Should I Delete That? - Ozempic: the truth behind the weight loss revolution

Episode Date: February 17, 2025

The body image landscape is changing in front of our eyes - and we have Ozempic to blame - or thank - for that. For the last few years - Ozempic has been the topic that has dominated the cultural conversation. Is it the silver bullet to help us with our body image or are pharmaceutical companies taking advantage of our collective desire to be thin? In this episode we speak to a doctor who is an expert on Ozempic, a psychologist and someone who has taken the drug to dig right to the core of this thorny, controversial topic.Is Ozempic a miracle or is it causing more damage than it’s worth? We don’t know where it’s going to end - but we know for certain that this isn’t the last we’ll hear of the drug.Thank you to our amazing guests who feature in this episode: Dr Giles Yeo, Daniel Cooper and Phillippa DiedrichsYou can buy Giles’ latest book Why Calories Don’t Count hereFollow @gilesyeo on Instagram Follow @phillippa.diedrichs on InstagramRead more about Phillippa’s work at https://www.phillippadiedrichs.com/ Follow Dan on BlueskyFollow @danielwcooper on InstagramYou can read Dan's article 'Wegovy helped me lose three stone in three months - and ruined my life' hereIf you would like to get in touch - you can email us on [e-mail] us on Instagram:@shouldideletethat@em_clarkson@alexlight_ldnShould I Delete That is produced by Faye LawrenceMusic: Dex RoyStudio Manager: Dex RoyTrailers: Sophie RichardsonVideo Editor: Celia GomezSocial Media Manager: Emma-Kirsty Fraser Hosted on Acast. See acast.com/privacy for more information.

Jimmy Kimmel opened the 95th Oscar's ceremony by looking out at the A-list crowd and asking, I can't help but wonder, is OZMPIC right for me? Referring to the new injectable promising rapid weight loss with minimal effort. It was a quip designed merely to elicit a laugh from the audience, but it also perfectly captured the zeitgeist because it was March of 2023. And from Hollywood stars to tech moguls and TikTok influencers alike, O-Zem-Pic was the word on everyone's lips. Originally deemed Hollywood's worst-kept secret,

the drug had become a household name after the media jumped to declare OZem-Pic as a new and powerful weapon in the battle against the bulge and one of the most effective additions ever to the front line in the fight against obesity. But before we dissect how and why the drug skyrocketed into our collective consciousness, let's strip it back and find out what OZempic is exactly and how it works.

To help us out, we've called on geneticist an OZMPIC expert, Dr. Giles Yo. So OZMPIC is actually the brand name of a drug called Samaglutide. And OZempic is the version of the drug that's actually meant to treat type 2 diabetes. Okay. Now, it is a, what's the best way to call it? It is a modified, a weaponized gut hormone. So when we eat stuff and stuff flows through our guts, hormones are released. And the hormones do a number of different things. And one of these hormones is called GLP, 1, and it does two things. GLP 1, so it's a native natural hormone that comes from your gut.

So it does two things. It goes to your pancreas and enhances the secretion of insulin so that for every given gram of sugar that you eat, more insulin goes up. GLP1 signals to the pancreas for that. The second thing it does, because it's a gut hormone, and we know of over 20 gut hormones, and the vast majority of gut hormones make you feel full. And so it circulates to the blood, signals to the brain, the back of the brain in particular, making you feel full and letting you know how much and what you've just eaten.

So that's what the native hormone does. The magic power of semi-glutide is the fact that the drug companies have taken it and have put chemical decorations of it, so they stick around the blood for longer. Typically, it gets chopped up in two minutes. JLP1 goes up, it goes to, it's meant to be very volatile, so it gets chopped up very, very quickly. But now the decoration on this means that semi-glutide, Ozempic, the brand, is able to stick around the blood for more than a week,

which means that you can do once weekly injection. And so hence, OZempic is for treating type 2 diabetes because it enhances insulin secretion. Wigovi, which is the exactly the same drug, but slightly different dosing regime, is the obesity version of the drug because it sticks around for longer,

it makes you feel fuller, you feel full, you eat less, you eat less, you lose weight. So ultimately, that's what OZMPIC-slash-WIGOV is. Given that semi-glutide was only approved by the FDA for weight loss in mid-2021, and by the start of 2023, it was established enough to be referenced in the opening line of the Oscar ceremony, the biggest award ceremony in the world. It's safe to say that its rise has been rapid and meteoric. But this is, of course, merely indicative of our culture's frenzy desire

for weight loss. We are so desperate to shrink our bodies by whatever means possible that this was, let's be honest, inevitable and probably not that surprising. It was still mind-blowing, however, to uncover the following figures whilst researching this episode. Demand for semi-glutide has been so fervent that the market value of Novo Nordisk, the pharmaceutical company responsible for making the medication, increased from 257 billion in 2022 to nearly 600 billion in 2024. Their share price is more than quadrupled in the past five years and the company has invested billions into new plants worldwide to keep up with demand.

Our overriding desire for weight loss is undeniable, and whilst it's still early days, it's reported that GLP1 receptor agonists have all the makings of one of the most successful classes of drugs in history. But let's take a minute to explore the intricacies of Ozempic's rise to fame. Just how did it become such a blockbuster drug? While it was likely a perfect storm, comprising many different components all coming together at the right or wrong time, plus our aforementioned cultural preoccupation with thinness, I'd argue that we could at least partly look to celebrities here.

In a sharp pivot from the slim-thick era of the 2010s, a trend pioneered by the Kardashians who were known for their curves in all the right places, we started to see a cultural shift towards ultra-thinnness in the early 2020s, and the Kardashians noticeably slimmed down. Known for their undeniable influence on beauty standards, fans were frantic in their efforts to uncover the methods that the famous women used to lose weight, and speculation was rife, as it always is when a woman's body changes, we know the drill, that a brand new weight loss injection called OZempic was behind the transformation.

It felt like the rest of Hollywood followed suit, with ultra-thinness appearing to sweep an admittedly already ultra-thin Hollywood, and a new theme swiftly emerged on the red carpet of the early 2020s, weight loss. The Kardashians neither directly confirmed nor denied using the medications, and it feels like this was, and still is generally a shared decision among famous figures. This is unsurprising, really, given the fact that there is a huge demand on women particularly to be thin and stay thin without making much effort, particularly as we are so quick to shame any methods that are seen to be a quick fix or the easy way out like Ozmpic would be. Only a handful of celebrities have owned up to taking Ozmpic to shrink their bodies. Tech mogul Elon Musk was one of the first, responding to a tweet or an ex, whatever.

In 2022 about his new fit, ripped and healthy look, he revealed that his secret was, Sigh, fasting and Wagovi. American actress Kathy Bates revealed she lost 20 pounds using the drug and a fair few reality TV stars of the Real Housewives franchises have admitted to taking Ozempic. Real Housewives of New Jersey star, Dolores Katania, confirmed she was taking Manjaro for weight loss for the series' end of season show, telling Andy Cohen during an appearance of Watch What Happens Live that I wasn't going to come to the reunion looking any bigger than anyone else so I got on the bandwagon. I think the biggest star, however, to have been honest about taking OZMPIC is Oprah Winfrey. It's important to acknowledge here that this feels particularly

notable given how Oprah is a woman very famously and closely aligned with weight loss. Having been open about her weight fluctuations for decades, and you'll likely remember we talked about the infamous moment Oprah dragged a wagon full of animal fat across the stage in 1998 to represent how much weight she'd lost in the second episode of this series. Oprah partnered with weight Watchers in 2015. She joined the company's board of directors and acquired a 10% stake. In 2003, Oprah told People magazine that she had recently been taking a weight-lust medication after realizing that weight management does not rely solely on a person's willpower and self-control. The fact that there's a medically approved prescription for managing weight

and staying healthier in my lifetime feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for, she said, I'm absolutely done with the shaming from other people and particularly myself. I now use Ozempic as I feel I need it as a tool to manage not yo-yoing. Honestly, huge props to Oprah for her transparency on this. It's brave and it's vulnerable. It inevitably garnered criticism. And to be fair, this is definitely a muddy one, particularly on the point of personal

responsibility because for almost a decade she sold Weight Watchers, which is a dieting system essentially founded on self-control and willpower to vulnerable and often desperate people. But, and admittedly, we find ourselves saying this time and time again during the series, but it's an absolutely necessary caveat. She was also a victim of her own culture and environment. She only knew what she knew and people are allowed to change their lines. Oprah cut all ties with Weight Watchers officially in 2024. I actually think the muddiest part of all of that is the fact that she had her stake in Weight Watchers and she made the announcement that she was using a GLP1 drug at the time that they started, Weight Watchers started using

them as a tool for their customers. I think I'm 100% with you on the transparency thing and it's absolutely her prerogative to do with her body what she wants. But that for me feels a little messy. Agreed and I was struggling to work this out this timeline because shortly after she cut ties with Weight Watchers because initially I thought yes, it It was a marketing, it was just a marketing move. But I'm not, I'm not sure. It's muddy. It's definitely muddy.

