VIDEO - Ozempic Magic Pill or Devil’s Bargain? The Free Press

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Just a few years ago no one had even heard the word Ozempic. Almost overnight, the drug previously used to treat type 2 diabetes became a household name. By the end of the decade, 30 million people are predicted to be on it. For comparison, that means that Ozempic is on track to do as well as birth control pills and Prozac\u2014a blockbuster medication. 

A little over a year ago we had a fiery debate on Honestly about these revolutionary weight-loss drugs and our cultural understanding of obesity. On one side of the debate, people saw Ozempic as the golden answer we\u2019ve been searching for. After all, obesity is the second biggest cause of cancer. 

On the other hand was another argument: Why are we putting millions of people on a powerful new drug when we don\u2019t know the risks? Plus, doesn\u2019t this solution ignore why we gained so much weight in the first place? 

A year later, all of those questions are still up for debate. Our latest guest on Honestly, journalist Johann Hari, has spent the last year trying to find answers, traveling the world investigating weight-loss drugs and. . . taking them himself.

In his latest book, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs, Johann investigates what we know and what we don\u2019t know about how these drugs work, their risks and benefits, how our food system sets us up to fail, and how movements like \u201Cfat pride\u201D and \u201Chealthy at any size\u201D have completely altered the conversation. (He also discloses how the Dalai Lama fat-shamed him after he asked the religious leader about homophobic statements he had made.) 

I asked Johann: How do these new drugs impact our brains, our guts, and our mood? What are the hidden risks? Are they really a permanent solution to the obesity crisis? 

To listen to our conversation, click below\u2014or scroll down for an edited transcript.

On discovering Ozempic:

Bari Weiss: When we last saw each other, we were both fatter. I was at a very wealthy home in L.A. when the wife of the couple said \u201CI love your podcast, you should really do it on video,\u201D and I said something self-deprecating like \u201CI gained 20 to 25 pounds and I hate seeing myself on camera.\u201D She looked me dead in the eye, took me up to a mini fridge in her home, and pulled out the pen and said, \u201CCan I give you some?\u201D I took it there on the spot. The craziest thing happened to me: the next week it was if I was full from a cup of water. I had never experienced the feeling of being so satiated with nothing. I was no longer interested in food. I shed 15 to 20 pounds of my Covid weight. 

How did you first find out about Ozempic?

Johann Hari: It was the winter of 2022, when the world was opening up again. I got invited to a party for the first time in years, thrown by an Oscar-winning actor. In the Uber on the way there, I was thinking, Oh God, I\u2019ve gained so much weight, and I was dreading it. Then I remembered that everyone had gained weight. And I thought, I\u2019m going to see these Hollywood stars with a bit of pudge on them. It\u2019s going to be fascinating. 

I arrived at the party and it\u2019s not just that they hadn\u2019t gained weight. . .  everyone was gaunt. Everyone was like their own Snapchat filter: tighter and clearer. I said to a friend of mine, \u201CWow, it looks like everyone really did take up Pilates during lockdown.\u201D And I must have had a confused look because she said, \u201CJohann, you know it\u2019s not Pilates, don\u2019t you?\u201D I had no idea what she was talking about.

So she pulled up an image of an Ozempic pen. And I learned about the existence of these drugs. 

On why these drugs are \u201Cmagic\u201D:

BW: You make the argument that this new set of drugs might be seen or come to be seen as profoundly transformative to our culture as the invention of the Pill and the smartphone. Make that case. 

JH: There are three ways in which these drugs could be magic. The first is the most obvious. They could just solve the problem.

The second way in which it could be magic is more disturbing: it could be like a magic trick. It could be like the conjurer who shows you a card trick while secretly picking your pocket. It could be that it\u2019s giving us this benefit, but at the same time it\u2019s screwing us over.

The third way I actually think is the one that\u2019s most likely: if you think about all the classic stories about magic that we grew up with, like Aladdin, you find the lamp, the genie appears, you make your wish, and your wish comes true. But never quite in the way you imagined. Think about Fantasia: you unleash the magic and the magic runs away from you and has all these unpredictable effects.

On how we got here and the food industry:

BW: Let\u2019s talk about how we got here in the first place\u2014how we got to a place where millions of people are shooting themselves with a drug whose consequences we don\u2019t fully know. How did we get to a place where in the richest, freest country in the history of the world, 40 percent of people are obese?

JH: It literally happens everywhere people move from eating a diet mostly based on whole foods that are fresh and prepared on the day they eat them to mostly eating foods built in factories out of chemicals in a process that isn\u2019t actually called cooking\u2014it\u2019s called manufacturing.

