Johan Hari on the risks and benefits of drugs

Johan Hari still remembers the strange sensation he felt two days after his first injection. Ozempic.

In 2023, when Hari weighed 203 pounds and had 32 percent body fat, her doctor prescribed the drug for weight loss, a well-known side effect of treating type 2 diabetes.

Hari's grandfather died of a heart attack at age 44, his uncle died in his 60s and his father underwent quadruple heart bypass surgery in his 70s.

Hari said she didn't have diabetes and was wary of weight-loss drugs because she knew her previous options had “always failed.” Weight loss with Ozempic It seemed like a way to lower his own risk of heart disease.

He noticed the effects of the drug a few days after taking the first dose.

“I woke up and I thought, 'Something's wrong. What is it?' I didn't know what it was. And then all of a sudden I woke up and I wasn't hungry. That's never happened before,” Hari, 45, a journalist who lives between London and Las Vegas, told TODAY.com.

“From that moment on, my appetite decreased dramatically. I felt much less hungry than before. I felt full quickly.”

Hari ultimately lost 42 pounds on Ozempic and its sister drug. WegsIt contains the same active ingredient, semaglutide, and is specifically approved for weight loss.

He tried to find out as much as he could GLP-1 drugs “It mimics at least one hormone secreted by the gut to signal satiety,” he said in his new book.Magic Pill: The surprising benefits and worrying risks of a new weight loss drug. “

Hari shared his views in an interview with TODAY.com. His answers have been edited and condensed for clarity.

TODAY: You call these weight-loss drugs “a massive experiment on millions of people, and I'm one of the guinea pigs.” Why is that?

Hari: I've been part of not just one, but two experiments. I was part of an experiment that made us more obese, and now I'm part of an experiment that uses drugs to reverse that obesity.

During my lifetime, we have seen an explosion of obesity, the likes of which have never been seen before in human history. We are eating processed foods and Ultra-Processed FoodsThese foods completely dominate our diet and are different from the foods eaten by our predecessors. They reduce our ability to feel full.

The second experiment I'm taking part in is these drugs, which help you feel full again, but they also come with some risks.

What potential risks worry you most?

Semaglutide has only been used in obese people for just over two years. The long-term effects of taking it are unknown. There are concerns that there may be some long-term effects that we don't know about.

Expert opinion: Dr. Christopher McGowan, obesity medicine specialist, Cary, North Carolina, When patients ask whether it's safe to take Wegovy for years, he says there are no long-term studies on that, but McGowan points out that GLP-1 drugs have been used to treat type 2 diabetes for more than a decade, so “there's a very reassuring track record in general for these drugs.” He previously told TODAY.com.

Dr. William Yancey, medical director of the Duke Lifestyle and Weight Management Center in Durham, North Carolina, added that after reviewing the research, he feels comfortable prescribing Wegoby, knowing that patients may have to take it for years or even decades.

“We're constantly gaining knowledge, so that may change in the future, but right now we have enough information to consider this as a long-term treatment,” he told TODAY.com.

When asked whether Wegovy is safe to take long-term, manufacturer Novo Nordisk told TODAY.com that GLP-1 drugs such as semaglutide have been used to treat type 2 diabetes for more than 18 years and obesity for eight years.

“Semaglutide has been extensively studied in a robust clinical development program, large real-world evidence studies and has more than 9.5 million cumulative patient-years of clinical experience,” the company said in a statement.

“Novo Nordisk guarantees the safety and effectiveness of all our GLP-1 medicines when used as directed and taken under the supervision of a qualified healthcare professional.”

The company also said it works closely with the U.S. Food and Drug Administration to continually monitor the safety of its drugs.

Today: What specifically caught your attention?

Hari: For me, the only risk I didn't expect was the psychological effects. That was really weird. For the first six months I was on the drug, everything I wanted happened: I lost a lot of weight, my back pain went away, all sorts of good things happened.

But instead of feeling better emotionally, I felt a little worse. Comforting Mealand how bad it was making me feel.

I went to a KFC in Las Vegas and did the same thing I did before I started taking Ozempic: I ordered a bucket of fried chicken. I took one chicken drumstick and all of a sudden I thought, “I can't eat this.” Don't eat too muchI would throw up. I remember hearing a voice in my head saying, “Then you'll just feel sick.”

Have you stopped using food as a way to cope with stress?

And that's true: For many, it can be a difficult adjustment process, one that can bring to the surface the deep, underlying emotional reasons for why you ate in the first place.

I realized that a lot of the time I was eating was because I was overeating to comfort myself – to calm down – and when I was on Ozempic I couldn't do that.

I thought about quitting taking it because of the psychological effects, but a friend told me, “There are better ways to deal with your emotions than overeating.”

You say you experienced “surprisingly persistent” side effects – what were they?

The side effects were not severe but unpleasant and gradually lessened over the course of four months.

I get my weekly shot and the day after I get it I feel a little sick, but it's pretty mild.

I did experience a side effect that is not so common. Some people may feel their heart beat faster. When my heart is pounding, my body tells me something is wrong and I can't help but feel anxious. For me, that was the most unpleasant side effect.

I want to emphasize that I have benefited a lot from this medication: I have reduced my daily calorie intake from 3,200 to 1,800 calories and I no longer feel hungry.

Editor's note: U.S. Food and Drug Administration label for Ozempic In placebo-controlled trials, administration of 0.5 to 1 milligram of the drug was reported to “increase heart rate by an average of two to three beats per minute.”

Should I continue taking Ozempic indefinitely?

Yes, there is a risk of heart attack in my family, so for me personally, the benefits of these drugs outweigh my very real concerns about the long-term effects. Studies have shown that Wegovy (which contains the same active ingredient as Ozempic) Reduces risk of heart attack and stroke by 20%.

We have to weigh two risks: the risks of obesity and the risks of these drugs. Obesity causes almost all of the health conditions we fear. More likely — Heart disease, stroke, dementia, cancer.

Expert opinion: When considering taking a weight-loss drug like Wegovy or Zepbound, you need to weigh the risks and benefits for yourself, including whether you want to continue. Obesity affects healthDr. Beverly Chan, an endocrinologist and obesity medicine physician at Weill Cornell Medicine in New York, He previously told TODAY.comShe is an adviser to Novo Nordisk, the pharmaceutical company that makes Ozempic and Vigovi.

“Many of my patients have struggled with obesity throughout childhood and adulthood, and I know that the benefits outweigh the risks as soon as they start taking the medication,” Chan said.

Are these pills really as “magic” as the book's title suggests?

These drugs have magical powers for three reasons.

The first is the most obvious: they just solve the problem. Some days it feels that way. I've been overeating my whole life. Now I get an injection once a week and I don't overeat. It's like magic.

The second magical possibility is far more unsettling. It could be a kind of magic trick. Over time, the risks associated with these drugs could outweigh the benefits. I don't deny that.

I think the third option is the most likely. Think of a magic story like Aladdin: you find a lamp, rub it, and a genie appears and grants you a wish. And your wish comes true, but never in the way you expected.

Medicines are very powerful tools. They have huge and unpredictable effects, some good and some bad. That is why we need to pause for a moment and really think about this incredible revolution that is coming upon us.