The Daily - Marriage and Sex in the Age of Ozempic

Episode Date: October 7, 2025

In the last few years, GLP-1 weight-loss drugs like Ozempic and Zepbound have been radically reshaping the people’s lives, changing appetites and health.But the drugs also have the power to affect other parts of consumers’ lives, including their romantic relationships.Lisa Miller, who writes about health for The New York Times, tells the story of how these drugs upended one couple’s marriage.Guest: Lisa Miller, a domestic correspondent for the Well section who writes about personal and cultural approaches to physical and mental health.Background reading: Weight-loss drugs have lesser-known side effects on relationships.Photo: Katherine Wolkoff for The New York TimesFor more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday.  Subscribe today at nytimes.com/podcasts or on Apple Podcasts and Spotify. You can also subscribe via your favorite podcast app here https://www.nytimes.com/activate-access/audio?source=podcatcher. For more podcasts and narrated articles, download The New York Times app at nytimes.com/app.

From the New York Times, I'm Rachel Abrams, and this is The Daily. In the last few years, GLP1 drugs like OZempec and Zepbound have been radically reshaping the lives of millions of Americans. They have the power to change everything, from our appetites and our health to the clothes that we buy. But they also have the power to affect other parts of our lives. lives, how we date, how we see ourselves, even our closest relationships. Today, my colleague Lisa Miller tells the story of how these drugs upended one couple's marriage and how they dealt with the fallout. It's Tuesday, October 7th.

Lisa, I don't think it's an understatement to say that we, in 2025, are in the middle of this, what feels like kind of a weight loss revolution in the United States. And, of course, we're talking about these drugs that everybody's probably heard of, OZempic, Ui, Govi, Monjaro. I think most people know somebody who's been transformed by them. Maybe a lot of people themselves have actually. actually had some experience with them. But I would just like to hear a little bit about what interested you initially. Yeah. It's a revolution in how we look. It's a revolution in our

health. It's got gigantic potential to help people who have not been able to be helped before. And the data show that one in eight Americans has tried one of these drugs. So that's a lot of millions of people, right? And so it's creating all kinds of conversations. not just about how we feel and our health, but also how we look and how that matters in the world. Like, I have a friend who takes the medicine, and he says, you know, if you are able to eat just five French fries and you used to not be able to eat just five French fries and had to eat the whole plate of French fries, it gives you grounding. in the idea that you can control things in your life that you didn't think you could control. So if you're a person who was completely helpless

in the face of a plate of French fries and suddenly you get control of that, what else can you control? Can you control your gym-going habits? Can you control the way you relate to your children, the way you talk to your boss. So my question was like, if your body has changed so much,

just the shell you walk around in, and your mindset has changed so much about what's possible for you, wouldn't that affect the way you relate to everything and everyone in your life, including your most intimate relationships? And what really interested me was this question of how the GLP1 drugs affected a marriage, especially when one partner is on the drugs and the other partner isn't. How did you go about trying to find the right people to talk to, to satisfy that question?

Right. Well, we at the times have a thing called a call-out where you ask the public a question, and that question is posted on social media and in the paper and all over the place. And then we get responses to that question. And the question was this, has a GLP1 drug like Ozempic and subsequent weight loss changed your relationship? And so it was the week last year between Christmas and New Year's and it was like, it was like presents. And I was getting all of these responses to the call-out, and a lot of them were really interesting, I just want to say. And one jumped out at me. Should I just tell you what it?

Yes, do you have it? Yeah, I have it. He wrote, I believe it has changed a few things. Less alcohol consumption, smaller meal portions, improved health outcomes, increased awareness of food and drink consumption. But I believe GLP1 has affected my wife's. libido, no interest in sex. Perhaps due in part to image issues, also increased mood swings on her part. And I thought, there's a lot between the lines here. First of all, a lot of people wrote in about sex, but he was very pointed about it. He's ruminating on why, struggling with it. And so I called

them up. Can you hear me? And I talked to both of them. Let's talk about middle names. And they agreed to participate in the story as long as I used their middle names. Javier. J-I-R-V-Y-R-H-Y-E-N-N-E. Okay. That works. They live in New England in sort of a nice suburb. We celebrated our anniversary a few days ago.

They had been married for 15 years. And would you be open to a visit from me? Yeah. Okay. And it became a long relationship in which I was probing and probing and probing about how these medications were changing the dynamics in their marriage. So tell me more about that. How were the drugs affecting their marriage? Well, I think maybe it's helpful to talk first about what their relationship was like before the drugs. And it goes back to high school.