It is muddy. It is muddy. And either way, there's money. Yeah, a lot of money. There's a lot of money. But other celebrity success stories with the ZemPEC are pretty hard to come by. And I find this particularly striking, given the drug's prevalence in Hollywood. And yes, of course, this is total speculation and all completely alleged.

But I strongly suspect that a huge amount of the people that have lost, weight in the public eye over the past four years are taking the drug. More common, however, is celebrities revealing their horror stories. During a June 2023 chat with Andy Cohen, Amy Schumer revealed she had tried those M-PIC about a year ago, but stopped shortly after due to its side effects. I was one of those people who felt sick. I couldn't even play with my son, she said. Despite noticing some weight loss, Amy said the side effects made it not worth continuing the

drug. Actor Stephen Frye shared that he tried Ozenpick on his doctor's recommendation, but it didn't go as planned. In the first week, I thought, this is amazing. I don't want to eat or drink any alcohol. This is going to be fantastic, you recalled. But then I started to feel ill, and it just got worse. I was throwing up four or five times a day, and I realized, I can't do this, so that was the end of it. Modolotti Moss, meanwhile, told how she was rushed to hospital and suffered a seizure after she took high doses of Ismpic. This is a warning to everyone, she said. Please, if you're thinking of taking it, do not take it.

It's so not worth it. We get into this a little bit later on, but the fact that she was on it in the first place, it's just coconuts. She's tiny. But let's dig into these side effects a little because complications are a huge area that can't be ignored when talking about Isambic.

One of the scientists who helped pioneer drugs like Ozempic Professor Jens Jules Hulse, even said himself that once you've been on this a year or two, life is so miserably boring that you can't stand it any longer and you have to go back to your old life. So is it that bad? We spoke to Giles about the side effects. So the most common side effects of this whole class of drugs, so it's not only a Zempic, okay? I just want to be clear. Have to do with the biology of the system. Okay. So what do gut hormones do? Remember, it's a gut hormones. So gut hormones, broadly speaking, regulate the speed at which food moves through your food to poop tube,

your gastrotestinal tract, okay? So clearly you need to make sure that food is shuffling through at the right rate so that you're digesting and removing the stuff that you need to do and then stuff comes out the other side. Okay, that's important. Equally, it's also important that you get rid of any toxins that are suddenly in you. So, number one side effect, feeling puky. and the reason is because

if you've got food poisoning and we've had food poisoning before you've got to eat in a bad prawn and suddenly you run to the loo explosively both directions the reason that happens is because your gut hormones suddenly spike including gLP 1 all right

and so this is the biology so it'll spike so you go there now imagine we know people who are slightly I know you're pregnant so this is a different scenario but there are people who are slightly puky than others just just feeling a little bit ill, probably because they're more sensitive to these gut hormones. So imagine if you're just slightly more sensitive, then you're taking a drug, so suddenly you feel a bit puky.

Side effect number one, okay? Side effect number two, because it has to do with the speed of food going through the tube, then the other side effect is either too fast or too slow. Okay, so diarrhea or constipation. That's side effect number two, and those are going to be the most common ones, they're not, most of the people who take the trials, finish the trials. So it can't be that bad, I guess it's the point. But it is relatively, it's rare but not, it's not super common, but it's not super rare either. And those are the two main side effects. So faster, too fast or too slow through the south side and feeling puky, those that are, those

are the side effects. people are being quite open about having the side effects but pushing through anyway and they deem the weight loss worth it why do you think that because it's weight because it's because it's weight because it's so difficult to I think it has to depend on how bad it makes you feel okay at some point like if you feel really sick you can't push through that no one can push through being really sick or most people can't because it's so deeply unpleasant doesn't. Okay. If, however, in fact, let me just, let me just change a different way of thinking about it. So imagine if you are the spectrum, okay, in which you're eating, and you're obviously

you can be hungry, you can be not so hungry, you can be comfortably full, you can be really full, you can be, oh my God, I feel like puking full, okay? And there's a full spectrum. A large part of that is the gut hormones. And so can you imagine where actually you are able to take it to the uncomfortably full section, which means that so that is a side effect, already uncomfortably full, and these drugs can sometimes make you feel uncomfortably full, and what then

happens is you end up backing off your food more, and then you actually end up losing more weight. So that kind of thing, I can imagine being pushed through. If, however, you take it and suddenly you explosively puky, there's no way you'll stick to it. It just won't happen.

I keep hearing sulphur burps. What are they? Sulfur burps. People on OZMPIC burping and it tastes and smells apparently like sulphur. Okay, from first, I have never heard of the term, but if we work on it from first principles, because it has to do with regulating the speed of stuff that's actually coming through, if your food is not moving through as quickly, then maybe you have food that's slightly more digested closer to the, you know, like when you puke, it doesn't smell nice, right?

And so you can imagine a situation, I've never heard of this before, but you can imagine a situation where therefore, if you got food that is inappropriately digested at the wrong part, how you can get weird smells that actually come through. There's another side effect. Have you heard of those Zempic babies? Babies. Or Zempic babies? No.

So what happens is when you are on an oral contraceptive, which many, you know, women are on, okay? It is absolutely crucial. The way that it works is that the drug, the hormone, is delivered to the right part of the gut at the right time, released at the right concentration so that it suppresses your reproductive system. If you suddenly change the rules of the game, where things moving too fast or too slow, suddenly you're just a little bit off. And so women who have been on contraceptive has suddenly got pregnant because their contraceptive

and are suddenly on OZempic so they're not being delivered. So now I think people are beginning to understand that actually if you have any sort of gastrointestinal issues in addition to being like being on these drugs then you should move away from oral contraceptives

and go into an injectable con. Because you solve that problem by injectable contraceptives because then you don't rely on the gut. But obviously the easiest way it took a contraceptive is orally, because then you don't have to inject yourself. So, was that big babies? That seems like a big side effect. We also spoke to journalist Daniel Cooper, who described his experience with taking the medication.

I was interested to read your article in the independent, and I'm just going to read the headline. Wagovi helped me lose three stone in three months and ruin my life. It was all about the mental side effects that you had as a result of taking the medication. So I wanted to talk to you about that. But firstly, can you tell us why you started taking OZMPIC and how you managed to get it? I've always been overweight. I mean, my, and I say this without, not as criticism, but my mum is someone who shows her love through food.

Food is the thing that you do, you have, you consume in order to kind of make yourself feel better. And when you learn that lesson from a very young age, it then becomes very difficult to one learn it. And I was, so I was put on a diet by a health visitor in the reception year of primary school. I sort of joke and say, I've been, I've sort of been on a diet pretty much since I was five years old. And as tongue-in-cheek as that sounds, it's also true. I was, I felt defeated because I had yo-yoed in terms of my weight many times. You can try and do the 5-2 diet, the Atkins, slim, fast, huell,

of this stuff and you sort of you go through them with the hope that one of them will be the thing that addresses the issue there is there is a moral judgment inherent with being overweight and I think as much as as it's important to to admit really that there is a lot of implicit judgment in people who are overweight and you you have these stories um where people you know they talk about it as a a moral failing. It's, oh, you just don't have any self-control. You don't. And there's less understanding about the sort of the psychological and biological effects of it all. And it weighs heavy on you. It weighs heavy on, it weighed very heavily on me. I went through pretty much my entire life saying, well, that's on hold until I lose the weight. I turned 40 in October,

and it felt to me like this was the, this was a sort of, come on down, this is preposterous now, you have to sort this. And I've seen all the stories about how this was a miracle drug and how, you know, people who had been sort of struggled with their weight for their entire lives were taking this and finding it sort of magical and transformative. Yeah, in January, I thought, well, it's now or never really. I would like to get to, I'd like to get to 40 having given this the best shot I can. And if it, if it, if it, requires medication, then so be it. Can you tell us about actually getting your hands on OZMPIC?

I'm guessing you did it privately? Yeah. Let's say that it was a reputable UK pharmacy chain. I didn't want to go with some sort of backstreet place. I definitely didn't want to go to sort of maybe, you know, you've seen the adverts for some of the online pharmacies where they sort of set up in the last couple of years. And I thought, well, I'm at a point.

and I'm a grown-up, I've got two small children, I'm not going to do anything reckless and dangerous. So when it was then, it was available, I think it's available now, but all the major pharmacy chains. You know, you go through the application process, and I did qualify for it, and it took about, probably took about two to three weeks

to sort of go through the administrative stage and then another couple of weeks after that to actually, because of supply shortages, for it to actually come through. So I think I was approved. I think it was approved for it probably the first week in February and then took my first dose on the 20th, I think. The way it goes with the dosages,

you start at 0.25 and you go up to, I want to say, 2.75. And the idea is that you go up like half a, half a mil, sorry, quarter of a meal every month for that process. The first week, no effect whatsoever. absolutely no effect and I thought oh okay maybe this is another maybe this this is another loss I was taking my doses on a Tuesday Tuesday night I'd sort of again you sort of read online and people say well don't take it in the daytime don't eat fatty food immediately beforehand injecting the thigh do it overnight so if you have an initial wave of symptoms you can

sleep through the nausea and everything else and to be slightly indelicate the night of that second dose, I woke up with a very urgent need to clear what was in my stomach at the time. But what was weird is that there was, you know, after, it was about an hour. It was a really miserable hour. The hour elapsed, and I suddenly felt euphoric and really well. And I went back to bed, and it was a slightly interrupted night of sleep, but, you know, it was, it was fundamentally a, you know, a night of sleep. And I woke up and it, it was like a switch had been flicked in my brain. And from then, I think I will say, I responded to it extraordinarily well. When you see, you know, on sort of on the internet, you see lots of people kind of comparing and talking about their experiences. Some respond really well. Some it takes them until they get to like the two, two, two, male dose before they start to really feel it, I responded so well that I basically lost any desire to eat from that moment. Wow. No amount of the pleasure of food was going to overcome at that point was going to overcome the kind of the disgust I was feeling about eating.

