Johann Hari's book explores the risks of weight-loss drugs like Ozempic

Ozempic makes people eat less, but its impact on physical and psychological well-being is not well understood. Johann Hari's book explains the science behind it in an accessible way

Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

Author: Johann Hari

Publisher: Bloomsbury

Pages:336

Price: Rs 699

 

The health issues and social stigma associated with weight gain push obese people to try every possible solution that can help them shed unwanted kilograms. Unfortunately, many of them struggle to lose weight even with a balanced diet and plenty of exercise. This sense of failure is hard to cope with, especially in a culture that offers shame in place of support. In the face of such despair, prescription drugs seem to hold out a promise of hope.

 

“Some financial analysts believe that the market for them could be worth as much as $200 billion globally by 2030. …Ozempic and its successors look set to become one of the iconic and defining drugs of our time, on a par with the contraceptive pill and Prozac,” writes Johann Hari in his new book Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs. 

 

What makes the book worth reading is the author’s openness to diverse perspectives. He is not a medical expert, so the information that he makes available is based on conversations with scientists, published studies, and his own experience of injecting himself with Ozempic.

 

Numerous Indians who were unfamiliar with the drug learnt about it thanks to jewellery designer Maheep Kapoor on the Netflix show  Fabulous Lives vs Bollywood Wives. She called out people who use Ozempic to lose weight quickly, leading to a shortage of the drug for diabetics. Her remarks also led to speculation around filmmaker Karan Johar’s recent weight loss, who took to Instagram and stated, “Being healthy and eating well and reinventing the wheel of your nutrition! Aur Ozempic ko mile credit (And Ozempic gets the credit)?”

 

It is difficult to tell whether this is smart product placement or playful banter but, going by Ms Kapoor and Mr Johar’s popularity, there is a need to clear up the confusion about the product’s intended use. Mr Hari writes, “Novo Nordisk (a pharma company) now manufactures and markets two forms of semaglutide—Ozempic for diabetics, and Wegovy for obese people. They are the same drug, sold for different purposes, and Wegovy can be prescribed at higher doses.” That said, people do buy Ozempic, which is intended for diabetics, and use it for weight loss. This has led to a shortage, and the emergence of bootleg versions in the market.

 

Ozempic makes people eat less. The science behind how the medication works on the gut is explained in a friendly manner in this book, without too much technical jargon, while also cautioning readers that scientists are still in the process of understanding how the drug works on the brain and the mind. The author is neither overly jubilant nor excessively sceptical. He sticks to the facts, and is honest about information gaps that exist due to a lack of long-term studies with Ozempic users. He also reveals how Novo Nordisk responded to his queries.

 

While Mr Hari’s research is commendable, his personal story adds much value to the book. The decision to opt for Ozempic was not easy. It felt like “cheating” because it did not involve the discipline and rigour associated with following a diet or committing to an exercise routine. Yet it also felt like something worth a shot because getting rid of excess weight could help lower the likelihood of heart disease, arthritis, kidney problems, and dementia in later life. Six months after the author started taking Ozempic, he found that he woke up feeling not only fitter, more confident and better-looking but also listless and emotionally dulled. Most of his acquaintances taking weight-loss drugs (Ozempic and others) told him that “their pleasure in food had plummeted, or even vanished”. They ate only because they had to. Drug-induced weight loss made Mr Hari “physically healthier” but also “more psychologically vulnerable”.

 

He writes, “What, I wondered, will be the effect when millions of people are deprived of the psychological protections they get from overeating?” This is not an imaginary concern for the author. It is personal because he used to derive a lot of emotional comfort from food. It is also worth noting that “there are now more than 70 anti-obesity drugs in development”.

 

The book also looks at potential risks associated with the new weight-loss drugs. They can lead to loss of muscle mass, malnutrition, pancreatitis, and stomach paralysis. The Food and Drug Administration in the United States advises people with a history of thyroid cancer in their family to not use these drugs. The European Medicines Agency has issued a warning that taking Ozempic can increase thoughts of suicide and self-harm in some people.

 

The author reminds us that the current obesity crisis is closely linked to the processed food industry that pumps chemicals into our bodies to make us feel hungry and ask for more. The appeal of artificially manufactured flavours and tastes might seem difficult to resist but we can take heart from the fact that initiatives aimed at fighting obesity are coming up gradually to promote healthy food and make it available to people across socio-economic groups.

 

The reviewer is a Mumbai-based journalist and educator, reachable @chintanwriting on Instagram and X