By now, you’ve likely seen or heard about Oprah’s very public endorsement of the weight loss drug Ozempic (semaglutide). The media mogul declared that this injectable medication was responsible for her “whole new renaissance” after struggling with weight her entire life. With Oprah shining such a major spotlight on Ozempic, many are wondering if this drug could finally be the breakthrough solution for lasting weight loss.

Here at Tend and Cultivate Counselling, we have major concerns about the rising popularity of Ozempic and similar weight loss medications like Wegovy. These drugs may promise quick and dramatic results, but with a near guarantee of weight regain over the long term, the devastating health implications of weight cycling, and the impact to self-worth when these snake oil treatments “fail”, is the cost to our physical and mental health worth it?

While seducing in its promises, especially when endorsed by such a prominent public figure, we urge you to consider some important points through the lens of body autonomy, feminism, and fat liberation.

As Hilary Kinavey and Dana Sturtevant from the Center for Body Trust® stressed in a recent live stream, we must remember Oprah’s primetime special is “a paid advertisement or infomercial, not real journalism.”

First, some background: Ozempic is part of a class of drugs called GLP-1 agonists, which work by mimicking a gut hormone that slows digestion and increases feelings of fullness. The higher 2.4mg dose branded as “Wegovy” was approved by the FDA in 2021 for chronic weight management in adults.

However, these medications were originally developed and approved at lower doses to treat type 2 diabetes by improving the body’s ability to regulate insulin and blood sugar levels. Using them for weight loss in non-diabetic individuals is considered an “off-label” use not studied long-term.

When a shiny new product like Wegovy or Ozempic comes out making big claims to be a “game-changer,” it can tug on the parts of us that are desperate for easy answers, quick solutions, and safety, love, and belonging. We’ve all been subjected to decades of pervasive diet culture programming that says our worth is tied to our size.

But as we’ve seen time and again with countless fad diets and products before it, the hype around Ozempic feels all too familiar. Just look at the historical marketing of supposed “revolutionary” solutions like the Atkins Diet, Redux pills, or Ayds appetite suppressants. They all promise to be the first and only thing that actually works, using persuasive language like “game-changing,” “cutting-edge,” and “scientifically backed.”

We’ve been down this road so many times before, chasing an elusive dream that diet culture keeps selling us. When has purposefully starving or depriving ourselves ever led to sustainable results or better self-worth in the long run?

What sets Wegovy and Ozempic apart is how they cause weight loss – along with some concerning potential side effects.

In the largest clinical trial, those taking Wegovy lost around 15% of their body weight over 68 weeks. That’s three times more than those taking the placebo.

However, up to 90% of participants reported gastrointestinal issues like nausea, diarrhea, vomiting, and constipation. A new study has also linked Wegovy and Ozempic to higher rates of serious conditions like pancreatitis, intestinal blockages, and gastroparesis compared to other weight loss drugs.

While the long-term impacts are still unknown, we do know that severe calorie restriction can put people at increased risk for slowed metabolism, nutritional deficiencies, loss of bone and muscle mass, gallstones, and hormonal disruptions – not to mention mental health issues like preoccupation with food, body image distress, and disordered eating patterns.

People with a history of eating disorders are advised to avoid these medications entirely, or if needed to manage diabetes, to use them only with intensive medical supervision. The euphoric feeling of appetite suppression can be incredibly triggering and feed restriction-based thinking.

Perhaps most significantly, the weight loss results appear to be unsustainable long-term without remaining on the medication indefinitely.

NovoNordisk’s funded clinical trial demonstrated that 12 months after stopping semaglutide, folks regained two-thirds of any weight lost – undoing almost all of the initial loss within a few more months.

Furthermore, any cardio metabolic benefits (blood pressure, blood sugars or inflammatory markers) returned to baseline.

In other words, the dramatic weight dropping effects only last as long as you keep taking the drug. This is concerning because decades of research tells us that chronic weight cycling (losing and regaining over and over) has significant negative health impacts.

If this all sounds a bit scary and disheartening, we want to offer a different perspective. What if instead of putting ourselves through the physical and mental strain of pursuing weight loss at all costs, we focused on caring for the bodies we have right now?

Author of Anti-Diet and The Wellness Trap, Christy Harrison, has spent years demonstrating through her popular podcast FoodPsych why dieting is the ultimate life thief. Instead of dedicating our lives, time, energy, and money into love, connection, community, education, and social change, diet culture encourages us to dedicate our lives to shrinking ourselves, monitoring and measuring our food and exercise, and generally feeling miserable.

Weight is not a reliable indicator of health or character.

Our self-worth and quality of life should never be determined by a number on the scale. When we look beyond surface-level weight, research consistently shows that engaging in balanced eating, joyful movement, adequate sleep, and nourishing coping strategies is what actually optimizes our well-being – no matter our size.

We also know, thanks to the World Health Organization, that over 70% of our health is determined by external factors known as the social determinants of health. Only 30% of our overall health boils down to personal choices and behaviors, and even that is inflated in some cases.

Add to that the well-documented impacts on our health that ongoing discrimination and oppression cause. Many researchers have posited that the negative health markers that some claim are due to weight are actually due to the violence of ongoing weight stigma.

Our work, inspired by Body Trust®, asks what if we respected our bodies’ natural cues around hunger, fullness, and satisfaction? What if we challenged society’s oppressive beauty standards and diet culture narratives that tell us our bodies are always problems to be fixed? What if we embraced body autonomy and the right to make choices for ourselves based on our own values and desires – free from shame or coercion?

If you find yourself driven by a deep internal motivation to explore medication like Ozempic, by all means discuss it thoroughly with your doctor while considering the risks and long-term outlook.

As Dr. Asher Larmie says, “I am not anti weight loss. I am pro body autonomy. In order to have autonomy over your body, you need to be able to make an informed choice. In order to make an informed choice you need to be presented with unbiased evidence that includes the benefits, risks, long term effects, and other options including the option of doing nothing. You need to be able to understand the evidence and then come to your own decision without any external pressure.”

Remember that many doctors are receiving bonuses and incentives for pushing weight loss medications on patients. There is HUGE MONEY in getting more people to take these medications, and if history is any indication of how this will play out, it’s that in a few short years, these drugs will be a fad of the past and a new silver bullet will be taking center stage.

If your desire to shrink your body stems from external pressures, societal conditioning, and desperation for thinness, we gently encourage you to pause and reflect on how you can cultivate more compassion for your body as it is. Your worth and right to exist in this world is not determined by your size. You deserve to feel at home in yourself without having to keep chasing an arbitrary size or weight.

We are not here to judge anyone’s choices, but simply to ensure we’re all making truly informed decisions – especially when it comes to something as personal and precious as our bodies and mental/physical wellbeing. As a weight-inclusive mental health practice, our role is to help broaden perspectives, instill self-trust, and facilitate inner attunement.

The weight loss industry will always be selling us the next new “solution.” But the real, lasting path to freedom may simply be to get radically honest with ourselves about what we most need to feel safe, whole, and enough right now.

We are here if you could use support.