I was forcing myself to eat because fundamentally I knew I had to, you know, look after myself. And so I was there, you know, I would get sort of three or four mouthfuls of porridge in the morning and think, this is, this is horrible. I want to throw it straight back up. So from that perspective, it curved all that because it just made food, the kind of the act of eating so tremendously unpleasant. And in fact, I found that my diet weirdly got worse because it was the sort of, it was only really the treat food that could sort of get in. So I would be eating, let's say, for instance, you know, like a sort of double hamburger. I wouldn't eat like a full meal, but I would go and have three bites of one of those and then stop because I could just about manage that.

And then the other thing, when I was researching it, I was trying to sort of understand this when it sort of, when it all went wrong, I found, someone had posted this on Reddit and it said, and they said that they have a theory that we're going to be a Zenpik doesn't cause depression, it reveals it because all of the people, you know, some of the people who are kind of taking it and then finding that their mental health is deteriorating, it's because up until that point they've been self-medicating. And obviously now the thing that has been keeping them going, they are no longer able to consume. And so as a consequence,

all of the other kind of stuff in the back of their head starts sort of rearing up. On the initial dose, so I actually took the initial dose for another month because it was responding so well, it didn't seem like I would need to step up. And I should add,

just in case anyone's thinking, oh, well, that's why, that is a common thing to do. But effectively, I was finding myself getting itchy, and jumpy and just generally just a little bit paranoid things that didn't affect me, things that weren't related to me, it was suddenly making me testy and I was thinking it was a comment on me and it was making me anxious in a way I'm not, I'm sort of generally mentally healthy, I'm very fortunate to be generally mentally healthy and I say that just because it was, you know, it was different. It wasn't a state I had experience. I was jumpy and testy and irritable and

just paranoid. I was starting to become paranoid. Then what really, what really did for me was then when I, after two months, I stepped up to the point five. And when I stepped up to the point five, everything kind of went downhill because I went from being testy to being not just paranoid, but manic and I was, I mean, at the worst, so I was, I was, again, I don't, you know, I'm lucky that I'm not a cryer. I don't, you know, it's not, it's not, it's not, but it's not healthy to cry. It's just, that is not my kind of go-to, if you see what I mean. And so, yeah, I would start, I would start feeling teary and I would get these, um, fantasies in my head that were sort of veering close to beliefs.

You know, when you sort of, you sort of, you're at work, the kids are at school, everything is fine, but in your head you've got this idea on, oh, well, you know, my children might not survive a day and the house might be repossessed. I might be, you know, and you have these fantasies and they sort of, they build and they build and they build to the point where I was crying on the floor my office about how dreadfully I had failed my family and everything else because of all this stuff that was about to happen. There was no evidential basis for that. I was just kind of at my desk working and then all of a sudden, oh yeah, someone's going to come around and repossess the house

in a minute and me and my family are going to be thrown out on the street and then we'll probably you know, die from exposure in the night and, you know, and I will have failed them and then I'll die and it will all be, sorry, I should have really said before that this stuff that I'm saying is quite triggering. I apologize. No, no, no. There was a point where I was going to bed thinking it would be better if I didn't wake up. It's a thought that when you're, From the position of distance, you think, goodness gracious, that's a worrying thought. You need to address that. You need to talk to someone.

You need to get help. All of this. At that point, it felt entirely natural. And I'm extraordinary. My heart goes out to people who have conditions like this. Because having had it sort of artificially induced, you can now see really that it feels natural. It feels natural to the point where you get to this very low state. You get to become a danger to yourself and it feels natural.

Did you know that this was a side effect of the drug? How did you put two and two together to realize that this is direct result of the drug? It was a Saturday morning and I, you know, working up with the kids, we'd gone down. I think we'd gone for a walk just Saturday morning walk, get some sunshine. I wasn't feeling great. So I thought, oh, go get a walk in the sunshine. Let our wife have a lie in. We came back about an hour later, and she came down.

Something innocuous, something had triggered me. And she turned around, kind of looked at me, and that was enough for me to burst into tears. And I had one of these episodes sort of in front of her. And I don't think, because, you know, I think because I work from home. So there are big chunks of the day where, you know, I didn't have. I wasn't having, you know, contact with people who could see this happen in real time. She's a biochemist by trade.

So she immediately thought, something's wrong, went to the fridge because you have to keep it in the fridge. And it, you know, sat me down and went through the list of side effects to see whether this was related. and the thing that what prompted me to write the article was that in the US I would later learn when I researched this in the US it does say very clearly there is a there is a potential risk of mental health side effects in the UK version it does not and because because it didn't say that she very reasonably drew the conclusion that there was something something else wrong with me and said, you know, maybe it's time to speak to a therapist. Maybe it's time to kind of do the healthy stuff to sort of address what, whatever's causing this. But yeah, I was on it for another month and things were getting worse and worse and worse. And we'd sort of, it wasn't until, yeah, things got a lot worse.

She said, well, get your diary. there's got to be we've got to find out what the cause of this was because i've recorded all the i'm one of these nerds who kind of records all this stuff so i record in my bullet journal i had like um you know when each injection was where it was um what time it was and so i had all that and then we were looking at like WhatsApp chats and stuff where i was talking about something that had gone wrong at work and then sort of putting all this data together and then suddenly thinking well hang on, the times when you felt really slighted at work and when you felt really low seemed to be the Wednesday and the Thursday after you've taken each injection on the Tuesday.

I mean, thank God you came to that conclusion. What happened when you stopped taking it? The thing that really drove at home was it was, so we discovered this and it was early on a Sunday morning. I'd had an email two or three days prior from the online pharmacy saying it's time to renew because you basically, it's like a sort of online chat where you know, someone messages you and says, oh, you know, I'm a staff pharmacist. Do you want to, do you want another month? Do you want to go up and do you want to stay on where you are? But I hadn't responded because I wasn't

functioning. I wasn't. I mean, by that point, I wasn't doing anything. I was, you know, I was in bed. I was sort of moving around, but the, you know, the brain was not cooperating. It was the Sunday morning before the renewal, and I didn't want the, because I knew a credit card payment was going to come out. And I sent them a message, let's say, let's sort of seven or eight in the morning in a sort of brief moment of uncertainty and said, you know, I'm, I think I might need to pause. I think I've, I think I might have a problem, uh, with this relating to my mental health. And I'm just going to pause this if that's okay. I just need to. And it was, you know, the message wasn't anything particularly controversial or in depth and then probably half an hour later something

like that again you know um not again sunday you can never get sort of anyone to respond to you on sunday and i get this call and um it's so hi hi mr cooper i've just just um i've just uh just seen your email i'm i'm the sort of the on-call doctor and i was wondering whether we could have a chat and sort of we went through the there's like a i forget it was called it's like a gad one or something and it's like a depression questionnaire and you know it's like have you thought about have you thought about um have you had sort of thoughts of self-harm and um you know are you finding it hard to to focus and be basically efficient and it was effectively like yep yep yep yep yeah and worse and worse and worse and she we got to the end of the form and she said stop stop now

When you look online, they say that the half of the kind of the 41 agonist is about 7 to 14 days. You still feel the, after you've stopped taking it, you should still feel the symptoms or the effect, sorry, for about one to two weeks afterwards. And in the short term, that meant that I was having these, because I knew what they were, but I was still having those sort of moments of mania. And so knowing what they were and, you know, tried all the things to tackle them, you know, I bought a load of Harabo bags and I would, I'd feel one coming on because it was a weird physical sensation of just my body went all, like, like, all of my muscles tightened and I felt like I was in like ice water and I couldn't breathe. And so I would take myself off with like a big bag of starmix and hug a pillow and eat starmic. just to see whether it was kind of low blood sugar that was bringing it on. But fundamentally, I just had to ride them out. But I had to ride them out not for sort of two weeks.

Probably, I mean, I stopped taking it at the start of May. And I don't think I was completely out of it until maybe July. The potential side effects honestly sound horrendous. And M, many of them sound similar to what you're experiencing with HG. which just feels quite horrifying that we're willingly choosing to put ourselves through this. But again, this is telling of where we're at with our relationship with food and our bodies. The term desperate times call for desperate measures really feels apt here. Short term side effects aside, what about the longer term complications?