Junior year is when I met her So that takes us to 19807 They both grew up in Sacramento What did you notice about her Like what made you like her Her personality Very outgoing Great smile

Well I thought he was cute He was a football player And also in the band So you know he's the offensive linemen He's fit but a big guy Which You know, as a woman is very comforting, you know, when you hug someone like that, you know, just feel safe. And so at that time in high school, how would you have described your own body?

I was overweight, you know, back then, I mean, 17 years old, fat. She was like in a bigger body and excruciatingly self-conscious about that. So always felt awful, never felt. And she would say that she became like a super competent pleaser on all the clubs, doing all the things in order to compensate for the way she felt about her body. And he had a crush on her. And they both told me this story about how in high school there was this band performance in town and he offered to walk her to her car. So that was my first attempt was, you know, let me walk you out to your car. and then, you know, kind of test the waters there.

And I said, no, no, you know, I'm a powerful woman. I don't need any man to walk me to my car. But I thought it was very gallant. It was as though she couldn't believe that he liked her in that way. Because she was insecure? She was so insecure about her body. You know, there have been times in my life where, you know, someone was actually flirting with me or trying to, you know,

on to me and I just don't register the signs because I feel so uncomfortable in my own body that I feel like they must be bullying me or, you know, teasing me or just being mean. So even though she had a crush on him too, she wouldn't believe it. So it sounds like basically, even though they might have liked each other or he certainly liked her, they did not get together in high school. They did not. But they were close. Yes.

they were unrequited high school sweethearts. And they each married other people. What happened was that my first marriage was coming to an end. My first marriage had just ended. And then all of our friends were reconnecting on Facebook. Jean looked up Javier on Facebook. Our 20-year reunion was coming up that fall. And I told her that it'd be great to connect and have a cup of coffee.

They told me about their first date, and it just felt when they both described it, like, finally. You know, they both had this feeling of like... They knew. They knew. The cup of coffee ended up being a dinner and some beers and then a ride up to the skyline where you could see down under the bay, and that's, you know, that's when a kiss happened. And I think things went pretty fast from there. I remember the first night that we got together, that we had, you know, we connected sexually, intimately.

And they both told me about the first time that they had sex. I mean, knowing, how should I say this, assuming that she may have self-image issues, I would. was really impressed and delighted that she had no problem disrobing before me. The way he talked about it was just as this unbelievably magical, uninhibited interaction. She didn't say, don't look at me, or I'm ashamed at this, or the other, or my boots are too big, or my butt's too big, or I don't like this role, whatever it might be, there was never any talk of that. So I kind of thought that she was happy in her body. His point was that she was so uninhibited about her body. And that that was so pleasing to him.

And I'm running the story by the both of them. And she was like, I don't exactly remember it that way. It wasn't that I felt great about my body. body. I never felt good about my body. What was amazing about that night was that I'd have this crush on him for 20 years, and here we finally were. Now, we know that they eventually get together, right? They get married. Yeah, they moved to the East Coast, where she gets big jobs in corporations. She's the earner. You get the sense that they fit each other's romantic fantasies. And they're extremely sexually attracted to each other. It's a big part of their identity

as a couple. They have a child. They settle into a life where they both love food. They love restaurants. They love wine and they get a big wine fridge in their dining room. Living the dream. And they have friends down the street and they have these game nights where they last like all night. And they have this kind of happy, suburban. Fun. They seem like fun people. They enjoy living life with gusto. Totally. They're doers. You know, they like to imbibe in life. But throughout this, you know, Jean struggled with her weight. I was obese from a BMI perspective. After she had her baby, she was heavy. She was heavy.

she hated it she had postpartum depression she could not lose the weight she did not feel good about that her self-image her sense of her body was not happy and she would say she's gained and lost 70 pounds

multiple times in her life and it just felt like an endless struggle to her did she tell you why she was having so much trouble keeping the weight off You know, she talked about food noise. Yeah, food noise, to me, feels like a constant need to eat. I don't feel hungry.

I don't feel full. So I don't have those physiological triggers to know when to eat. And the feeling of self-loathing that she describes of not being able to control that. Like it's a failure. of will. And then being embarrassed about the food that I was eating. So sneaking food, you know, when I was home by myself, having a pint of ice cream because I could and I could hide it. Eventually, this leads to health issues. I do have other chronic conditions that developed over time. I had non-alcoholic fatty liver disease. And she says to her doctor,

How about one of these GLP-1 drugs? And he wrote the script. And can you just remind us, Lisa, how do these drugs actually work? Well, they work by reducing your feeling of being hungry. And because of that, people lose a ton of weight really fast. And people who have been dieting their whole lives and struggling with their weight are able to keep their weight off as long as they're on the drugs. And, you know, she starts losing a lot of weight really fast.