There\u2019s an experiment that really drove this home to me: there\u2019s a brilliant scientist called Professor Paul Kenny. He\u2019s the head of neuroscience at Mount Sinai and he grew up in Dublin in Ireland. When he was in his 20s, he moved to San Diego and he quickly clocked, Whoa, Americans don\u2019t eat like Irish people did at the time. There was way more processed food, way more sugary, fatty food. And he started to feel like this different kind of food wasn\u2019t just affecting his gut; it was changing his brain and what he wanted. So he designed an experiment to test this.

He got a load of rats and he put them in a cage. And he raised them with nothing to eat but the kind of fresh, whole foods that rats evolved to eat throughout their lives. And when they had this food, they would eat when they were hungry, and then they would stop. 

Then Professor Kenny introduced them to the American diet. And he put it in the cage alongside the healthy food. And the rats went crazy for the American diet. As Professor Kenny put it to me, within a couple of days, they were different animals. And they very rapidly all became obese. 

Then Professor Kenny tweaked the experiment again: he took away all the American food and left them with nothing but the healthy food again. What happened is they refused to eat anything. When the American food was taken away, it was like they no longer recognized the healthy food as healthy food at all. It was only when they were literally starving that they went back and ate it.

On being fat-shamed by the Dalai Lama:

BW: How did we get to a place where we are knowingly and happily eating petrochemicals and sawdust?

JH: You\u2019re reminding me of one of the real low points of my life. It was Christmas Eve 2009 at 1 p.m. I went to my local branch of KFC and I said my standard order, which is so revolting I won\u2019t repeat it on a podcast, and the guy behind the counter said, \u201CJohann, I\u2019m really glad you\u2019re here,\u201D and he said, \u201CWait a minute,\u201D and he went behind where they fried all the chicken and came back with a massive Christmas card in which everyone who worked there had written, \u201CTo our favorite and best customer.\u201D And one of the reasons my heart sank is I thought, This isn\u2019t the fried chicken shop I come to the most. It was genuinely chilling. It was one of the two lowest moments in my fat life, along with the time the Dalai Lama fat-shamed me, but that\u2019s another story I can tell you later if you want. He\u2019s a horrible bitch, but. . . 

BW: Wait, I\u2019m sorry, we need to hear the Dalai Lama fat-shaming story.

JH: It was actually genuinely quite upsetting. So I was a baby journalist, I must have been, I don\u2019t know, 25, and I got sent to interview the Dalai Lama. And I believe, even when you really agree with a powerful person, and I actually agree with the Dalai Lama on resisting communist tyranny for example, you should challenge them. So I looked up: Has the Dalai Lama ever done anything wrong? Turns out, he thinks disabled people are being punished for what they did in a previous life. That seems quite bad to me. He\u2019s quite anti-gay. \u201CYou shouldn\u2019t use the other holes\u201D is an actual quote from the Dalai Lama. 

So I go to interview him, and the first 20 minutes I\u2019m asking about all the stuff we agree on, the brave resistance to communist tyranny. And then I started asking him about this stuff, and he started pretending that he didn\u2019t speak English. And I said, \u201CYour Holiness, I know you speak English. You just gave a speech in English. I know you can understand me.\u201D And his goons\u2014I assume that\u2019s not their official title\u2014were giving me really dirty looks, and I thought they were going to throw me out, and I was meant to have an hour. So I thought, I\u2019ll bring it back to something where we agree. So I said, \u201CYou know, Your Holiness, you\u2019ve always been very critical of income inequality in Western countries.\u201D And he said, \u201CYeah, I don\u2019t see why people need so much money. We each only have one stomach.\u201D And then he said, \u201CExcept you, you clearly have at least three.\u201D I was like, Wait, isn\u2019t the Dalai Lama meant to love blades of grass and rocks? Is he calling me fat? Is that what\u2019s happening here? 

And it wasn\u2019t my finest moment as a journalist, but I said, \u201CWell, you\u2019re quite fat as well.\u201D And when I later wrote about this, I got the world\u2019s first ever Buddhist death threat, which I was thrilled about. I wrote back and said, \u201CYou\u2019re going to have at least three lives as a wood louse now.\u201D So yeah, it wasn\u2019t ideal. Where are you now, Dalai Lama? Let\u2019s send him an Ozempic pen. 

On the risks of these weight-loss drugs:

BW: Talk about the side effects of taking the drug. 

JH: There\u2019s a brilliant scientist I interviewed called Professor Jean-Luc Faillie, who\u2019s at the University Hospital in Montpellier in France. He looked at loads of the diabetics who\u2019d taken these drugs between 2006 and 2012, and he compared them to an almost identical group of diabetics who had not taken these drugs. And what he found, if he\u2019s right, is really alarming. He found that they increase your risk of thyroid cancer by between 50\u201375 percent.

It\u2019s important to not misunderstand that. That doesn\u2019t mean that if you take these drugs you have a 50\u201375 percent percent chance of getting thyroid cancer. If that was the case, there\u2019d be bonfires of Ozempic all over the world. What it means is, whatever your thyroid cancer risk was at the start, it will go up\u2014if he\u2019s right, and this is highly disputed\u2014by 50\u201375 percent.