As a relatively new drug, how much do we know about the potential consequences. Is the research there yet, or will we simply not know until further down the line about the long-term effects on the body? The class of drugs, so in other words, these weaponised modified gut hormones, because they've been in use for a good 20 years already, it is likely to be relatively safe, okay? Side effects, notwithstanding what we're talking about. The big difference is these are once weekly, and they've really only been released a few

years. So kinetically, which means that how the drug, the concentration of the drug behaves in your bloodstream does change. And so it is true that we do need to make sure we have a good look within the field that people who are looking at the safety of the drugs, we do need to make sure that in the longer term they're safe. I mean, it is a big reason why initially the NHS have only approved OSEPIC to be prescribed for two years. Now, this is only a NHS. Clearly, privately is a different story. And that's because the trials have only been for two years. And we know that it's safe for two years. So as more and more people are on the drug and we get a better idea, we will have a better idea about the long-term safety profile of these specific type

of once-weekly injections. But the class of drugs do appear to be safe because they've been in use for 20 years. Okay. So the answer is we don't know. We don't. We don't know. We can kind of It's likely, but we, no, no, we don't know. So we do need to know. And that is another big reason why it should still stay on prescription. There's been reports that 18 deaths have now been linked to taking in the UK have now been linked to taking these injections. And we hear about potential side effects like gastroporesis, pancreatitis.

I've even heard that it can increase your likelihood. to get a bezor. You know, when you have a ball of undigested feelings stuck in your tummy, what about all of these? You know, we've got the feeling sick and having diarrhea, but what about these more serious potential consequences? So there are going to be more serious potential side effects, but are just incredibly rare.

And by definition, they're rare because, so the reason why we're seeing them now is because I don't know of millions yet, but certainly tens of millions will be on this drug pretty damn soon, okay? which means that the rare side effects will suddenly begin to rear its head. Now, how much of it is because they're slightly, for lack of a better term, allergic to the drug, that's not, that's going to be just, I'm putting it in quotes because I don't think it's that kind of allergy. But you are going to have people who respond very badly to something,

but that's going to be true to a lot for a lot of stuff as well. I think you need, and the drug companies have their eyes, beady eyes open, and trust me, like, I mean, there are rarest side effects that have appeared both positive and negative. I mean, there are, for example, let's go with a negative first. There's getting hints of rare cases of people with a little bit of suicidal ideation, which is obviously not a good thing, okay, for that, very rare. But I think this is related as well, okay, where people have found that actually if you want

to quit smoking or quit drinking or quit drugs, being on Ozempic or equivalent makes it easier to stop. They're not trialling for this. Why? I don't know the answer why, but I can imagine. So now opinion, I'm just giving you an opinion about why rather than what I know. Okay. For many people, for most people, eating feels nice. Okay? That's like sex feels nice. Eating feels nice. Okay. There are things which tickle the part of your bread. Oh, delicious chocolate. But imagine if you suddenly take away the edge of that pleasure because you make yourself feel fuller. Because this is what these drugs do they make you feel fuller and you know that the moment you feel full

you enjoy the food less by its very definition it's when you're really hungry that the food is really delicious so if you suddenly make yourself feel fuller all the time chronically because you're in the drug you no longer have that acute for lack of a better term high now I know people who are slightly more depressive than others I am I am a perennial optimist so it's not me

But there are going to be people who are slightly depressive. Imagine if someone is a little bit on a spectrum of being slightly depressive and you take a bit of the edge of, okay? Then you can figure maybe that tilts someone into that area a bit quicker. On the other side, if you've taken away that little bit of a joy, then maybe you don't get the same joy from smoking. Maybe you don't get the same joy from having a, you know, drinking alcohol and you need to stop. And so it's, it's an interesting time. The more and more millions of people go on it will be able to unpick this. It's now being trialled for treatment of Alzheimer's.

How to freaking hell does that work? Okay. But it looks very good. The trial data looks very, very good. It's being trialed for any number of different things. So I think they're going to be, and these are all side effects, quote, and quote. Like the weight loss was a side effect originally. These are all side effects.

Some are going to be positive. Some are going to be negative. and we really need to parse this. We need to really have a good, close look and understand how this all works. But yes, they're going to be positives and negatives to this whole story. But you don't necessarily foresee it as a,

I mean, and I guess all you can give is your opinion on this, but you remember like that diet drug, fen, fenn. That's very different. That was very different. So that one was a situation where the side effects were because the drug were not reaching, were reaching other places that it wasn't meant to be reaching. Okay, because fen-fen is a small molecule drug that targets other receptors.

So in other words, this is a modified version of a normal hormone. And what happens is the normal hormone, it just keeps in around your blood for longer. The normal hormone self-homes to the receptor. It automatically goes to the normal place it's supposed to go to. It just sticks around the blood for longer. So it's not going to be that kind of Fen-Fenn-Fen scenarios because it's a different type of drug. You don't see it being taken off the market. All of a sudden because of...

No, no, no. Do I... Will I say never? No, I won't say never, right? So I do think we need to watch. Things have been removed for... Under less weird situations, right? I don't think so from first principles

because of trying to understand how the system, how the system works. It's not impossible, of course, depending on the situation. But no, I don't foresee it happening based on first principles. Speaking of long term, something we haven't yet discussed is the efficacy of the drug for a sustained amount.

amount of time. We know that in the short term it can provide rapid weight loss, but how does that weight loss hold up in the following months or even years? Do patients have to take a Zempic forever? We ask Giles. You've said that a Zempic or its counterparts are good for some people. They are objectively a good thing for some people. Many people. For many people. With that in mind, do you envisage their treatment, them using this as a treatment as something that they will need to do for the rest of their lives? Is that kind of the expectation of professionals in this space when it comes to these drugs? I think it is the expectation that the majority of people that start these drugs will be on it for a pretty long time. Can I ask about what happens if the drug

is successful, if we're speaking in very binary term for the BMI here, if you have a BMI of let's say 40 and you take it because you are obese, you need to lose weight, you then get into the healthy range over a long time and you end up with a BMI of like, I don't know, 24. You're in a healthy range. You would no longer meet the criteria for being allowed OZMPIC on the NHS. What happens then?

At the moment, the drug's taken off and you gained a way back. That seems terrible. Sorry. No, no, no, no. But you're right, it is, right? Because you're absolutely right, but that's because we're trying to get our head around how we treat this. So just as an example, let's take something which many of us does, it's not that foreign to many of us because we know people on it or maybe you are on it. High blood pressure medication.

I know lots of people on high blood pressure medication. And the moment you start on high blood pressure medication, you have to stay on it. Because the moment you stop it, your blood pressure is no longer normal. By its very definition, that's how it works. but high blood pressure doesn't accumulate, right? Your blood pressure doesn't increase to pop and it doesn't decrease to you die, okay? It stays at the rate that it's supposed to stay.

Body weight is very different because you can have a little bit more and you start gaining weight because it accumulates on you. If you have a little bit less than what you need, then you start losing weight. That's how it works, right? So it is going to be a balance, okay, of when you either ratchet down

the dose, because you remember, these drugs do not come as one dose. Most of them come in three or four different doses in which you go up. And for some people, they'll never reach the maximum dose. They'll just hover around the middle or maybe the stay in the lowest dose. So there is room, there is room for maneuver. But if you are going to be losing too much weight, then you're going to be pulled off the drug. You are. You're going to be pulled off the drug. And then you can start and stop. I mean, it's bad and it's good. It's bad in a sense where, well, I don't want to gain all the wait back again. But it's good in a sense where you just stop because there's no permanent effect. We also need to consider the cost of OZMPIC. Philippa Diedrix, who we spoke to earlier in

this series, made a really good point about the finances. It's a lifetime drug. So it's not something that you can just use for a year or two. You have to use it for the rest of your life if you want to maintain those effects. And the providers and the experts tell you that and the people who created it. It's a lifetime drug. So you're signing up to that and there's research showing if you stop using it, you're likely to regain at least two thirds of the weight that you lost. And also any of the potential health benefits to cardiovascular health. So we need a lot more research looking at the long term effects. We know that when people stop, they regain. It's also incredibly expensive so prices vary but you know you're spending at least 250 pounds a month in some

cases in the US it costs around on average $1,300 a month so you multiply that across you know the year and how much that costs then across the lifespan how much you're spending on this drug we also know it has side effects so 20% of people experience nausea around 10% experience vomiting and diarrhea and what happens when you stop if you can no longer afford it or perhaps there's a surge in demand and it's not readily available or, you know, eventually if more research comes out about the side effects, what happens then? Tressie McMillan Cottom, who's an amazing scholar and writer that I would recommend everyone check out. She's written a lot about a ZemPEC and she basically summarised, she referred to a Zemphic, but you could apply it to the weight loss injectables

in general, Uzampic can't fix what our culture has broken. And it speaks to this issue that it will suppress your appetite, but it doesn't deal with any of the psychological, social, or emotional factors associated with eating and weight. But something we hadn't considered was the perspective that Giles offered on this. These drugs have a limited patent life. Okay. So semaglutide, Uzampic slash Vigovie, comes off patent in 2032.

