Ozempic and the sugar coating of reality

Old or young, fat or thin, body-positive or body-embarrassed, man or woman, everyone with money seems to be on a weight-loss drug: Wegovy, Mounjaro or Ozempic (which although a diabetes drug, is so often used off label for weight loss that there have been supply shortages). In the past couple of weeks alone, two freewheeling 60+ titans of journalism – my Spectator colleague Julie Burchill and my Telegraph colleague Allison Pearson – have written about how Mounjaro has curbed their hedonism (the former) and unhealthy, ancient patterns around cake (the latter). If these life-loving ladies have taken the plunge, I thought, maybe similarly life-loving 42-year-old me should be considering it?

There are few rational reasons left to resist. Last week, American researchers published findings that suggest these weight-loss drugs could substantially shrink the opioid crisis by muting addiction. Alcoholism could be cured. There are positive effects on the risk of stroke and heart problems, and promising signs the drugs might help in the fight against Alzheimer’s. All these in addition to the straightforward benefits of losing excess weight. Labour are considering handing Ozempic out to people on benefits to encourage them to slim down and regain the energy needed for work.

So what’s holding me back? I am certainly not one to let ‘body positivity’ get in the way of fact: being overweight is bad for one’s health, and might therefore have a knock-on effect on others, such as one’s children. It may also come with behaviours you don’t want your kids imitating.

Am I fat? Alas, this is one of the most consuming questions a woman can ask herself. It’s similar to those middle-class Bordeaux-lovers who ask: ‘Am I an alcoholic?’ The answer to the question of whether I am fat, just like that of the middle-class boozer, is complex. According to the photo histories that the ‘memories’ feature of Facebook and iPhone photos throw at me relentlessly, not especially. Far from thin, but not someone you’d do a double take on, thinking, ‘uh oh. Get that girl on a weight-loss drug, right now!’

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But according to those merciless BMI charts, yes. Definitely overweight if not ‘fat’. A course of Mounjaro or Ozempic would stand every chance of pushing me down into the technically healthy zone for my height, and therefore of extending my life by such and such years. My relationship to alcohol – keen, but not desperate – might be recalibrated so that I returned to the way I felt towards booze in pregnancy: a strong lack of desire.

And yet I won’t be taking any of these wonder drugs any time soon, thank you, and there are a few reasons for this. There is my hatred of feeling sick, one of the most common side effects. I prefer pain to nausea any day of the week. Nausea isn’t just an unpleasant feeling: it’s the opposite of all that is good in the world. It is the opposite, as Sartre so accurately put it in his novel of the same name, of comfort. It is the state of not wanting – food, yes, but also, in some sense, life. It is a sense of alienation and sense that things have entirely lost their nice or familiar qualities. I simply cannot imagine living a jolly life, full of beans, while keeping at bay a leeching feeling of sickness.

Then there is the complicated pleasure of the unhealthy. Maybe I don’t want to be healthy in the cold terms of the BMI chart, or the textbook charts of psychologists. Maybe there is survivable pleasure in having an unhealthy relationship, at times, to food – maybe the feelings of greed and remorse are part of what makes life life.

The truth is I am, by now, attached to the cyclical drama of diet, indulgence, weight gain, restraint and weight loss, just as – at times in my life – I have been attached to a similar cycle with men, of excitement and pain, or, put another way, over-indulgence followed by loss. And it’s not just the drama of it, the sense of self-loathing that in 99 per cent of cases follows a Dark Night of the Biscuits and Cereal.

It is also the genuine enjoyment, and the soothing qualities, of the overeating itself. I truly love biscuits and cakes and chocolate bars, both for their taste and because of their unhealthy position in my psyche representing reward, treat, naughtiness, and so on.

Being in a nervous state, or a bored or jaded state, and overdoing it on calorific food, can bring about a kind of calmness that nothing else can. The mind slows and it is peaceful. In those moments I feel that I could live inside a muffin. The regret – and the indigestion – that follow are always difficult, it is true, but are they so awful?

Probably. But in our age of vigilant healthiness, eating too many cakes and the occasional late-night newsagent chocolate bar serves an important purpose. I get to have the highs and lows of a drug addict without the tailspin of destruction. Sugar is a drug, of course, but right now it’s my drug. Ozempic will have to wait.