BW: Is there any research into Ozempic muting people\u2019s ability to experience pleasure, happiness, even ambition?

JH: This was fascinating to me. I asked all these leading scientists, What\u2019s it doing to my brain? And they all gave me a variant of \u201CCome back to me in a few years, maybe we\u2019ll know.\u201D 

One theory about how these drugs could be working, and I stress it is a speculative theory, is that in your brain you have something called your reward center, which basically motivates you to do anything pleasurable: eat, have sex, see your friends, etc. And one theory about these drugs is that they are dampening the reward centers in your brain. You and I are eating fewer Big Macs because we don\u2019t want it as much because we don\u2019t get as much of a reward from it, because our reward centers have been dampened. Now if that\u2019s right, that obviously raises a question: If it\u2019s dampening my desire for an In-N-Out burger, is it dampening my desire to write my next book or to have sex?

On how culture contributes to the obesity crisis:

BW: The New York Times recently profiled this woman who identifies as a \u201Cfat activist,\u201D named Virginia Sol Smith. And here\u2019s what the Times writes about Smith: \u201CSol Smith says that parents need not be concerned about how many Oreos their children eat. . . . If parents put restrictions on food, then children will never figure out how to eat according to their own bodies\u2019 own needs, she explained.\u201D I\u2019d love for you to respond to that logic.

JH: The idea that you\u2019ll learn your body\u2019s needs from Oreos is a profound misunderstanding. The kind of food we\u2019re eating is so different from the food that we evolved for that we do not have nutritional wisdom when it comes to this food. There isn\u2019t an innate nutritional wisdom that your child will discover about an Oreo. No human before us encountered an Oreo. 

On other solutions to obesity:

BW: Let\u2019s talk about some solutions to the deeper problem. You traveled with your nephew, who has recently lost a hundred pounds, to Japan, which has a food culture so different from the food culture in America, and they have not experienced the same obesity crisis that we have here in America. Tell us a little bit about what you discovered on that trip and lessons that those of us who are concerned about this crisis might learn from it.

JH: So Japan has 4 percent obesity. Americans have 42.5 percent obesity. But Japan shows us that is not inevitable, right?

I went to a Japanese school, a normal middle-class school, with a thousand kids. It was bizarre walking around this school. There were no overweight children in this school. Every school in Japan has to employ a professional nutritionist. Her job is to design the meals. All processed food is banned. 

So I go to the school and I\u2019m watching these kids eating these unbelievably healthy meals. And I said to them, \u201CSo what\u2019s your favorite food?\u201D And one of them goes, \u201CMy favorite food is broccoli.\u201D Another one goes, \u201CMy favorite food is white fish.\u201D And another one goes, \u201CI like boiled white rice.\u201D

And I turned to my translator and I said, \u201CAre these kids fucking trolling me? Their favorite food is broccoli?\u201D She said, \u201CWe teach our children to love healthy food, don\u2019t you?\u201D No Japanese person understood why I was shocked. 

One of the funniest experiences I ever had was trying to explain the concept of \u201Cfat pride\u201D to Japanese people. They were just completely baffled. 

They have a law; it was so bizarre witnessing. . . in 2008, in Japan, obesity went up by 0.4 percent, and there was a massive national freakout. And they introduced a law called the Metabo Law. And the law says every company in Japan has to weigh its entire staff on a particular day. And if your weight has gone up, you have to make a plan with your employer to bring it down. And if as a company overall your staff\u2019s weight has gone up, you are fined by the government. 

I went to this company in Tokyo. You arrive at the company; it scans your face and says, \u201CHi, Bari, you walked 13,000 steps yesterday. You are 112th in the company\u2019s ranking.\u201D It might also say, \u201CBy the way, Suzy, who works at the desk next to you, hasn\u2019t weighed herself in the last two weeks. Could you remind her?\u201D 

For me, the most moving experience I had was when I went to a place called Ogimi. It sounds almost mythical. It\u2019s the oldest village in the world. It\u2019s in Okinawa. They\u2019ve got 215 homes and 190 people are older than 90 years old. Japan has, by far, the longest life expectancy in the world, but more than that, people are healthy almost until they die.

So I go to their little community center. The first person who walked through the door was a 102-year-old woman called Matsu Fukuchi, who walked there on her own, from her house up the mountain. This is what you get if you solve the obesity crisis. 

I went to countries that have begun to solve the obesity crisis. I went to Mexico, where they\u2019ve got a sugar tax. I went to the Netherlands, where they give obese children personal trainers, and where they took sugary drinks out of schools. We can solve this crisis. We do not have to tolerate this being done to us. It shouldn\u2019t be the case that half the population of the United States wants to inject itself with a risky drug to prevent an even riskier medical condition.

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