What does that mean? While on patent, only the company who make the drug can make the drug while it's on patent. And therefore, they can charge what they want. Okay? They have to be in competition with somewhere else. And so market forces take a play. The moment it comes off patent, it means that anyone can make it. So paracetamol.

Why is paracetamol dirt cheap? It's dirt cheap because it's not on patent. And so anybody can make paracetamol. And that's why I can go to boots and spend a pound 25 and get my paracetamol. that's not going to cost that little. It's a slightly different drug. But the moment it comes of patent, then any drug manufacturer that understands the recipe of how to actually make it, can make it. And the moment that happens, then the cost of that specific drug will plummet. It will plummet. And now, the rich people are always going to want the shinier new one. I want the ones

monthly injection. I want the ones that give me 30% weight loss. But semi-glutide, the one we're talking about today, Ozambic, will go off patent in seven years? 2025, 24. Yeah, it'll be seven years soon. Seven years. There's not that long away. I don't know how much were the price plummet. Tenfold. The moment it goes, because the moment it goes generic, it means that anybody who is, you have to fulfill specific criteria can make it. The cost implications for this won't be that way, at least for the majority of people. For some people, they'll never be able to afford it because. But the cost implications are a time-limited issue.

Okay. For now, though, it comes in at approximately 2,760 pounds a year, this is at the time of recording, which is approximately £230 a month. So it is currently a huge financial commitment. And I think here, you know, we are talking about people that are taking it privately, people who are taking it solely for weight loss purposes,

who aren't being prescribed on the NHS. We know it's a different situation in America where you pay for your own drugs anyway, but, you know, speaking to Giles, it's kind of unprecedented how many people are paying for this drug here. It's quite unlike anything else. And it's something I think that is not read in this more print. People aren't considering it.

But they are going to have to keep coming up with this money every single month. And it's a really big toll. Now look, we are leaning heavily into the cons of the drugs here. And all are absolutely necessary to discuss. But we want to be as well-rounded as possible in our investigation of the EZempic phenomenon. So it's really important to acknowledge that this drug has been, at least to this point, hugely beneficial for some. And if we're going to share the bad, then we have to spotlight the good, too. The pros are the fact that they work.

Okay. They're super effective. And broadly speaking, they're actually safe, okay? If given to the right people. The downsides, is they're super effective, you know, because it'll work, even if you don't need it. That's the downside. There are going to be the side effects. but the side effects rarely, if any, kill you.

So I think the side effects are unpleasant, but I don't think are dangerous, okay? Which is a very, very different thing. So that's the pro. The pros is they work and they're going to save a lot of people. The cons, interestingly, is they're so powerful they work for anybody, including for the people that don't need it. That would be the pros and don't be the cons.

And another con is they don't prevent obesity to begin with and we still do need to tackle that problem. we were also keen to find out if there are any positive Saddam's experience of taking the drug do you do you have you heard of the concept of food noise oh god yes yes so um you know you have people talking about oh just stop eating just just eat when you're full and stop have self-control that you remember when um what's her name

gained all that weight and then lost it afterwards to to prove that everyone who was struggling with their weight was just making it up Katie Hopkins, yeah. And fundamentally, I suddenly knew what self-control was. I suddenly, after all that time, and I had no food noise, and I had my breakfast, and I got about a third of the way into my bowl of porridge and stopped because I was full. I thought, oh, I'm full. I do not need to eat anymore.

This is interesting. And it was, it was a revelation, and it did. I mean, I was never someone who subscribed to this. theory that, you know, it is a moral failing and it is a lack of self-control. But being able to see that, you know, when you have, when you are medicated and all of a sudden it changes, it really kind of drives home the fact that there is such a biological component to this. You know, it is not a simple, you know, just having force of will, you know. This is something that I'm just, I'm really interested in because, like, I have food noise as well.

I mean, similar to you, I've been on a diet since I was like a baby. And I think for those of us that have and that have yo-yo diet, chronic dieters, I think we're really susceptible to food noise because we're so used to restriction and just constantly having to think about food, just constantly. So you do end up with this food noise. And that's, I think, one of the things that interests me so much about Ozempic and why I can see the allure of Ozzympic because to banish food noise from my head would be incredible.

So this is the side of it that I'm really interested in, but what happens when you stop taking the drug? Because of course the food noise comes straight back, right? I would say the food noise came back, but it wasn't as loud. But then probably I would say that given the kind of the bad place I was in at the time, I was probably spending a lot of kind of mental energy just trying to focus on functioning at that point. But now, for instance, the food noise is back as loud as ever

and it's still hard to not want to give into that and to fall back into the old habits. But also I'm trying to, on one hand, be very kind to myself but on the other not backslide because I feel like after going through all of this and losing three stone in three months, I don't really want to have to get it all back on and sort of feel like it was for nothing. I think the food noise aspect is something that can't be ignored when it comes to the conversation around OZEMPIC.

Now, what is food noise? Food noise is the constant internal chatter around food. What to eat, when to eat, when's my next meal? I'm already hungry. Or am I? Intuitive eating, Al, are you actually hungry? Should I eat a cookie? Do I want a cookie? That cookie tasted really good. Wait, but now I want another one. Or do I? Do I need another one? I'm going to have chocolate after. dinner or maybe we should just have yogurt and on it goes this is a very small snippet of the non-stop dialogue that dominates the thoughts of so many of us me included I actually believe that many of us who grew up yo-yo dieting and went through years of regular food deprivation

have been left with food noise as a result I think this is really interesting because actually I was quite surprised to hear you say that I didn't know that that was the noise why would I but I didn't know that that was the noise inside your head like if I ever eat a cookie with you I just think, oh, look, we're eating cookies. Like, I don't, but it was only in the conversation with Giles that this came up for me because I realized I don't think I have food noise. And I think it's therefore made it quite difficult for me to understand the appeal of it. Not understand the appeal.

I understand the appeal of Ozympic and I understand why people are doing it. And I understand that I don't need to understand, if you know what I mean. For me personally, when people have talked about this food noise, I haven't really understood it. and the idea of it being turned down and I think I've realised having these conversations with you guys that I just don't have that noise which is interesting. It's so interesting.

I guess I do think that's quite, I do, that does strike me as odd considering that you have had like a check-in-past with dieting and food. I'm surprised that you haven't ended up with any kind of food noise but fuck that's so good. I know, I think going back we talked about this in the wellness episode I think for me because of the amount the kind of shift I have an exercise, food really became fuel for me at a point, I guess,

and maybe that's where the shift happened. I'm not sure. But I don't, yeah, I don't, I think, I think, think about it when it's happening. But not at the times in between. And I mean, maybe if I'm like going for a long run, I'll be like, oh, I need to eat loads today. But it's always in that way, not the other way. Really?

Yeah, which is interesting. But then again, like, I mean, I know I literally sound like I'm being sponsored by marathons, but I can't tell you how, like, they changed my life. They changed my relationship with my body with food with all of it, so. Oh, I love that. I don't know where, but it's interesting. It's just, it's like... It is so interesting.

And I imagine a lot of people listening will be able to resonate with this about food noise. Yeah. I have to admit that it's like a little bit, it feels a little bit embarrassing to admit. I don't think, well, I mean, I understand I feel like that, but you shouldn't be. Yeah, I know, I know, I know. And I know it will be the case for so many of us because we have all got such, like, fucked up relationships and pasts with food and it's normal it's like it's a like the wires in the brain have just been like rewired wrongly but it's it's it's loud it can be

deafening and food noise like is for a lot of us ubiquitous and this makes me understand the allure of ozempic so very deeply to live life without the constant burden of it is incredibly appealing but is it just a quick fix I suspect that weight loss injections would merely put a plaster over deeper, psychological issues with food and eating that probably come back as soon as it's no longer prescribed and perhaps they come back even stronger. Let's hear from Giles.

The consequences of being overweight, of being obese, of yo-yo dieting, of the weight going up and down, of fluctuations, we know that that causes an effect on self-esteem, self-worth, on mental health in general. Is that not quite a risky thing that we're doing with people? So I think it's a cost-benefit analysis. I do think that the drug should come with full wraparound care, which means that you shouldn't just get the drug to someone,

which is back to my point. It should be prescribed. But it should be prescribed, not in isolation, but come with a whole suite of other things, including dietary improvements, including proper exercise to maintain muscle mass. And from a purely scientific perspective, your risk from being too heavy,

from carrying too much fat there's an area under the curve which means that the more you spend at that too much fat range the longer the problems you have with your health and the more time you can spend at close to healthy range the longer you add you add time at the end of your life

health span at the end of your life okay so ultimately actually it's probably it's better to have been on the drug even if it's only for a few years than never to be on to have been on the drug at all from a purely, from a purely scientific perspective. Your mental health point is very well taken. And I do think that that's why it does need to be,

your doctor needs to understand and says, okay, well, look, you're losing too much weight or you're in a healthy range. Why don't we either take down the dose or why don't we stop for six months? And let's see what happens. Okay? If you feel you're getting too much weight,

please come back to us and then maybe we'll have to see something, do something about it, maybe restart it again. And I think that for some people, that is going to be the case, where when you reach the maintenance weight, what do you do?

