Is Obesity a disease? Is being fat something people should be ashamed of? The answers to those questions may determine how you feel about GLP-1 weight-loss drugs. Medical experts argue that obesity is related to a host of heath problems, including hypertension, cancer, diabetes, fatty liver disease and even dementia. Yet, people in society are constantly told not to fat shame people. Doctors are hesitant to embarrass their patients who seek care in their offices for obesity-related conditions, but not the underlying cause. I have even read that the standard practice of weighing patients at the start of a physician visit is unnecessary, and large women are even advised they are free to refuse.
Pardon the pun but the elephant in the exam room during many physician visits is the unspoken fact that the patient’s health conditions are the result of obesity. Back when excess weight could only be shed through diet and exercise, nobody wanted to talk about obesity because it was an intractable problem. Now that there are GLP-1 drugs, people are descending on doctors’ offices clamoring for drugs to lose weight. The biggest compliant is how to get insurance to pay for drugs that benefit both aesthetics and health.
By all accounts, GLP-1 drugs work very well by decreasing appetite, food cravings and some report the lessening of other types of cravings. Patients report significant weight loss while injecting GLP-1 drugs. The Wall Street Journal reports not everyone is happy, however:
Weight-loss drugs have a surprising foe: fat activists
Doctors and many patients are embracing GLP-1 drugs as a vital solution to the growing problem of obesity. But some bristle at the thought that obesity is a problem at all.
In the world of fat activism, the “O-words”—overweight and obesity—are expressly verboten. That’s because advocates and “fat studies” scholars want to destigmatize and accommodate fatness—their preferred term—and push back against the view that overweight or obese people are somehow abnormal or diseased.
Millions of Americans want cheap access to Ozempic, Wegovy, Zepbound, Mounjaro and so on. Telemedicine clinics have sprung up largely based on a business model of producing (questionable) generic versions to sell cheaper online. Yet, fat activists claim GLP-1 drugs are causing even more pressure on people to lose weight. The argument follows that with the advent of weight-loss drugs, nobody must be fat. More from WSJ:
These concerns contrast sharply with the latest thinking in obesity medicine, which views reframing obesity as a disease—which the American Medical Association did in 2013—as a crucial step toward destigmatization.
Fat activists and scholars argue that a causal relationship between obesity and its associated maladies has yet to be definitively established, and that obesity itself is not a disease. In their view, it is inaccurate and unhelpful to stigmatize overweight people as inherently ill. Fat people, they point out, can be just as healthy as thin people, and diseases like hypertension can afflict anyone, regardless of weight.
Doctor claim they are not prescribing drugs for aesthetic purposes. Rather, they are treating serious health concerns.
Patients who lose weight with GLP-1s regularly see their health markers for prediabetes and hypertension improve. They often suffer less from sleep apnea, which allows them to feel better rested and elevates their mood. This can eliminate the need for antidepressants, which can themselves cause weight gain.
Health experts say weight-loss drugs represent a turning point in the treatment of obesity and the related medical problems. No longer do doctors have to advise patients in vain to lose weight when they can merely prescribe a drug that is highly effective. Many patients will take GLP-1 drugs for aesthetic reasons and enjoy the positive side effects. Other will take the drugs for serious health conditions and experience the positive aesthetic benefits as a bonus. It seems strange that activists working to change attitudes about fat also oppose drugs that can reduce weight.
GLP1 agonists are just another form of calorie restriction and suffer from all the same problems we’ve seen for centuries now. Fat people do not eat more or differently than thinner people. That this fact is not acknowledged means that the madness of forcing anorexia to the point of dangerous levels of malnutrition on fat people is somehow seen as health promoting. Look at all the articles that are somehow surprised that glp1 agonists are causing blindness and gallbladder disease and renal failure and malnutrition. Golly gee. And, when people stop funneling cash into big pharma to pay for all this garbage. They gain back all the weight “lost” within months, just like with any other form of calorie or macronutrient restriction. Same crap different day. And, watch the news, because any day now we’re going to see reports that fat people are gaining back more weight than they lost when they take these drugs. Because, like any other form of calorie or macronutrient restriction, they reset set point to a higher level. Disease when the drugs are inevitably discontinued after several years. All this garbage is is another excuse to force restriction on fat people to the point of unhealthy and even deadly levels. Fat acceptance is the only way to make fat people healthier. We are not thin people and never will be. We are not some broken form of humanity. In fact, fatness exists because under extreme deprivation we survive and reproduce preferentially. We are an evolutionary adaptation. We are not going anywhere. Stop trying to kill us for our own good and start thinking in terms of improving our health right now as we are.