When I was an adolescent, large of thigh and round of belly, I dreamed of a drug that would make me thin: a couple of pills a day, similar to aspirin, which would render me slender and gorgeous so that the girls I wanted to snog would stop thinking of me only as best friend material. Now I am an adult, large of thigh and round of belly, and it seems the very drug I dreamed of has arrived. It is a weekly injection called semaglutide and it promises immense results. The NHS has been given the go-ahead to prescribe it for weight loss or you can get it from private clinics. For a couple of hundred quid a month, you can jack yourself up on a drug which, by mimicking the hormone that makes you feel full, acts as a magnificent appetite suppressant. The excess weight falls away. My fantasy future is here.
It’s sold under the brand names Wegovy and Ozempic, which sound comfortingly like self-assembly bookshelves from Ikea, and they really do sound great. Until you get to the common side-effects: nausea, diarrhoea and in many cases a desperate sense of revulsion at the very thought of food. It’s as if the pharmaceutical companies’ new product development departments had taken their inspiration from an early episode of the ribald, gloriously filthy animated series Rick and Morty in which the devil sets up shop handing out enchanted items which come with curses. He gives lonely Mr Goldenfold an aftershave which makes him irresistible to women. Only it also makes him impotent. Well now, here’s the real-life version: yes, this drug will make you lose weight, arse over thigh, but it will also make you hate the thing you once most loved. As the devil says: ‘A price for everything, Mr Goldenfold. A price for everything.’
Semaglutide was originally developed as a treatment for type 2 diabetes, which can be debilitating and even a killer. Likewise, obesity can be life-threatening. Treatments for life-limiting conditions are to be applauded. We know there’s a lot of it about. What’s questionable is their adoption as a route to weight loss in general rather than the management of pathologies in particular. Or perhaps it’s just questionable for me. Bar a few curious episodes, which sometimes feel like personal betrayals, I have never been thin. Being a big man who loves his dinner is a profound part of me. As I’ve explained a number of times, I have made an accommodation with it, mitigating the worst effects by occasional bouts of low-carbing and a chronic gym habit. If I can’t be thin, I can at least be fit.
It’s not a perfect solution. But then with age you learn that there really is no perfect. And no, I do not need you to email me with your opinion on my body and my health and how I should change. We must all of us find a way to accept who we are.
The problem is that by threatening nausea and a revulsion at the very idea of food these drugs propose a new kind of side-effect which is the reverse of that: a different sense of self. That’s not a trade I’m willing to risk making. Yes, I would like a smaller belly. I would prefer it if my nipples weren’t in different time zones. But I also want to be recognisably me, a man with appetites who does what he can to manage them. Some might argue that Wegovy, Ozempic and the rest are the perfect solution to the obesity epidemic. They might even be right for you. But I know for certain that they are not right for me.
