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Image: Canva.

Editor’s note: This piece discusses medical weight loss and disordered eating.

Every time I go to the doctor she weighs me. I do not enjoy this.

I’m pretty sure she knows. Her voice takes on an uncharacteristically girlish, sing-song cadence as she suggests I ‘just pop up onto those scales’. As though they were a fun new carnival attraction.

On this occasion, she observed that I had gained a kilogram since my last visit.

‘Hmm, that’s not very good, is it?’ she said with a shake of her head.

I agreed that it was not good.

She told me my BMI was now in the top of the overweight range, pushing towards the category of obese, and that my cholesterol was creeping up. While I was still in the low-risk category for cardiovascular disease, my doctor made it clear that this was all a concerning trend. If I didn’t lose weight and lower my cholesterol in the next six months, I’d have to start taking statins.

‘They’re for life, you know. Once you start taking them you can never stop,’ she said with another sad look.

Every time I go to the doctor she weighs me.

While I knew that BMI was a debated, Anglocentric metric and that my lipid profile was not yet dangerously high, this encounter—the price of receiving my quarterly prescriptions for testosterone, hair loss medication and antidepressants—sent me into a familiar spiral of shame and self-loathing. A mood that stayed with me into the evening as I met up with a friend for a drink.

Our chat soon moved on to Ozempic and all the blockbuster weight loss injections that were all over the news. Produced by the Danish multinational pharmaceutical company Novo Nordisk, Ozempic works by mimicking a naturally occurring hormone called GLP-1 that suppresses appetite. Originally designed for lowering blood sugar in adults with Type 2 diabetes, it’s only approved by the Australian Therapeutic Goods Association for that purpose. But that doesn’t mean you can’t get it.

Despite not having diabetes, my friend, who was also deemed to be in an ‘unsafe’ weight range, had just been prescribed a similar drug ‘off-label’ via an online health platform. With brand names like Juniper, Mosh and Hub Health, these slickly designed direct-to-consumer telehealth clinics were suddenly all over Instagram. After answering a few questions and offering up her credit card details, she’d begun receiving a monthly supply via express post. I asked her how it was all going.

‘An hour after I injected it, I was so sick I vomited all over myself as I was driving,’ she said with a grimace. ‘I couldn’t even pull over because I was stuck in traffic and had to rush into Kmart to buy a new work shirt.’

 I asked how she was doing on it now.

‘Are you kidding? I’m not taking that shit anymore. It turns out I don’t hate my body enough to keep feeling that bad.’

She hadn’t managed to cancel her subscription, however, and was now approaching a six-month stockpile at the back of her fridge.

‘God, we could put these on Brighton Buy/Sell/Swap and make a killing,’ I joked, in reference to the news of a global shortage spurred on by celebrities and TikTok influencers.

After considering the possible criminal charges that could be brought for illegally dealing in prescription pharmaceuticals, we decided against it. But when I told her about my trip to the doctor, she offered me her supply.

Here, I’d like to say that I stopped to do a deep dive into the medical literature to really consider the health implications of her proposal. If I’d done so, I might have read about the risk of thyroid tumours, pancreatitis, kidney failure or a rapid loss of vision. Alternatively, I might have reconsidered my lifestyle choices and recommitted to vegetarianism, size acceptance or Couch to 5K.

But I didn’t.

I felt ashamed of my excess body weight and wanted to be rid of it. I guess I just figured, if everyone else was doing it, how harmful could it really be?

*

A few days later, after I’d got my hands on her stash, I stacked the small, white boxes in my fridge behind the alcohol-free beers I’d bought but so far hadn’t drunk (which sat beside the full-strength beers that I did). I was intimidated by the process, but once I had read the instructions on the packet and watched a YouTube demonstration, I found it relatively simple. I unboxed the thick blue pen, screwed on a tiny, disposable needle tip and turned the measuring cylinder to the starting dose. I then pressed the needle to my stomach and pushed the button.

I just figured, if everyone else was doing it, how harmful could it really be?

On the first day, I felt tired and nauseous. This continued for a few days, as I continued to feel lethargic. After a week, my appetite had evaporated almost entirely. The thought of food made me feel queasy. The pleasure I got from eating was gone. The flavours I usually craved, like vinegar, chilli or salt, were distasteful. Having no desire to eat, I started skipping breakfast altogether, with my first meal at lunchtime and only a snack for dinner. I hadn’t eaten in such a bird-like manner since my years as a teen with anorexia.

The drugs even seemed to rid me of my sense of thirst, and I only knocked back a glass of water when I noticed that my urine had yellowed. My bowels shut down for a while, perhaps in shock at their sudden lack of work, and I had to take Metamucil to keep things moving. But on the upside, I didn’t even have to think about restricting my meal portions anymore. Willpower had been replaced with pharmaceutical satiety.

Given that I’d drastically reduced my caloric intake, I was tired all the time. I didn’t feel like doing a lot of the physical activities I usually enjoyed, like bushwalking, using the cross trainer at the gym or exploring every crook and cranny of Melbourne’s ever-changing CBD. The most enjoyable part of my workdays had been to take myself out to one of the hundreds of cheap restaurants in Chinatown, near my office, but I stopped bothering with that, too.