Will there be some people who are able to shift to a purely behavioral approach? I think so, okay? I think so because it depends who you are, right? It depends how your new habits. You know how we're very habitual creatures. If we've been on the drug for two years and suddenly when I cook a meal,

you know, and we follow a recipe, but because I've been eating less, I have reduced all of the component parts of this dish, whatever the dish I'm making. And suddenly you get used to only cooking this amount of food. If you come off the drug, will you continue just, because you've now memorized the recipe for your chicken dish or something? You know, would you end up just cooking that smaller amount of meal? Some people probably will. I mean, we'll have to, we'll have to see.

So this is going to be very, very personalized. For some people, this is not going to be a problem. For other people, it is, because they're mental. health is going to come into play, then we'll have to treat it as such. It was really interesting to hear Philippa's perspective on this as well. Most people who are considering taking these drugs, a lot of them will probably be in larger bodies. And if you live in a larger body in today's society, you are likely to have experienced bias and prejudice at school in the workplace, at home, and in lots of different settings.

you're also likely to have tried dieting in the past because you've been encouraged to do so and that creates a really complex relationship with food and a complex relationship with your body so you have a drug that suppresses your appetite but it doesn't address your relationship with food or your relationship with your body so although it might feel alluring in the short term I think in the longer term it won't necessarily help all of those feelings will still be there. And also the amount of money that you're going to spend to access that, it's really hard to access therapy or other forms of treatment because of cost. But if you're accessing these drugs, unless it's prescribed through a doctor for other medical reasons,

but it won't be technically at the moment for weight loss, you could spend that money on healing your relationship with food in other ways and taking that noise away. It might be harder work in the short term or the medium term because it's hard. work to do that emotionally, but the benefits in the longer term, and they're going to be with you whether or not you can afford these drugs in future, whether you can tolerate the side effects or not. It's tricky. And also, we don't know the harms, the full harms of these drugs yet. And I think for people with eating disorders, that's why a lot of this conversation can be very triggering and can make you question yourself and all the hard work that you've done

to heal your relationship with eating and food. No, your answer is spot on. And I guess it's the thing that none of us want to hear is like there is no quick fix for any of this, not for weight loss, not for fixing your relationship with food. Like just the way that we've had a thousand diets come and go before a Zenpick, you know, this is not the silver bullet either. It can't, it can't be.

And I want to read this just quickly, this one quote, which was actually, I'm going to read it so that I don't paraphrase it. and this is one of the scientists who was involved in developing the active ingredient and a lot of these injectables. And they've been interviewed recently and said, once you've been on this semi-glutide, which is the active ingredient, for a year or two, life is so miserably boring that you can't stand it any longer and you have to go back to your old life.

This is someone who was involved in creating the active ingredient, which these drugs were originally for diabetes as well, not just for weight loss. And I think what that quote, though, it sounds a bit flippant, but what it's really speaking to is the fact that doesn't address the emotional, social, psychological and sides of eating and weight, which is so complex. And if people are at the stage where they're willing to spend 250 pounds a month on something like this, chances are they've got quite a complex or nuanced history with eating, their relationship with their body,

the way in which their appearance and weight has influenced their self-worth and how others have treated them, chances are if you're considering doing that, there's a story there and that story is ignored if you just access these drugs and it gets prescribed to you really easily. You have very little ongoing psychological support or treatment with them. It's hard for us to stay impartial, especially when our views on body acceptance and diet culture are very public and clear and we are so aware that this is an incredibly emotive subject. The moment the word ozempic is even mentioned on my Instagram account, I get hundreds of messages, some defensive, some angry, some sad, some confused, and I understand

the emotions behind all of them. This is a really loaded topic because, as we know, the stakes are high when it comes to body size, especially for women. And for so many of us, body size is something we've battled relentlessly to change for all of our lives, yet we find ourselves constantly falling short of reaching this elusive goal of thinness. OZempit comes along and gives us hope, real, tangible hope that this is, at last, the silver bullet. Then hearing people crush that hope by slamming the drug or passing negative opinions on it can therefore be totally devastating. But we can't ignore the very real issues with the drug and all of the GLP1 counterparts. Its side effects can be brutal. We don't really know the long-term effects.

It's expensive. And it's hard to imagine that it won't get into the wrong hands. In fact, it is already absolutely in the wrong hands. And by that we mean vulnerable people, perhaps with eating disorders who want to use Ozempic to take away their appetite and lose weight are able to get it. And that shouldn't be the way. Giles explained to us why and how it's getting into the wrong hands and how actually unprecedented it is for that to be the case. This drug is going to save a lot of lives. Okay. These drugs, these drugs, these drugs, or the entire class are going to save our lives. They're going to really give people the necessary tools. I've been in this business for nearly 30 years. We have not ever had this many

tools in order to be able to reduce the burden of obesity in a long, long time. So we have to understand that. But that doesn't mean that we don't, that doesn't mean that we take off the guard rails. I think if we play a mind game, some fantasy mind game, will we ever get to, like, for example, for example, paracetamol. Okay. Now, we know that if we take too many paracetamols, you're going to take, right? Or you have to take no more than six and 24 hours, whatever rules are, and we all read the back.

And we know that if I take a whole, I can injure myself if I take a whole tub of it. But yet I can go to a, you know, a drugstore and actually get it. We give it to our kids, okay, as scalp hole or what have you. So we've got to the stage now that we're comfortable that there is this drug

where if I took the whole bottle, I would need to go get my stomach pumped. at the hospital, but yet I don't, and I can go to boots or whatever and take it. So will we ever get to that stage with this drug? Let's imagine that we can. Okay, I'm not saying we are, please. I'm not saying we are. If we get to that stage, is this a bad thing?

I think just as a middle game, right? I don't think it is if we get to that stage. I'm not saying we, I'm not saying we will. So back to your original question. I think we need to still consider it a drug. We need to really get a handle on this and try and make sure that it only gets to the right hands. That's what I think it should do.

And maybe it requires legislation. I don't know. Is it the company's job? Is it the government's job? It depends which country I guess you're in. But I think it's just make sure we stay just on the right side of the line when it comes to these drugs. Because otherwise, it could get out of hand.

We shouldn't shy away from calling it dangerous if people that don't need to get their hands on it. And at the moment, it's easy to do so. And so we do need to wake up. We, the entire field, do need to wake up and make sure that more safeguards are in place. I think the problem is the safeguard. Like people are scrambling for the safeguards. They didn't quite realize. Certainly in the UK, we never thought we have an NHS.

People, why would people pay for it? Wow. They're obviously underestimating the desire for actually having these drugs. So, nope, it is dangerous. the wrong people get their hand on it, undoubtedly, because they're so powerful. And so we need to make sure that they don't get in their hands on the wrong people. In the thick of my eating disorders, I would have stopped at nothing to get my hands on O-Zem-Pic. But you wouldn't have had to go that far out. You wouldn't have had to do that much to get it. You know, that's what we're seeing.

Right. I don't even think it would have been a huge effort, because from what I've heard, it's not hard to get your hands on these weight loss injections. When I came to do the research and what the official criteria for being prescribed OZM-PIC was, as I was typing, literally just typing criteria into Google, I hadn't even finished spelling the word criteria, before Google flashed up a suggestion criteria for OZMPIC, and it was the very first suggestion. Perhaps it's down to the algorithm knowing that I've been researching OZMPIC for weeks now, or it could very well be just a direct result of such a huge demand. At any rate, let's talk about the requirements. The official line is that you need a BMI of at least 30, which is the number on the scale at which overweight switches to

obese in the UK. Or you need to be at 27, which classes you as overweight, with a weight-related medical condition and have tried to lose weight through diet and exercise, but been unsuccessful. In the name of fulfilling our own role here as investigative journalists, we decided to try for ourselves and see just how easy or difficult it was to get our hands on OZMPIC. Spoiler alert. We're both on OZMPEC now. I'm kidding. I literally. Googled, OZNPIC, UK, and a ton of private GPs, private online GPs came up, and I just picked the first one. Now, look, so I had to fill in some basic information name, blah, blah, blah, do I have any like pre-existing conditions? But I just check no for all of them. A classic. Yeah,

just no, no, no. And then I was asked to submit a picture of my weight. So a picture of me on the scales showing the weight. I couldn't do that because, well, I actually don't off scales in my house, but I don't know if I would fit the criteria for being prescribed it. So I went on to TikTok and I just typed in, woman stepping on scales and I observed a ton of videos and I just screenshot a video of someone's weight from one where I knew the weight would be suffice to get Ozmpic. I submitted the photo and a day later I was prescribed ozempic.

Unbelievable. Yeah. And I mean, you could have just stood on the scale holding Betty or Tommy or Dave or... Oh, I didn't even think of that. I like your way too. Interestingly, I pursued my own means of getting the drug, which at nine months pregnant, I thought, would be hard. And I was wrong. I use a service called Ruby in London, which is like a deliveroo, basically, for beauty treatments.