Their clothing. Her clothing was starting to fit a lot looser, you know, 10 pounds, 20 pounds. She used to not wear jeans, for example, because she wouldn't be able to fit in them comfortably. She was always wearing the leggings type of clothing. They both noticed it. So she slowly transitioned from the yoga pants to the, you know, to the jeans. Not eating that much. And I feel for the first time in my life, like, this may be it. like, I may be able to keep this weight off because I've addressed the food noise.

The food noise that had been tormenting her is gone. She feels like it's like a miracle, really. Wow, so this is just a really dramatic, very quick shift. Yes, I mean, she lost 60 pounds inside of eight months. And then, you know, she notices that, like, people start treating her differently. Yeah, so flying home on a trip, work trip, and I was in the window seat. She told me this story about she travels a lot for work, and she was on a flight home from Chicago,

and she was sitting in the window seat. And a guy sat in the middle seat and said, oh, I'm so glad I'm sitting next to a small person. You know, he said, you know, sometimes you're in the middle seat. middle seat and you're crowded between two big people and it's really uncomfortable. And so on the one hand, I'm like, yay, I'm a small person. But on the other hand, it really pissed off because when people looked at me before or sat next to me on the plane before, were they thinking these things the whole time where I'm trying to have a nice conversation and all that's in their head is I'm stuck next to this fat person? She was so furious.

on behalf of her bigger self. It's like in this moment she's almost caught between her old self and her new self. She's defending her old self as she's like happy for her new self. It's really an unbelievable moment of transformation. Well, and even at work. You know, at work she felt this way. She's a successful professional. She's always been a successful professional.

But I feel like the marketing team is putting me out there more. Now, suddenly at work, she's getting these outward-facing opportunities, where she's being put forward as a talking head to talk to the media, for example, or she's being put forward to talk to the board in a way that she hadn't been before. But I feel like there's this different perception of me. I'm the same person. I'm just 60 pounds lighter. Now, this is a thing that others have said, too, about these drugs, that once the world starts, you know, approving of you, and I've got air quotes up here, the doors open. And a lot of the people I talk to for this story talk about the opportunities that get presented to them, promotions and dates. You have access to partners that you didn't have access to. before. And you can do things physically with your body that you couldn't do before. I talked to one guy

who started running marathons all of a sudden. Wow. And if you're married, it presents a whole world of things that you have to suddenly start figuring out that may have been latent or unspoken or the agreement that you made when you got together has to be reneutral. negotiated in some way that you didn't anticipate at all. And that was definitely true for Jean and Javier. We'll be right back. Lisa, I'm so curious how these huge changes the gene is going through, both physically and emotionally, are affecting her relationship with how.

I mean, one of the first things that happened was that she totally lost her appetite for alcohol. And that's not unusual. People on these medications frequently lose their appetite for alcohol so much so that researchers are investigating whether GLP-1s are a good treatment for alcohol abuse, addiction, other kinds of compulsive behaviors. And for Gene, the loss of appetite just changed her whole approach to having fun with her husband. I mean, no longer could they sit on the couch and uncork a bottle of wine at the end of the day or go to the local brew pub and try out the new beer. None of it felt good to her anymore.

We go over to a friend's house and we'll have a game night or something like that. I mean, we'll still go. I just won't drink. And that's fine. Yeah. But it was also just that her like appetite for that kind of life where you're going out and you're hanging with friends and you're staying up late and everybody's drinking, those appetites, they had limits as well. I would have liked to get home earlier before anyway. And now I can say, I'm not drinking. I would like to be home. In fact, she had an introverted side that hadn't been able to express herself because she was so busy being a pleaser extrovert because she was in a bigger body and she wanted people to like her.

I am not as much of a night owl as my husband is and I like to read my Kindle a little bit before I go to sleep at night and I just don't do well the next day if I'm out really late. Once she was in a smaller body, she could assert her. herself and say, like, actually, I like being at home. But she's also telling Javier she doesn't want to do the things that he thought that she loved. And that they loved together. They love together, right. That was like the fabric of the fun that they had always had together. How does he respond to all this?

