The Real Cost of Ozempic
Reading Time: 5 minutesI Was Ashamed of My Weight. Now I’m Ashamed of Taking Ozempic., I inject myself once a week. It’s changing my body—but not how I see myself., Ozempic and body dysmorphia: What the drug can change, and what it can’t.
In the second week of December, I found myself sitting in one of those dark, windowless rooms in the back of a salon on a papered table used for bikini waxes. A physician assistant in navy scrubs was holding a vial of semaglutide, the popular and polarizing medication used for the treatment of Type 2 diabetes—and, controversially, as a weight-loss aid for celebrities.
Cassandra, we’ll call her, pulled out a bag of syringes and showed me how to inject myself: Put four fingers below your belly button, and shove in the needle. Empty it, wait a few seconds, and you’re done. There’ll be a little pinch.
A couple of years ago, I gained 60 pounds. It didn’t really matter that I’d gained it after going on meds for a chronic illness with a much higher mortality rate than obesity. Or that the meds worked to make me more functional and less bedridden, more able to leave the house and less likely to binge eat—healthier.
It didn’t matter why I’d gained the weight because my parents, along with everyone else in their generation, were raised to believe that thinness was healthy. And they raised me in the same world that created ‘almond moms‘ and late-’90s leading ladies who were compared with clothes hangers and the Atkins diet and Monica on Friends in a fat suit.
The weight gain made my family confused and worried. And, sure, maybe I was a little confused and worried too. I didn’t think I looked ‘like myself.’ My parents gifted me gym memberships and shipments of soup: generous, but neither subtle nor very effective. And while none of my medical providers thought my weight was the most important thing about my health, none of them approved of it going up either. I worried about what other people thought too. When dates didn’t go well, there was a little voice in the back of my head, asking: Is it because I’m fat now?
Of course, I knew the antidote to that kind of shame wasn’t losing weight. It was figuring out how to accept my body for what it was. So I worked on culling fitness influencers from my Instagram follow list; I researched and adopted several tenets of fat activism; I tried to self-love my way through it. I didn’t contend with actually calling myself obese until that was named as one of the dangerous comorbidities associated with COVID-19. It bumped me up the vaccine list, but only once I admitted to myself, and then to a pharmacist, that I was fat. But grappling with my new reality only helped so much: There’s a mountain of shame that the medical industry, that pop culture, that random people on the street lob at fat people. And it felt insurmountable.
I found out about the shot most popularly known as Ozempic around September, along with the rest of the nonmedical, non-celebrity world. ‘Hollywood’s Secret New Weight Loss Drug, Revealed’ read a Variety headline; the piece explained that the injectable had ‘saturated the industry in recent months.’ Finger-pointing ensued. Chelsea Handler swears she didn’t know she was on it. Is Mindy Kaling? Kim Kardashian says she never took it. But did Oprah? What about Rebel Wilson? Adele? The world was suddenly one big party at which everyone responsible talked disapprovingly about ‘Ozempic face‘ in judgment and horror at the idea of women taking these new ‘diet drugs.’
Not long afterward, Instagram began showing me ads for Found, a telehealth company with the slogan ‘Weight Loss Medication Is Not Cheating. It’s Science!’ So I started there, with a pricey subscription. The physician assigned to me through the app suggested we start with Naltrexone. When that didn’t work, we tried Metformin. They both made me feel incredibly sick. When I asked about Ozempic, he said it was the ‘gold standard’ for anti-obesity medications when it came to long-term weight management. Unfortunately, he noted, I’d have to get on a more expensive subscription involving a waitlist—and the medication itself would cost me $1,000 a month.
It was my mom who somehow found ‘Cassandra.’ At our first appointment, she showed us pictures of herself at 70 pounds heavier, she talked about side effects, and she prescribed vials of semaglutide and the syringes for just $400 per month. I quit Found, and I got that first shot in December. My doctors and my parents were fully on board when I said I was taking Ozempic.
After that first shot, I felt vaguely nauseated, but it was much better than the other meds I’d tried. But after a few months, I was bumped up to a higher dose because I plateaued. That day, I wasn’t able to move without marijuana. Now I’m learning about my body’s limits from square one. If I eat too much or eat the wrong thing or have more than two glasses of wine, I may be sick. For one day, maybe even two. And not just nauseated, but the kind of sickness where you’re unable to get up from the toilet and have to throw up in your sink and then spend the whole day unclogging that sink. No turning over, no speaking. Forget about working.
And still, incredibly, I’m most preoccupied with the optics. The fact that it would be embarrassing to admit to my friends that I cared that my doctors think I’m fat enough to be on this miserable miracle medicine. I would never agree to write about this under my own name.
But now that I’m more than 25 pounds lighter, my physicians are happy. Cassandra, whom I visited on Tuesday in the back of that salon after getting my nails done—while sipping a ginger-and-CBD soda to curb the nausea—lit up when she saw me. ‘I’m so happy! Are you happy?’ she said, looking me up and down. ‘How do you feel inside?’ (Frankly, I was still trying to think of a good answer to that question several hours later.) When she thought I was already out of earshot, she turned to my mom: ‘I’m so impressed; she’s doing great.’ Even my psychiatrist mused last week that I ‘must feel great’; she said she was ‘jealous.’
I tried to tell Cassandra that my body looks the same to me but that my clothes look much bigger. She touched her neck and her face. In shock, she said, ‘Even here? You were so puffy.’ Pants, underwear, bras, and even rings fit differently. If I didn’t already have body dysmorphia before, I certainly do now. I was actually convinced this week that I’d gained back some of the weight, but when I got on the scale, I realized I’d lost 6 pounds. Now I need to regularly check in to make sure I’m not dropping too quickly. And still I don’t recognize myself in the mirror. I’m completely disconnected from my body. I’m running into things; I’m misjudging what fits and what doesn’t. And then, when I walk into a room, people say things like ‘Wow! Look at you!’ They speak to me as if I ran a marathon or wrote a book—only I haven’t done anything.
And there’s no endgame here. People who stop taking the drug sometimes gain all the weight—and more—back. I’m still on those meds for my chronic illness, and so my metabolism is still what it was in November. What happens when I reach my goal? Must I stay on it forever? Can I even afford that?
And I can’t stop asking myself: Am I vain for wanting to lose weight through a doctor-recommended method, even if that doctor is relying on dated or racist standards like the BMI? Am I supposed to know more than my doctors and my parents and my psychiatrist? Is my responsibility here to be more informed than medical experts and ethical enough to put diabetics’ health before my own and responsible enough not to spend money on this medicine I’ve been prescribed and well-adjusted enough to be unaffected by societal fatphobia and misogyny?
Even Cassandra said, on Tuesday, while discussing what dosage made sense in balancing my stomach sickness with semaglutide’s efficacy: ‘The best doctor is you.’ Of course, what she meant was that only I know how nauseated is too nauseated to function. But what I need right now is not a doctor at all. I need to be able to consider my own health, without shame. And I still don’t know how to do that.
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