By Soma Das
Is obesity a disease or a moral failure, a sheer laziness to work on your will to reduce weight? Those who thought being fat is being lazy are still living in the ‘dark ages of obesity management’, claims obesity specialist Dr Alexandra Sowa, in her new book The Ozempic Revolution. The new generation of weight-loss drugs, Ozempic (from the Danish firm Novo Nordisk) and its cousins (the likes of Wegovy, Zepbound, Maunjaro, drugs that are Glucagon like peptide-1 receptor agonists or GLP-1 drug) are helping Dr Sowa’s patients melt their fat and simultaneously correct underlying metabolic disorders like never before. No wonder she calls them her ‘power tools’.
For most people suffering obesity, diets and exercises cannot do it alone, no matter how hard they try, because obesity is a ‘chronic, complex and progressive’ disease, the underlying causes of which we are still figuring out, she says. GLP-1 drugs are giving heavy-set people a chance at a healthier life they never had, but drugs alone won’t sustain the miracle of weight loss forever for them unless they combine it with healthy habits, food-choices and behavioural shifts in the long-term. That’s the core message of this new work—bookish offering on weight-loss drugs in the self-help genre, that liberally dispenses with tips on habits you need to cultivate (she dubs it habit foundations), diet changes you need to make (food foundations), and alterations in thoughts and attitude you need to make (mental foundations) for the life-long GLP drug regime to work in your favour to keep your weight down, and your health profile up.
A doctor’s guide
The book, written in accessible style, is clearly designed for people planning to start their journey on a weight-loss GLP-1 drug or those who are already on them. It uses GLP-1 drugs as a conduit to launch useful tips around good habits that weight-watchers must inculcate such as checking their weight every day, food-logging which means journaling what you ate, when, how hungry you were then, and what mood you were in, and planning your weekly menu in advance; making food-choices such as eating your protein first, not skipping meals and eating in 12-hour windows, and keeping yourself hydrated.
Interestingly, the obesity medical expert finds that once people lose about 10 pounds, many of them start self-sabotaging by dropping off the drug regime. She also discovers during her patients’ journey that at times family and friends may be our worst companions during the Ozempic journey. With preconceived notions, they can be quite unforgiving and judging of the process that can prove to be emotionally triggering for people undergoing weight-loss drug therapy. How convinced you are with the author’s indirect advice to not reveal to such family members that you are on a weight-loss drugs regime is a decision you must fully evaluate keeping your own personal conditions in mind. The book offers answers to FAQs (frequently asked questions) for life with weight-loss drugs, addresses anxiety about side-effects, and even curates a set of recipes for people on weight-loss drugs. It goes a step further to offer tips to navigate insurance companies for coverage of these drugs (in the US, of course) and asks you to choose a doctor wisely who can help you with this process.
The Fangirl
The author, an unapologetic fan of the new generation of weight-loss drugs, gushes over the ‘superpowers’ of GLP-1—how it regulates your blood-sugar, how it turns the hunger volume down, so you naturally eat less, how it talks to the brain from the gut to regulate appetite and food intake. At times, even while discussing the possible side-effects, the book can seem too smitten by the new generation of weight-loss drugs. “For Almost Everybody, the Side-Effects are Manageable,” the book says in highlighted italics. And there lies the point of discomfort with this book—this ‘superpower’ of the obesity drugs is wielded by the hands which prescribe them—the obesity medicine experts.
This means that in addition to people who may feel empowered by losing weight, the set of people who perhaps feel most empowered by the birth of these medicines is those who prescribe them. Tucked inside the book in one of the middle chapters, there is an admission somewhere: “It’s clear that I am biased. I love to prescribe these meds when a patient’s history and labs support it”. It’s difficult to not take this confession seriously. Elsewhere, she writes “I had so many tools to offer, but it still wasn’t enough. I often incorporated the older generation weight loss meds in my treatment plans… tended to have marginal benefits. And then came GLP-1. It was like Dorothy landing in Oz and seeing the world in Technicolor for the first time”. This lens of a fangirl and at times a touch superficial treatment can sometimes make the reader feel whether objectivity is being compromised while discussing serious topics. Sample this: “If you are on a company health plan, you can also begin to lobby your human resources department to cover these drugs in the future”. Though this advice is being made in the US context, coming from a doctor, this can feel uncomfortably promotional in tone to some readers, at least in the rest of the world. It is important that that we start hearing about the experience with this drug from other perspectives from across the world.
GLP-1 drugs are not only reshaping the waistlines, they are also reshaping the world we live in. Just like Ozempic, many books that will be written first on them, will go on to become bestsellers. Not all of them will be for everyone. The Ozempic Revolution is a user-guide, an obesity doctor talking to her patients—existing and prospective. If you are one of them, you may find this useful. If you have picked this book expecting to read about the world-shifting revolution Ozempic and its cousins are bringing to the humanity, you will be disappointed. In that event, you can use a tip this doctor-author gives to her patients—be kind to yourself, always.
Soma Das is the author of The Reluctant Billionaire and an adviser to agencies in the development space.
The Ozempic Revolution
Alexandra Sowa
HarperCollins
Pp 256, Rs 499
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