How 'Ozempik's Shame' illuminates the complexities of treating weight problems — Harvard Gazette

The frenzied demand for new FDA-approved drugs like Ozempic, used to treat diabetes, is fueled by reports that some celebrities like it. oprah winfrey, Elon Muskand various social media influencers I lost a lot of weight in a relatively short period of time. But it also struck a cultural nerve.

The need for more effective weight loss treatments is clear. Nearly 42 percent of American adults are obese, and the condition disproportionately affects older adults and racial and ethnic minorities, according to the CDC. National Health and Nutritionist Examination Survey. Studies show that about 80% of people who lose weight lose most of it back within two years.

However, the sudden popularity of these treatments has also led to news, editorial, and social media criticism questioning the safety, effectiveness, and cost of these treatments. It also caused a backlash against users. Dubbed the “Ozempik disgrace,” many users face prejudice and negative comments. online and directly Instead of relying on diet and exercise, take these medications.

Chika Anekwe is a bariatric physician. mass general weight center and a lecturer at Harvard Medical School. Anekwe spoke to the Gazette about drugs, the complexities of obesity treatment and the social stigma against being overweight. This interview has been edited for clarity and length.

Why is there so much backlash against these treatments, especially from people who have never used them or have no expertise in treating obesity?

Fear and prejudice are the main causes of the backlash. Distrust of the medical community may also be one reason why people are so opposed to using drugs for weight management.

Also, deeply ingrained beliefs in our minds are that a healthy weight should be something we can maintain on our own, and that anything other than healthy eating and exercise is seen as evidence of cheating or deficiency. Masu. of willpower. People think they can overcome this disease on their own, but you never say to someone with cancer or any other chronic illness, “Don't take your medicine. Don't take your medicine.” I won't say it. If you try hard, you will recover. ” That's not the case.

Is it because many people don't think of chronic excess weight as a disease?

That's definitely part of it. They believe that metabolic disease is the real disease and obesity is only a symptom of it. Therefore, they probably think that obesity will go away if they treat the metabolic disease.

All of the recommendations we make for treating metabolic diseases are the same as those we recommend for treating obesity. Literally, this is what we do when we treat obesity. But I think we should do it without drugs – that's their view.

Due to the influence of the pharmaceutical industry, many people believe that doctors are agents of Big Pharma and the medical industrial complex. There is an assumption that doctors are paid to prescribe medicine because it is in our own interest, when in reality we are paid to take care of sick people. is.

The challenge is that lifestyle, behavior and preventive measures can only go so far. Therefore, in today's modern lifestyle, pharmacotherapy and even bariatric surgery are necessary tools in the obesity treatment arsenal.

Many people learned about these drugs not from medical journals, but from celebrities. Does this help explain the perception that these are just expensive, vanity-driven stopgap?

I don't doubt it. The fact that people are hearing about Ozempic from TikTok and random blogs because Oprah Winfrey or Kim Kardashian or someone else is using it, and the fact that people are hearing about Ozempic from TikTok and random blogs, and the fact that people are hearing about Ozempic from TikTok and random blogs because Oprah Winfrey or Kim Kardashian or someone else is using it, and the fact that people are hearing about Ozempic from TikTok and random blogs and saying, “Open up the New England Journal of Medicine and say 5 years of heart… “I looked at the vascular outcomes study and now I think I can talk to my doctor about this'' is a great illustration of this problem. People need to be aware of their information sources and be rigorous in evaluating the credibility of those sources.

Being overweight increases your risk of heart disease, diabetes, and some cancers.but Research has also shown Overweight stigma is associated with medical avoidance, clinician disengagement, and numerous social, economic, and educational difficulties. Is it possible that such bias poses greater health risks than being overweight in some cases?

Looking down on or judging someone because they are overweight is weight bias. Self-stigma is the internalization of such perceptions. A person begins to believe that he has these negative characteristics associated with excess weight.

a study April Planty and colleagues examined outcomes related to these two types of stigma, as well as specific health behaviors such as physical health, health care utilization, physical activity, and smoking. The study showed that people who experienced both weight stigma and self-stigma had worse physical and mental health. They used less health care (i.e., were more likely to avoid or delay medical care) and were more likely to live a sedentary lifestyle.

Therefore, all negative attitudes and beliefs about people with excess weight are internalized and lead to poor health, further exacerbating health problems. It goes beyond poor self-image. This is a downstream effect of wanting to avoid accessing health care or taking less care of yourself because you believe negative attitudes and beliefs about yourself.

Why is weight bias and prejudice so prevalent?

It's the concept that behavior and lifestyle are part of the treatment, and people think it should be the whole treatment. and the concept that willpower is the primary cause of obesity, as opposed to physical, environmental, genetic, and other factors that contribute to obesity.

There is also a lack of knowledge about some of the socio-economic factors involved. People who have easy access to healthy food and don't have to think twice about where to shop or whether they can afford groceries recognize how difficult that is for people who live in rural or low-income areas. Maybe you haven't. As a single parent, there are many economic and logistical factors working against you when it comes to being healthy.

Many people have some basic knowledge about the factors that cause obesity, but they don't realize that there is more than one solution to the problem.

Are the medical and public health communities doing enough to educate the public about all the factors involved in weight management and that some people require surgical or drug intervention? ?

With the exception of cosmetic surgery, there is no other medical condition for which the general public is less informed and often the subject of critical opinions. So you can probably do better.

All published research and clinical trials are [same] Facts that we tend to share with people, whether it's in one-on-one patient encounters, online media, articles, or interviews. So the information is out there, but it's not being picked up by the general public. Perhaps it's because it's being overshadowed by flashier, more likeable content from social media influencers.

I would like to see what should be and is being done at the primary care level. The question is, do people have reliable access to primary care? Not everyone is doing it, and it's certainly not at the rate that is needed due to the lack of primary care that we currently experience in medical settings. Even if you think you're healthy, many people go years without seeing a PCP.

What should the general public keep in mind regarding weight loss?

The main thing people need to know is that when it comes to personal health, BMI shouldn't be noticed or talked about at all. This is what we use when talking to insurance companies because that is how they still handle approvals. However, BMI has numerous issues based on how it was developed and its intended use, and does not apply to the treatment of individual patients in a clinical setting. Therefore, it is important to understand it.

Also understand that excess weight is not a person's fault. It is a disease and it has consequences. Excess weight doesn't automatically mean you're unhealthy, but it does increase your risk of disease now and in the future. Another point: Excess body fat is the problem, not overall excess weight. Even if a bodybuilder has a lot of muscle and therefore weighs more, it is not a health risk. Therefore, these different concepts are key to understanding.

I would also like to emphasize that if you have concerns about your weight or health, the first person to talk to is your doctor. Then, if you would like a referral to a weight specialist, we are here. Many of us are responsible for treating and prescribing these medications and are willing to help anyone who has concerns or wants to discuss their health.