Even after spending a year on Ozempic and 20kg lighter, I'm still really skeptical about it


The protagonist of British-Swiss author Johann Hari's new book 'Magic Pill' is Ozempic – the weight loss miracle diabetes drug that helped him go from 92kg to 73kg in a year. Still, when Hari, 44, traveled from Tokyo to Iceland and talked to its makers, experts and users, he was left wondering whether this appetite-suppressant was really helping his lifelong struggles with food, weight and body image. Struggle was the answer. , Speaking to the Sunday Times from his London home, Hari talks about the promises and dangers of OzempicLet's reflect on our journey with Ozempic so far. Do you wonder if you are taking a risky gamble with your health?
Every day. From the moment I heard about this medicine, I felt really confused about it. On average, you lose 45% of your body weight and the next generation of these drugs will make you lose 25% of your body weight, and I can see the benefits right away. I am now older than my grandfather. He died due to a heart attack. My father had to undergo bypass four times. My uncle had a heart attack. I knew that obesity massively increases your risk of heart disease and more than 209 other diseases — from cancer to dementia to stroke. So, I thought here was a drug that could reduce those risks in a big way. I also thought, wait…I've heard this story before. Every 20 years a new miracle drug is announced, many people rush to get it and we always find out that it causes some catastrophic health problems and it has to be withdrawn from the market. I wondered if it was really possible to get so much benefit from Ozempic without any cost. So, I went on this big trip from Iceland to Minneapolis to Tokyo, interviewing leading experts and people who played a key role in developing the drugs, their biggest defenders and critics, and today I'm back, including 12 of the big ones compared to before. I know a lot. risk. But it's strange that I still feel really confused about the risks from these drugs and the risks from obesity. This is a difficult calculation.

Then how to take any decision?
One might say 'Yeah, it'll save us' or 'Boo, that's the worst thing ever' but what's missing is a much more complex conversation in between. I spoke to scientists who said 'people have been using these drugs on prescription for diabetes for about 15 years. So, if it causes any catastrophic event, we will know by now. This should give some assurance to the people. Then there were some scientists who said these drugs increased the risk of thyroid cancer (one of the 12 risks I talked about earlier). But I have tried dieting since I was a teenager. I always lose and gain weight back and end up fatter than before. So, realistically for me, it was a choice. So, at every stage you have to assess these competing risks. This can be annoying because there is no magic calculator to do this for you.

While much of your language is about wellness, medicine is also being used as a vanity tool by celebrities.
There are two completely different groups – obese people who use these drugs to achieve a healthy weight loss. Then there are the celebrities who are already at a healthy weight but are using it to become extremely thin. I strongly urge them not to do this for the sake of cosmetic changes because they are putting their own health at risk. If you are going through the aging process and these medications are causing your muscles to weaken, you are more likely to become sedentary in old age.

Your questions to Novo Nordisk (maker of Ozempic) and Eli Lilly (maker of Monjaro) received either standard responses or silence. How can one address the concerns and disclosure of risks given the lack of discussion about these blockbuster pills?
To be fair, Novo Nordisk didn't interrupt at all but gave a standard planned factual response, but I was very surprised that Eli Lilly declined to comment on anything. All we can do is study the best evidence we have at the moment. One of the things I'm concerned about is that we don't know what the long-term effects of these drugs are going to be. I'm reminded of a phrase Donald Rumsfeld once used about 'unknown unknowns'.

Affluent Indians are getting it from America, West Asia and it is easily available in the gray market…
This is very disturbing. The risks of unlicensed use are very high. These medicines should only be given on prescription by doctors whom you have met in person.

You say Ozempic has put you in a place where you imagine food as fuel for your body, not for your mouth or emotions. Do you still enjoy food?
I'm a little unusual because this increases my enjoyment of food a little. I grew up in a chaotic environment with a lot of fighting in my family and one of the ways I used to control my emotions was to deliberately stuff myself without even tasting it. So, a friend pointed out that now that I'm eating more slowly, I seem to be enjoying it at a much lower level. But the biggest drawback for most people taking these medications is that it reduces or eliminates their enjoyment of food. For example, there's a food critic in the UK named Jay Rayner who started taking Ozempic and was going to the best restaurants in Paris and not getting any enjoyment out of the food, which was terrifying to him.

You remain in conflict until the end of the book. Do you think you might get rid of it at some point?
When I started taking these medications I saw the evidence. For people with a BMI over 27 initially, they reduce the chance of heart attack or stroke by 20%. For me this is such a huge benefit that can literally save me, that I will continue using it for the foreseeable future. But with great uneasiness. This is not an easy decision and I could be wrong. In 20 years, you can go, what a fool you were! But we will know soon.

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