He does not like it. No. No, I like going with the flow. I mean, living in a moment and enjoying, you know, whatever's going on in social aspects or social events. Yeah. He was like, no, this is not how we are. We are the people who do these things. I think he misses his drinking buddy, the person who is going to stay outweigh.

It sounds like the lifestyle stuff led to a lot of tension, more than tension. I mean, I think they had a really, really, really hard time. And when I met them, they were fighting a lot. Before it was a conversation, and now it's a fight, and one of us is going to walk away angry because we're not seeing eye to eye on something. thing. And their fights could be loud and ugly. So I started really wondering who I was with. I mean, this person that I had been with for, you know, a better part of 15 years really started to take a change. You know, Javier said to me, you know, we go to from zero to 60 in like

seconds. Bottom line is it became very confusing to me as far as how to manage our relationship. I would even comment to her and say, you know, I don't recognize you. I need a role. I mean, it's like I need a roadmap to figure out, you know, what's within bounds and what's out of bounds. I don't feel like I can be myself with you the way I used to be because I don't want to offend you or I don't want to make you feel badly because things have changed a lot. And one of the biggest things that changed is that they completely stopped having sex. When I met them, they hadn't had sex since she started taking the drugs, which was almost a year. And Javier told me that he really missed it, and he missed her, and he missed her body. I used to love feeling her body, her big body, next to me in bed, the softness of her body, you know, the extra tummy and the extra booty.

They both talk about the loss of her butt. Are there things you miss about your previous body? my butt they both loved her butt right um so i i missed that that voluptuousness um and and i became and that was an attraction early on in our relationship to me anyways uh being able to lean up next to her and feel her the lack of a better word draping over me or onto me um that's you know longer an option now it's it's cuddling and it's cuddling as tight and closely as we can or as i can and that's that's the extent of the intimacy yeah i i'm at a loss for why there's no physical intimacy or hasn't been any this like physical connection that they had has completely

changed into something else and neither one of them knows exactly how to find it again. But for you, the voluptuousness was erotic. It was erotic. It was comforting. It was nice. It was, you know, sensual. And that's no longer the case. And this new body, I haven't really been able to touch or explore or anything like that. It's not as accessible to you. It's not, no. Why haven't they had sex?

Like, was that just another appetite that the drugs reduced? I mean, that's what Javier's theory was, is maybe. There's some evidence that these medications decrease sex drive, but there's more that they increase. reset. And Gene has different theories of the case. She's gone through menopause. She's been on antidepressants for a really long time, and both of those things are known to suppress sex drive. But I think there's actually something bigger at work here. I haven't said this to him. I just didn't say no before. She's started to be able to draw boundaries,

between doing things for other people because they want them and being able to articulate what she wants and she doesn't want to have sex and she's saying so in her marriage to her husband. I'm setting the boundaries. I don't want to have sex, but before I would because I felt like it was my responsibility. That is empowering for her in some way.

I can totally see why making an intense physical and emotional change could lead somebody like Jean to need to, if you, if nothing else, take a break from having sex. But I can imagine if you are the person's partner, that's suddenly finding out that, like, the person that you shared a really active, pleasing sex life with doesn't want it or doesn't like it,

I can imagine that that's totally devastating. Did she tell him that that's how she felt? I mean, he could tell. But he very much wants to be her loving partner. Mm-hmm. And what does that mean in the context of, like, not having sex when you want sex? Well, they were both working on this in therapy, individually and together. For example, we discussed with my therapist, and she provided a nice, a link that has to do with intimate touch.

And Javier's therapist gave him an exercise that was meant to help couples who aren't having sex or who want to get over some hurdle in order to have sex. There's just three steps or three phases. And the first stage is, you know, one partner lies. down fully clothed. And the other partner touches him, her, everywhere except the erogenous zones. And the partner who's clothed and lying down says what they do and don't like. Now that's out of bounds or that makes me ticklish or don't touch me there. Or they can say, I like that. And they did it one time. And Javier said he enjoyed it very much. But when he asked her, did she want to do it again? She said no. They didn't even get past the

the first phase of the exercise. I want to solve this problem because it's difficult for a married couple not to have that physical intimacy. But also, you have to share this new body with him when you haven't totally gotten comfortable in it yourself. Yeah. Does that resonate with you? Yes, it does.

I have never felt comfortable when he has made a positive comment about. my physical appearance. I feel more entitled to that praise now, but still trying to come to terms with being in a smaller body and what does that mean? Yeah. For us. Yeah.

