OPINION: It’s the new “togs, togs, undies”, only not nearly as amusing.
Irish obesity patients are complaining about being reduced to tears by lectures from their pharmacists, because of a new gradient in social acceptability: “fat, fat, diabetic”.
If you’re merely fat, or even terribly fat, but this hasn’t yet developed into diabetes, then you’re in the wrong place if you’re at the counter requesting the hormone-taming injectable drug semaglutide. Even though your doctor prescribed it, you should waddle away in shame for hogging diabetics’ drugs.
It’s a peculiar new moral battleground that holds fatties to be greedy and thoughtless, and diabetics martyred – even though they’re often on the same health spectrum, for the same reasons.
This developed-world moral panic is ostensible because semaglutide drugs are temporarily scarce, but there’s a heavy overlay of righteous judgment.
Ireland and other countries’ health authorities warn diabetics are missing out because of obesity patients internationally muscling in on their drug. Semaglutide – sold as Ozempic, among other brand names – helps regulate insulin and appetite, and has been found to be extraordinarily effective for weight loss.
Obviously, no diabetic should miss out on their meds. But resolving this ethical dilemma creates another: people whom the drug could spare from developing diabetes among other deadly conditions must be denied its benefits.
Ozempic is manufactured by Danish firm Novo Nordisk, which also makes Wegovy, a weight-loss semagutide product for obese people which is sold at a much higher price. Tik Tok users are blamed for fuelling the runaway consumer demand.
Pandemic, war, inflation and other logistical factors complicate the picture, but none quite so confrontingly as the ambivalence of some health professionals and non-obese folk to the possibility of a non-surgical treatment that takes the vice and virtue out of weight.
We’ve been here before. Surely, said many medicos and the Calvinists among us, if naughty, weak-willed people would simply amend their lifestyles, they wouldn’t need statins to regulate cholesterol levels. Likewise, Viagra unnecessarily “medicalised” impotence (with added snickering value). Sceptics positively crowed when past weight-loss drugs proved to be false dawns. It’s amazing how much gleeful malice can be packed into the phrase “oily anal leakage”.
Ah, lifestyle; such a perky little word. Pity that in this context it means people eating strict rations of tucker they don’t necessarily enjoy, forgoing any treat that makes them feel temporarily better.
Pity it also means exercise – for which they’re often ill-equipped – while also being warned, confusingly, that it probably won’t help them lose weight as such, but they should absolutely do it anyway or they’re not trying hard enough.
New treatments’ long-term effects are unknown. Semaglutide, like surgical gastric intervention, is not universally effective, side effect-free or cheap, and its benefits are readily reversible. But to overweight folk trying, mostly in vain, to counteract a lifestyle often inculcated since birth, nausea and loose skin may seem rather jollier side effects than hunger, shame, frustration and failure.
It’s true, as the Jeremiah Chorus warbles, that emotional issues are part of the picture. Happily, finally losing kilos and feeling in control around food are guaranteed mood boosters.
The semaglutide shortage will likely abate faster than governments can vanquish the rapacious moguls who produce addictive processed food, and very much faster than survival-brained humans can evolve from wanting to eat things just because they taste nice.
Not to be too silly about it, but what if semaglutide and subsequent refinements kick-start those virtuous lifestyle amendments, enable people to enjoy being more active and leave populations healthier overall?
Then we’d need a new anti-bile drug for all those disappointed Spartans. Dammit, Big Pharma always scores.
