently organized is terrible for the environment, for the use of land and other resources, for climate change, animal welfare, human labor, and more. And it’s still far from clear that eating ultra-processed food (UPF) – which now comprises the majority of calories eaten by Americans – isn’t bad for you for reasons other than weight gain. Yes, the new drugs may make people less likely to gain and even more likely to lose weight, and may even protect against diabetes, but do they slow the rate of diet-related cancers? Unlikely.
It’s like someone hitting you in the head with a hammer and then feeding you a painkiller. Or, more nuanced, it’s like “We’ve found a way to end fossil fuels’ contribution to climate change.” Well, great. But what about the other ill effects of fossil fuels? What about the other causes and effects of climate change? All this would sound like is permission to drive gas-guzzlers. And all Ozempic sounds like is permission to keep marketing junk food: “We’ve taken the harm out of it.” But of course that’s not true, and it’s yet another in the long list of our plainly seeing the cause of a harmful disease or condition or syndrome or crisis and, instead of addressing that cause, we attempt to pick off the symptoms and “cure” them, one by one.
Obesity can cause disease, but obesity isn’t a disease. If anything, it’s a social disorder, one brought about by the force-feeding of Americans (and others) with “food” that’s really closer to the dictionary definition of poison: It makes you sick, not well. You don’t need to be obese to get diabetes, or cancer, or heart disease.
The root causes of all of this are, undeniably, really really really hard to address. Because in this system, corporations make money both ways: by seeding the causes of diseases — and charging for them — and then selling the so-called cures. The whole system needs reforming if we want food that’s healthy, fair, green, and affordable for all.
That last bears emphasis, because it’s likely that Ozempic and the other anti-diabetes weight loss drugs will be available only to people with the best health insurance, thus increasing even further the health disparities between rich and poor.
There’s so much wrong here, and it’s so awful to see the near-infinite positive publicity. (In the midst of an anti-vaccination movement, no less!)
To sanity-check myself on some of the outrage I’m feeling, I reached out to David Katz, my co-author on How to Eat and among the country’s best-informed and sanest medical authorities. His immediate response was, “It’s just like ignoring the sources of air pollution because we can market gas masks that work quite well.” (You can read a more detailed analysis of this whole issue by David here.) We have a big problem, a social problem, and our reaction is to devise a drug that addresses some of the effects of the problem in some of our bodies. That doesn’t even sound like an adult reaction, does it?
I’m not sure – I’m not equipped to know, although it could well be that no one is at this point – whether there’s actually anything wrong with using Ozempic as a treatment, any more than there’s anything wrong with taking ibuprofen for chronic headaches or, for that matter, donning the gas masks. I just worry that it’s yet another distraction from the real problem.
As David said to me a couple of weeks ago, “If I believed we could hold two ideas in our minds at once — (1) it might be good to help people attenuate their appetites/cravings; and (2) we still need to direct the bulk of our efforts to fixing the production of food, the supply side, the marketing, etc. — then I would be far more enthusiastic about the drugs. But I don’t believe that — I believe the drugs will provide cover for business as usual on the supply side.”
In short: We’re solving for symptoms while belittling or ignoring causes.
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