Other than not being embarrassed on his behalf, you know, he's not married to a fat woman anymore. It sounds like the drugs kind of They unearthed something. They unearthed some kind of dynamic in their sex life that Gene had only been maybe vaguely aware of, but certainly had not been in a position to act on before she felt differently about herself. Yes, I think that's true. I think they're both completely blindsided by that. I didn't see, you know, from being ignorant or naive, that there were many fundamental differences. We seem to enjoy everything. the food, the drinking, the socializing, the active lifestyles, being parents. I felt that we were always on the same page and going on, you know, we were on the same.

We weren't two ships in the night crossing paths. We were one ship. You know, we all get into our relationships with these unstated contracts. that are not totally happy compromises sometimes. And then something like this happens, and you have to, like, ventilate that contract and say, okay, like, this is not what I want. And they're doing that.

So you're empowered in a way to take up space to say what you want, and that forces you to have to figure out what you want. Yeah. Yeah. beyond just like, I want to leave the party at 10. You know, that's, in a way, that's easy. Like, do I want to have a sexual relationship with my husband? Do I want to leave my corporate job?

Do I want to, like, these are much bigger questions. Yeah, yeah. And kind of sad that at 53 that I'm starting to have those thoughts, Aren't those the kinds of things that most people think about when they've graduated from school, right? I just, I'm the good girl and I do what's expected. In a certain body. And now you have a different body. Yeah.

I know this is just one couple and one anecdote, but I am really curious if you had any big takeaways for how these drugs could affect relationships. I mean, one psychotherapist said to me, you know, romantic partnerships, marriages are invested in stability and everything's staying the same. And so we have books about what happens when you're going through the death of a parent or when you move or when you have a baby. Like, these are gigantic life changes. But we haven't spoken about what happens when one partner's body completely different. changes and their feelings about their body completely change. But I talked to a lot of couples and what I concluded after speaking to them was that the couples that seemed to manage it best were couples who weren't rigid in their expectations of one another. What do you mean? What I mean is

you can't get too committed to like we are the people who have dinner. I wasn't sure what you were going to say. You can't be too committed to like, I make this lasagna and he loves to eat it. We have two margaritas on Fridays with the so-and-so's. Those kinds of rituals, which are very reliable and very defining for couples, especially if you've been together for a really long time, all of that gets renovated with what. one person on a weight off drug. And if a couple can say, like, it's okay, like still the same

person, we'll do something else, we'll eat less lasagna. I believe, Lisa, what you were describing is flexibility in relationships. Flexibility in relationships, which is really, really hard. All right. So how have you been? I will say that I spoke to Javier and Jean again recently, And I noticed a softness between them, a level of empathy and understanding that I hadn't seen before. It's not bad. It's not toxic. It's not horrific. It's harmonious. But there's still times of tension. But then that's normal with relationships. How would you describe it? Kind of like a dance? I think, well, not as anxious and angry as we had been. When I met them, they said that they had agreed to be together, but I felt that that was at stake.

And this most recent time when I met them, I felt that they were bought into that agreement. Yeah. And what about the physical stuff? I have to ask. Still the same. Yeah. But they're still not having sex. And my reaction to that has been to be patient and to not be pushing it. So there's not much more I can do. I mean, other than to say, it sucks. and I miss that.

And I wonder if it'll ever come back. Is there anything you want to say more? I still feel very strongly that this is one of the best things that I've done for myself. This is it, you know. I have lost the weight and I will maintain this for life. and I'm just so grateful. Lisa, thank you so much. It's such a pleasure to talk to you. I really enjoyed it too. Thank you, Rachel.

We'll be right back. We'll be right back. The decision was Maxwell's last chance to get clemency from the courts, and now her only option for an early release from prison is likely a pardon from President Trump. And, on Monday, a federal judge declined to block federal troops from heading to Chicago, setting up a fight between Illinois and the federal government. The state has sued the Trump administration, claiming that it's creating chaotic and unsafe conditions for residents

and violating the U.S. Constitution. We'll be covering the efforts by President Trump to send troops to Chicago and other cities on our show tomorrow. Today's episode was produced by Nina Feldman, with help from Anna Foley. It was edited by Ben Calhoun and Lindsay Garrison, with help from Patricia Willens.

It contains music by Marion Lazzano, Dan Powell, Pat McCusker, Diane Wong, and Leah Shaw-Demeron, and was engineered by Chris Wood. That's it for the Daily. I'm Rachel Abrams. See you tomorrow.