Have you all been following the coverage of the diabetes drug Ozempic? Ozempic is the brand name of semaglutide, one of a series of drugs in the category GLP-1 receptor agonists. The drug, which mimics a hormone, works by suppressing the body’s production of glucagon. Since glucagon cues the body to raise its blood sugar, when it’s suppressed, insulin is better regulated and insulin resistance can be prevented. Ozempic sets off the cascade that signals the brain to tell the body it’s “full.”
The drug received approval for people with type 2 diabetes and/or obesity, to help them eat less and control their weight and blood sugar. Because Ozempic and other drugs, like Wegovy, that use the same chemical, not only produce the feeling of fullness, but also slow down the actual emptying of the stomach, people who take the drug report not only consuming less food, but also not suffering from cravings. Several people who have taken the drug have written in online forums that they feel like a “skinny person” because their brains can now tell them to stop eating. They say that something that was always broken is now fixed.
Here’s the thing I’ve been wondering about, though. For all the press this drug received over the last six months, all the excellent discussions of whether Ozempic is the death knell to the body positivity movement, and a restoration of white thinness as the beauty ideal associated with the rich, there’s a question I’ve yet to see someone raise: what happens to a person’s ability to access their emotions when they are taking a drug that suppresses their appetite?
That is, is there a link between loss of “appetite”—the literal hunger for food—and the loss of connection with desire itself, with feeling itself? One thing I know as a therapist is that our feelings exist on a spectrum and along a continuum of intensity. We cannot suppress grief and terror and still have access to joy and excitement. We cannot dull the level of intensity of one feeling and still have access to the high intensity of another. Most people who are moving from a state of numbness or dissociation to instead feeling their emotions in real time, for example, cannot access their joy without first feeling and processing their suppressed grief.
There’s a beautiful passage by Uruguayan journalist, writer and novelist Eduardo Galeano from his series called “Windows.” This one is called “Window on the Body”:
The church says: The body is a sin.
Science says: The body is a machine.
Advertising says: The body is a business.
The body says: I am a fiesta.
When science—the pharmaceutical companies Novo Nordisk and Eli Lilly & Company—sees the body as a machine, then Ozempic looks like a miracle. Suppress hormone A with chemical B; trick the brain into engendering the satiety response, and diabetes and obesity, heart disease and sleep apnea, cancer and liver disease all decline.
But the body isn’t a machine. It’s a feedback loop. We are the ones who impose the metaphor of machine onto the body, to help us tame and study it, specialize in its systems, tweak its engine, bang on its hood. In reality, any intervention we make into one aspect of being will impact other aspects, often in ways we cannot anticipate.
What happens when our dominant culture, which already encourages us to consume objects, people, drugs, and entertainment, in order to numb out and disconnect from that which terrifies us, is granted a drug so powerful that the numbing could be a kind of permanent state? What kind of capitalist productivity will be achieved by people who never need much to eat, and who can’t access the slowness, the pleasure, the rest that being truly full forces upon us, regardless of what our mind, or our boss, might demand of us?
What happens to our feelings of commonality and connection to others’ bodies, if our own body is unable to tell us what it wants and needs? Will Ozempic usher in a higher level of loneliness and numbness in its consumers? Or will they experience great happiness, looking at how beautiful they are in the mirror?
I’m writing this post to you, and to myself, as a reminder that the body’s hunger, its appetites, its beautiful and unruly nature is a kind of music, always playing, asking me, and us, not just to listen, but also to respond. I wonder what you do with your hungers and your terrors; if you’ve used the flat dullness of restriction to tame your moods, or if you’ve gloried in the music of your own embodiment and refused the siren song of transcendence that promises the ultimate escape from decay and death. I wonder if you know someone on Ozempic or if it’s coming up in your sessions when people talk about their bodies and desires. I wonder what you’re saying in return.