I’d also been a lifelong drinker. Since I’d started working full-time in my early twenties, 5pm basically meant that it was time to crack out the wine. But on the weight-loss drugs, I didn’t especially want booze either. When I did have a drink at a bar with friends, I no longer had my usual urge to order a second, soon followed by a third. It was like someone offering me a glass of Midori, one of the few alcoholic drinks I’d never been interested in. Yes, I could drink it. But why on earth would I?

For me, this was an astounding and positive side effect. I’d battled with alcohol addiction and the ensuing hangovers since I was in my early teens. Nothing—not counselling, mindful-drinking apps or complete abstinence—had ever worked for long. Then, suddenly, with the flick of a weight-loss pen, my most unhealthy and troubling compulsion was gone.

The desire to be free from one’s cravings will be familiar to anyone who has been in the clutches of the diet industrial complex. Or as a teenager battling an eating disorder in Rebecca Burton’s Ravenous Girls succinctly put it, ‘I don’t want the things I want, you know?’

There was a momentary feeling of power in this state beyond desire. I’d finally gained control over my unruly body. This sense of mastery was a new form of intoxication.

But the drugs did more than just kill my appetite and thirst for wine.

Did I want to eat?

No.

Spend time with friends?

No

Go shopping?

Nah.

Catch a movie?

Can’t be fucked.

I felt a sense of nothingness, a blahness, a deep absence of want. While this was all good for my waistline and my bank balance, it was very bad for my mental health. While I’d been on antidepressants for a long time and felt deeply concerned about the state of the world, I’d always managed to find moments of humour and joy in life. Life without desire was just not very fun. I had lost some weight, but my humanity felt muted.

*

As the days got colder, my mood began to match the grey Melbourne winter. As I lay on the couch after cancelling my evening plans, I did some research to try to understand why I was feeling this way. There were some articles about possible links between drugs like Ozempic and suicidality. Fortunately, that wasn’t where I was at. Many people had found their depressive symptoms had intensified after taking the new wave of weight-loss drugs, while others reported a dramatic improvement in their mood. Some were also experiencing the same loss of verve and flattening of emotion that I was feeling.

While this was all good for my waistline and my bank balance, it was very bad for my mental health.

Johann Hari described a similar state of mind while taking Ozempic in his popular science book Magic Pill: ‘My mood was strangely muted. I didn’t feel as excited for the day ahead as I normally do. I felt a little listless.’ Hari goes on to explain that the clinical term for this is not depression but anhedonia. Derived from the Greek, the term translates to ‘without pleasure’. Coined in 1897 by French philosopher and psychologist Théodule-Armand Ribot, anhedonia is described as a loss of interest in usually desirable activities or a disconnect from emotions.

For the most part, it seems that scientists don’t know in full what these kinds of drugs do to the mind or the body. People with depression were excluded from the clinical trials. And it wasn’t just them. As Michael Hobbes outlined in the long-awaited Ozempic episode of the Maintenance Phase podcast, the trials also excluded people ‘with a lifetime history of a suicide attempt, any history of myocardial infarction, stroke, hospitalization, any kind of existing cardiovascular stuff, known or suspected abuse of alcohol or recreational drugs’, as well as anyone who is ‘pregnant, breastfeeding, intends to become pregnant or is of childbearing age, and not using a highly effective contraceptive method’. Given those parameters, I couldn’t think of a single person I knew who would qualify for an Ozempic clinical trial.

Images: Magic Pill (2024) and Maintenance Phase (2020–).

As I lay in bed in the mid-afternoon with tangled hair, growing body odour and little desire to change my situation, I became aware of what this all reminded me of. While I’d never been spiritual or even managed to meditate, I thought I knew at least a bit about Buddhism. Was I not a flame fast going out due to lack of fuel, released from all worldly want? By injecting these weight-loss drugs, could I be drawing ever closer to a pharmacological state of nirvana?

*

As winter finally came to an end, I caught up with my friend who’d given me the drugs. She told me that I seemed very down. I admitted as much. I told her I couldn’t stop thinking about an article I’d read about penguins dying in Antarctica and felt as far down in the dumps as I’d ever been.

During my time on the drugs, I’d been more like a sullen ghost trapped halfway between life and death.

She implored me to stop taking the weight-loss medication. Since I was fast running out of her supply and there was a global shortage anyway, I didn’t have much choice in the matter. But within a fortnight, I felt much happier. While I wasn’t exactly bouncing off the walls, my sense of impending doom had at least dissipated.

When I woke up in the morning, my mind returned to thoughts of coffee and breakfast. My body started telling me when I needed to drink water again, and my urine returned to a less alarming shade of yellow. I started making plans with friends to go out for dinner again and discuss the various menu options with interest and enthusiasm.

Within three months, I’d put all the kilos that I’d lost back on. It’s like they had never left. And I’m not alone. Despite media touting the drugs as a ‘cure for obesity’, their effectiveness and potential risks are still under review.

Looking back, during my time on the drugs, I’d been more like a sullen ghost trapped halfway between life and death than an enlightened, transcendental soul being released from all suffering. For me, for now, I’ve decided I’d prefer to be fatter and happier than thinner without desire.