How does Ozempic work? Trick question. Even scientists can’t agree whether the miracle weight loss drug works its magic through the gut or the brain. Despite its seismic impact on reducing obesity rates (reversing what had been an upward curve in the United States for the first time since 2011) and boosting Danish GDP (manufacturer Novo Nordisk is now the most valuable company in Europe), the drug remains quite poorly understood. As do weight loss drugs more generally, presently used by one in eight Americans and, soon, many in the UK too.
Two weeks ago, the Health Secretary announced the UK government would be spending £300m on weight loss drug trials with the US company Eli Lilly, to assess whether such medication could help the overweight and unemployed return to work. A plan which, at the outset, assumes people are unemployed because they are overweight and fails to target the cause of the obesity crisis, which costs the NHS £6.5bn a year as well as £8.9bn a year in lost productivity.
Sally Baker, a therapist and author of the 2017 book, Seven Simple Steps To Stop Emotional Eating, has been working with overweight patients throughout her career and says there is a very real possibility that the plan won’t just fail: it will backfire.
People are addicted to eating, she says, because of unresolved trauma that usually dates back to childhood. Like other common addictions – shopping, smoking, drinking – it is “an unconscious coping mechanism” which weight loss drugs that mimic the impression of satiety simply cannot address. Throughout her career, Baker has observed a disquieting pattern among emotional eaters: once they’ve kicked their addiction to food, they usually find another vice with which to allay their pain: a phenomenon known as "addiction switching".
Baker has observed a pattern among emotional eaters: once they’ve kicked their addiction to food, they usually find another vice with which to allay their pain
Caution should be shown there as well. Further studies of weight loss drugs have evinced additional benefits: namely, a reduction in addictive behaviours. There is evidence that by reducing appetite, the active ingredient in weight loss drugs (semaglutide, in Ozempic’s case) also reduces the habit for compulsive eating, which could reduce compulsive habits more generally. Other benefits of weight loss drugs include a reduction in sleep apnoea and kidney disease, a lower risk of developing cancer and possibly a slowdown of the ageing process.
In the case of Baker's patients, though, their newfound ability to lose weight does not translate to a shift in mindset: a necessary step for getting people back into work. Baker, who is a private consultant, tells me her patients are in work to begin with, but remain "overwhelmed, anxious and depressed, without recourse to healthy mechanisms" with which to address their problems. While Labour's policy is a commendable effort to target a crisis that affects nearly 26 percent of adults in the UK, and is likely to help those who are overweight as a result of a poor diet and ultra-processed foods, it won't shift the dial on the emotional complexities behind compulsive eating, which affect 50 percent of the overweight population, according to the National Centre for Eating Disorders.
Beware, then, of the lobbyists who tout the “economic and social benefits” of drugs that are still experimental. Indeed, where such benefits are concerned, how do other addictions stack up? Alcohol, a substance enjoyed by more than half the UK population with no sign of respite, costs the economy £5.06bn in lost productivity, according to a 2024 report by Alcohol Studies which also reported a £14.58bn burden on the criminal justice system. The statistics are harder to find for anorexia, but the condition is a major burden on the NHS, costing £9.4bn a year: more than obesity.
The link between weight loss and productivity is infinitely more complex than the current proposals care to acknowledge, and weight loss drugs are no panacea. The solution ought to be more than the subtraction of its parts.
Sally Baker’s new book, The Getting of Resilience from the Inside Out, is out now