And you can get your nails done, you can get your hair done. a blow-drys, fake tan, whatever. You can also now get Wagovi white-loss injections on there. So I went on, booked for someone to come in the afternoon, and that was that. Now, I cancelled it because I thought this is going to be a very, very expensive conversation

because hopefully they're going to meet me and go, oh, you're already pregnant, you can't have it. And I probably should have followed it through because I'm actually, I can't be sure. the fact that I can just book it I then looked at these other apps and it's on all of them I mean you can get Botox and stuff and this one's crazy now you can get anything but yeah but it was the easiest thing and to be honest I then spoke to a lot of my friends um people that I know got some numbers and I mean literally like got some numbers that I could just text and be like hey can you hook me out give me some not a question fuck not a question so scary terrifying and you know Giles said when we talk to him about how important it is that doctors need to have line of sides. They basically need to see the person before they're prescribing it.

I only have dopesick, the show with Michael Keaton and Will Poulter, which was an amazing TV show, if you've not seen it, all about the rise of oxycotton in America and how so many people were being prescribed this and then becoming totally addicted to it. And I don't know why I always assume that we're safe from that. sort of thing happening in the UK. But this is showing us that we're absolutely not. If you've got the money, you've got the means. Like, that's it. You can just, you can just buy it. And

I know, speaking to Giles and it's, okay, it's FDA approved. It's nice approved. It's approved, right? It's not like taking smack. I don't know. It's, it's not like people have gone totally insane taking this like, I don't know, some weird wacko thing that some randoms made that's never passed any regulation. Like, it's been, it's regulated, right, to an extent. However, we see the detrimental effect of opioid medication, for example, on a nation, on mental health, on, we see misuse of drugs all the time. It does seem staggering how accessible we have made something that is very easy to misuse. Right.

It's not like if you, like, sorry, to be candid and triggering and horrible, if you misuse most drugs, you'll probably just die or be very sick. Like if you misuse paracetamol, there's no fun in that. There's no good in that. It's just bad. If you misuse some drugs, you get high or erections or whatever. If you misuse this one, you get this very specific thing. And I think it's really frightening.

The Sunday Times did an article recently with the headline, you've got this in later. Sunday Times did a headline recently saying long-term effects of OZempic. Who cares? At least you'll be thin. And I feel like that sums up the appetite for this in such an extraordinary way. We spoke to Dr. Giles about how people are getting their hands on OZNPic. we are seeing people with less and less weight to lose being prescribed

ozempic they're taking it privately okay so the vast majority of of the so let's just in the in the UK rather than the United States which is the Wild West in terms of that but in the UK the nice rules the NHS have given some pretty clear rules for these drugs ozempic is not the only drug that's out there there are a number of other drugs that are out there as well but in this particular class of drugs you need to have a BMI body mass index above 35 or a body mass index above 30 with what they call a co-morbidity, which means that plus another illness. BMI 30 with diabetes or high blood pressure or high cholesterol or something, then you can

actually get it. So it's a very, very specific. However, people can get it privately, and I know a lot of people who do it. It's really quite amazing in a country with an NHS, the vast, the vast majority of people on these class of drugs in this country is on it privately. And what do you think about that? I think they are...

I think they're more or less scrupulous purveyors of these drugs. I'll give you an example. So I think the drug needs to be prescribed and I think you need line of sight, the physician, the doctor needs a line of sight to the individual before they get given. the drug. And the reason why is these drugs are incredibly powerful. And they're powerful in a sense where they will work whatever your starting weight. They'll work whether or not you are a 350-pound man

needing to lose X stone, or a 16-year-old girl weighing, you know, 50 pounds. Okay, so maybe not that light, but a 16-year-old girl. So you will feel full and you will eat less. So you, they're so powerful, you need to make sure the doctor sees you, looks at you, why do you need the drug and then give it to you, privately or not? And that's up to people to do. It is a powerful drug, it is an effective drug, but I think it should be treated as a drug, which means it needs to be prescribed to the people who need it to cure a disease rather than to lean up, rather than as a cosmetic tool. For this episode, we saw if we could try and get it, how easy it would be. Have you tried?

It's incredibly easy. I know. I'm nine months pregnant, and I could order it online. I know. It's nuts. I know. Yeah. So that feels a bit frightening.

The only criteria that I came up against was a picture of my weight on the scales. So I went on TikTok and I found a woman stepping on the scales, screenshotsed it, put that in. Shut up. I got approved. It's crazy. You can get it on these apps to your house. You can get it delivered to your house. Do you know, here's the point.

problem that I really have with this. Look, I study how the drug works in terms of in Cambridge. That's one of the things which I do. I study how the drug works. We map where signals to in the brain and things like that. So I understand how the drug works. It should, it's powerful. It should be used. It's going to help a lot of people. The problem is this kind of stuff. It's going to get someone killed. And if someone gets killed, there's suddenly a wonderful, and I'll use the word wonderful tool that can help a lot of people having a very tough time trying to lose weight, we'll suddenly get pulled off the shelf because it's suddenly, we need to really get a grip. It's a drug. It's a drug. It's not a freaking, you know,

cosmetic tool. It's a drug and it should be treated as such. We find ourselves nearly at the end of this episode and at the end of our investigation into ZemPEC. And I would love to know, given what we now know and the information we've received from all the people that we've spoken to, what is your overarching opinion about OZMPIC? Where do you land? I think it's really interesting. I want to be really careful

because, like I say, I haven't experienced food noise. I haven't, this hasn't been part of my life in the way that it's been part of other people's. And I'm also not obese, and I'm not trying to lose weight. So I don't think it's for me to cast

a conclusive judgment, right? Because I don't know. I don't judge anybody taking it because I absolutely understand why they will. What I find insidious and absolutely terrifying is the mishandling of it by healthcare professionals. And I mean that like sort of systemically rather than individually. I think something we talked to Giles about was people who were on OZMPIC long term. if the drug works for them in the way that it's supposed to, they will get down to a healthy weight

and they will then stop being prescribed it. They'll stop being eligible for their prescription, which means that they will put the weight back on again. And, you know, he talked about in an ideal world we'll have this full wraparound care for these people. We're not in an ideal world. And there isn't that. There isn't, and there won't be.

We're so far. The NHS is so overstretched. It can't wrap around care for anyone with anything. and we know how fat phobia is such a massive part of the medical profession and the medical world. So I think that's a bit idealistic in a hope. And I think that's very naive and very dangerous. So individually, I understand how people are taking it. As for influences taking it, body positive people say, fair fucks. Like we've done how many episodes of this now with this massive pressure. We know that everybody feels a certain kind of way about their body

yeah you've been given a golden nugget here like you're going to take it fine i i can't cast judgment there but i i have this like just horrible anxiety about the the misuse of it and the trend of it and it's like i don't believe that it's fine the comparison that i keep thinking about when we were offered the covid vaccines a lot of us took them. A lot of us didn't. People, I took mine. I had mine because I trusted doctors. I'm like, yeah, cool. It's stunning. We'll all get out of the house quicker. That sounds fine. There was a lot of noise from people saying, I'm not doing that. I don't want that in my body. Long-term effects, side effects, terrifying, filling us with poison. Do you know how many of those

fucking people I know who are now taking Ozmpic? Who are also stuffed full of Botox, by the way. And I just think it's really interesting. and frightening how we're playing with drugs. We're making loopholes for ourselves. We're making allowances for ourselves. You know, if we feel really strongly, which you're completely within your rights to do, that vaccines aren't a good thing

because you're worried about what's going into your body, the fact that we can make this massive loophole for ourselves and say, but this one will make me thin. So, like, fuck it. Like, that frightens me. The mental gymnastics that we're playing, that nice are playing, playing, that private doctors are playing. The fact that we are, that this drug is accessible

to the point that it is, it does frighten me. And I can't get away from that. So individually, I've got no idea. I don't know how I feel about, I get, I'm gutted actually when my friends tell me that they're taking it. Same. I mean, same. I co-iside everything you say. I'm scared about the misuse. I also fear that it's going to leave people that take it in a worse place than when they started taking it and were probably more confused than they were and and just a bit hopeless well jyle said that right it isn't like a vaccine actually that works and once you've had it it's in it's stops the minute you stop taking it it it stops working and at some point the doctor is going to stop prescribing it for you or you'll stop being able to afford it right or or or or or

right and then where is it how does that leave people then it hasn't tackled any of the reasons that they want to be on the injections in the first place. And I think that's societally where we go wrong time and time and time again, right? We can acknowledge that obesity is a disease and it is a problem and it is something that we don't want for our kids and we don't want for ourselves because it's, and I'm not saying this on an individual level. I'm not saying fat is bad. I'm saying obesity is a disease, right, or the things that come alongside it.

I can understand why there are health concerns around this, right? Research goes into it, whatever it is. But time and time again, we've got it wrong, and we've shown that shame doesn't work as a motive. And we see NHS campaigns that are riddled with shame. Right. We see consistently the oversimplification of a disease that is so complicated. And it's consistently putting it as personal responsibility, which it is not. Food is so expensive.

