In a society where body weight is often unfairly linked to personal character, a new class of pharmaceuticals is radically reshaping the conversation around obesity and health. Reuters journalist Aimee Donnellan's first book, Off the Scales, provides a compelling and nuanced exploration of this seismic shift, examining the discovery, use, and profound implications of drugs like Ozempic and Wegovy.
The Social Stigma and a Scientific Breakthrough
Donnellan firmly situates the rise of glucagon-like peptide-1 (GLP-1) receptor agonists within a culture rife with weight-based judgment. She references a contentious 2022 column by Matthew Parris in The Times that advocated for 'fat shaming' as a solution to obesity, highlighting how society has long treated excess weight as a moral failing rather than a medical condition. Against this backdrop, the arrival of effective weight-loss drugs feels nothing short of revolutionary.
The book opens with a poignant interview with 'Sarah', a 34-year-old marketing executive from Michigan. After losing five stone (32kg) on Ozempic over six months, she experienced a dramatic change in her professional life—suddenly included in key meetings, given more responsibility, and awarded a raise. Her story starkly illustrates a painful truth: in the eyes of many, her worth increased as her weight decreased.
Serendipity and Science: The Path to a 'Miracle Jab'
Donnellan recounts the fascinating, decades-long scientific journey behind these drugs with the flair of a thriller. A pivotal figure is Svetlana Mojsov, a Macedonian immigrant who began postgraduate chemistry at New York's Rockefeller University in 1972. At a time when obesity was dismissed as a simple lack of willpower, Mojsov's research focused on satiety and metabolism. Her work led to the engineering of a synthetic version of the natural hormone GLP-1.
Scientists at the Danish pharmaceutical giant Novo Nordisk later identified GLP-1 as a potential diabetes treatment. Their efforts culminated in semaglutide, a weekly injection that not only excelled at controlling blood sugar but also triggered unprecedented weight loss—up to 20% of body weight in trials. Novo Nordisk had inadvertently discovered a highly effective chemical treatment for obesity.
The drug's profile exploded when celebrities like Oprah Winfrey publicly credited it for her weight loss, calling it "relief... redemption... a gift." The commercial success has been staggering, boosting Novo Nordisk's market value to a figure now exceeding the entire GDP of Norway.
Not an Unalloyed Good: Complexities and Unanswered Questions
Commendably, Donnellan avoids presenting these drugs as a simple panacea. She details significant side-effects like severe nausea and addresses the ethical dilemma of non-obese people using them for cosmetic weight loss, potentially harming their health. She also notes a glaring scientific mystery: while GLP-1 receptors are present in the brain, researchers still do not fully understand why the drugs are so effective at curbing appetite and food obsession.
This unknown mechanism raises profound questions. If these drugs can quiet the 'incessant chatter' about food, could they be licensed in future to treat other addictions, like those to drugs, alcohol, or gambling? Off the Scales posits that Ozempic is more than a medical breakthrough; it is a rebuke to a century of stigma and a challenge to our very understanding of human desire and free will.
Aimee Donnellan's Off the Scales is published by 4th Estate, priced at £20.