Food is so confusing. Food is overwhelming. We are time poor. We're in a cost of living crisis. We don't have a fucking clue what to do. We're doing the best for ourselves and for our kids. And it's, I'm really alarmed and like hurt by this. Well, it works for obese people, so it's a solution.

And it's like, no, it tackles the symptom. It doesn't tackle the problem for most people. And this is just, this is copy paste everything we've tried to do to tackle obesity, to have a war on obesity. We're tackling a symptom. not a cause. And it hurts, I think people more, I don't know science on it, but I suspect it hurts people more in the long run than it helps them. For sure, and actually it was really interesting to talk to trials about this and how he, how he foresees the problem being solved.

If everyone who wanted the drug had access to the drug, would then suddenly obesity no longer be a problem, okay? Certainly the symptoms of the obesity. I mean, from a mental game, play, that's possible that for a large percentage of people that will be the case. But I think that there is a significant number of people that won't respond to it, five, 10%, won't respond. We don't know why. And a significant percentage of the people who do respond have side effects, which means that they don't want to stick on. So call it another 10%. So I think ultimately, there's still going to be 20% that are people who need to lose the weight, who need something else to lose the weight. That's a substantial proportion of people. But I still think that there are more.

and more pathways and more mechanisms and more targets to be found. And this, I don't think, is the B-O-N-N-R-R, to my view. You have to remember that this treats the obesity. It doesn't prevent the obesity to begin with. Now, the prevention of obesity requires policy change. It requires education in kids. It requires improving our bloody diet. This drug will not improve your diet.

The drug will make you eat less of your diet. If you're nice and middle-classy like us and live in leafy areas and we eat relatively healthy anyway, then that's fine. But if your diet was crap to begin with, okay, you ate whatever Oreos and chips only, all this drug is going to do is make you eat less Oreos and chips. So yes, you'll lose weight because you're eating less of it. But you may very well go into malnutrition because suddenly now you're no longer eating enough crap to actually maintain what you're having. So it is an important point. where it does not prevent the obesity. That's fine.

I think it should be, we should use a hammer for a nail and a screwdriver for a screw. Okay, use the tool for the job. The drug to treat the obesity and help save lives. But we still need to fix our food environment to prevent obesity from happening to begin with. And even Dan, who we spoke to earlier, who took it himself, agrees on the regulation front.

I'm not against the use of this medication. I really want to be there. I am aware of its transformative effect. I know that it's possible to use it on people. So they found that people who've got issues with alcohol use and problems with sort of gambling, and they're finding that this is having a beneficial effect. And I think fundamentally, if it is effective for people with diabetes

and weight issues and all of these associated issues, I think hand it out like, hand it out like, candy. I think the NHS wants to look at it for heart disease as well. And sort of broader, diseases of affluence, they call it, where, you know, it's sort of the fact that we have this sort of Western diet and everything's sort of processed. So I'm not, I'm not against it. My concern is that I didn't, you know, I wasn't warned. I wasn't warned side effect. It wasn't highlighted. And the consequence was from, let's say from March all the way through to August, I live through, I live through hell, you know, because I never, I never wanted to tell people

about it because there, it's definitely, there is definitely the connotation, it's loaded, this idea of, oh, well, you know, again, you don't have the willpower, therefore you're just going to turn to the shortcut. And I was really hoping that I could just take it, lose a bit of weight, and then be like, oh, this, this, me, oh, you know, just a, just a few more letters at lunchtime you know nothing nothing nothing to you nothing to your owners um because it because it does worry me that people will people will be down on this um and again sort of say say it's calmer for taking the shortcut and things like that and fundamentally i'm generally i'm generally pro it as long as as long as people are

able to um able to get the support the warning up front and the support afterwards I think something that I haven't got an answer on, so fair enough if you don't. But I would be interested to hear how you feel about people in the public eye taking OZNPIC. And particularly, and again, it's a small subsect, it's quite specific to where we are, but people who have long since celebrated their bodies or made a career out of celebrating their bodies or who have been fat representation or icons or whatever to hear. see, suspect that they're taking a Zempic, what do your thoughts? And do they owe us the Oprah Winfrey confessional? This is such a tricky one. And for people who are like just joining us for

this body image series, you probably won't have heard that we've actually discussed this topic at length and tried to come to some sort of conclusion on this because it's, it is so difficult. And I think again, it comes back to that I understand an individual's desire to take this drug, no matter what area they're in, no matter how hard they've campaigned for fat acceptance or body positivity, I understand that it's still going to be very tempting

and I understand them taking it and I genuinely don't cast any judgment on them for it. Do I think that it gets muddier when it becomes a question of moral responsibility when this person has a platform

and has been using this platform prior to, you know, discuss the virtues of self-acceptance and body positivity. Yes, I think that's, then it's like a, it's really difficult then. But this, it's hard to draw a conclusion on this because it also feels unprecedented. We had the body positivity movement, which has not happened the way it happened so mainstream ever, and followed so swiftly by this, the Olympic phenomenon. I just, I don't, I don't know the right. course of action for people who want to take it but feel like they have a moral responsibility

to their audience not to. How do you feel even when people, okay, scrap the audience because that's unique and unusual and relevant to us but not really to everybody else, how do you feel when celebrities are taking it? Do you think they should be telling us that they're taking it or do you think that by telling us they're promoting it? Do they always transparency? I think a bit of both. I think it's both. You can't do it both, though? No, as in, I think on one hand, it's, I don't think they, I don't think they owe as the transparency, no, I don't think so.

I think they are at the behest of a huge, a giant, like this industry that is telling, like, screaming at them to be thin. And I think whatever means that they have to do to survive in that world, like, go for it. Like, that's your prerogative, and I get it. I don't think they owe it to us. I think it's good if they are transparent, and they are open and they say this is how I lost the weight.

I think on one hand that's good because it's not creating any like false expectations with other people or false standards. So in that sense I think it's good. But on another hand, it's also promoting it. Of course it is. I think it's both. So then we can't win. No, we can't win.

And that's the thing. That's the frustrating thing with this is again on an individual and this is where we land with it is that not we, you and I, but I think this is where it's, lands is that it's another diet, whatever product, like marketing technique, whatever it is, that puts it all on the individual's plate and leaves us in a situation where we can't win. You go back to any one of these episodes, you can't be positive enough in your body, going back before with wellness, you can't be healthy enough. You're never, but you don't, you're doing hit, shouldn't you be doing Pilates?

Like, whatever it is, you go back before that and we're looking at diets and it's, oh, you should be doing this. We shouldn't be talking about it. Oh, you do, oh, you've got to watch your weight, but you can't talk about it because diets are boring. Like, it's another, and perhaps the most intense one yet, of an individual will never feel. I don't understand how an individual is supposed to feel empowered by the decision to take Ozempic, or not to because you're damned if you do and you're damned if you don't and you're damned if you do and then you don't because you've I mean you're just you're really damned then but it feels really unfair it does overwhelmingly I just feel like this is very unfair yeah and I think it

what we're saying it all ludes to like it all points to shame which I think is at the crux of all of this and it's and it lives at the core of our body image issues Absolutely. And I think what we both love a huge takeaway from this entire topic to be is around the issue of shaming. It's a through thread of the entire series. And like you said, when it comes to body image, women especially are shamed no matter what for being too thin,

for being too fat, for gaining weight, for losing weight. But to make things even more complicated for us within that last category, losing weight, lies another subset of shaming because our society has concrete views on what obesity is and what the morally acceptable ways to overcome it are obesity is like we said considered a personal responsibility something that can simply be solved and managed by eating less and moving more and that therefore is the only defensible method

of losing weight and anything deemed a quick fix the easy way out which is how ozempic is viewed because it takes away the typical diets need for self-control and willpower doesn't pass and predictably is accompanied by a ton of shame that's it you know it's like cowards way out easy way out The language is poisonous, and we strongly believe that we need to swap shame for compassion because we are merely trying to survive and thrive in a society that values us for thinness. And of course, we will take whatever measure, including Ozempic or whatever comes next. Why would we be shame for that? How can you shame, given everything we've given you in the context of this situation,

there's just no way you can shame an individual for this. But look, no matter what our individual personal opinions are and weight loss injections, we think it's safe to say that OZMPIC has changed the landscape of diet culture and potentially irreversibly, and I guess that remains to be seen, but it doesn't feel outside the realms of possibility. But in turn, it's changed the landscape of body image too. Celebrities began getting smaller first, and as tends to be the case of beauty trends, sadly. They have trickled down to the general population. I'm pretty sure all of us listening know someone taking OZNPIC, whether openly or in secret,

and we're noticing people in our everyday circle shrinking. We don't know where it's going to end, but we do know that this certainly isn't the last we're going to hear of OZMPIC. Retrospective and actually current day speculation done. Join us next Monday for the final part of this series. A look back on what we've learned, a conclusion perhaps, to the issue. or maybe it'll leave us with more questions. Either way, we'll see you then. Should I delete that as part of the ACAS creator network?