Are weight loss injections are changing the conversation around body image?

As I approach my late twenties, some of my friends have been asking me to tell them about my wedding plans a year in advance only so that they can get on Ozempic to fit into their outfits. The much sought-after drug has taken over the world so much that even American television host Jimmy Kimmel couldn’t resist joking about it in this year’s Oscars monologue. Social media posts of celebrities like Khloe Kardashian, Mindy Kaling, and Julia Fox often have their followers guessing if they’ve been using weight loss injectables. The demand for these has seeped into the upper layers of society and no one’s making a secret of it.

Dr Roshani Sanghani, American board certified endocrinologist, attributes the rise in the demand for weight loss injections to the obesity epidemic that has plagued the planet. “The increasing consumption of processed and unhealthy food, erratic sleep, and stress management patterns, lack of exercise, and binge eating are all contributing factors”, says Dr Sanghani, who is also the founder of Reisann Health and author of Turn Around Diabetes. This comes as no shock with India ranking third globally in obesity, according to a report published in the Economic Times this year.

Just like Ozempic, Mounjaro and Zepbound have also become rapidly relevant after the wonder drugs received the green light to be imported and marketed in India. With #Ozempic amassing over a billion views on TikTok, its counterparts are likely to do the same now. Social media has a massive role to play in popularising these medications, especially when influential figures like Elon Musk post about taking Wegovy, an injection that is intended to treat obesity, just to look “fit, ripped and healthy”. 

“Until 2022, more than 90 per cent of these weight-loss drugs were only prescribed by endocrinologists and metabolism experts for health concerns, such as obesity and diabetes,” reveals Dr Arti Thangudu, endocrinologist and CEO of Complete Medicine. Ever since celebrities have reportedly started using these medicines and showing results, the demand for them skyrocketed, she explains. The cultural obsession with being thin mixed with the efficacy of these medications are driving factors for their popularity. The media-fuelled frenzy of these drugs to achieve a conventionally attractive body shouldn’t be taken lightly.  

Ozempic and Mounjaro are prescribed for treating Type 2 diabetes with severe weight loss being a by-product of their prolonged usage. Zepbound and Wegovy were created to treat obesity specifically after making lifestyle changes. It’s not difficult to understand the workings of these drugs. Ozempic contains semaglutide, which replicates the hormone GLP-1 to stimulate insulin production along with reducing appetite. Mounjaro and Zepbound work similarly, but instead of semaglutide, these use a molecule called tirzepatide to stimulate two hormones—GLP-1 and GIP. “Semaglutide and tirzepatide work to increase insulin and act on the brain signals of satiety, causing food digestion to slow down, resulting in a reduced feeling of hunger,” explains Dr Mikhil Kothari, a Mumbai-based consultant diabetologist. In simple terms, this whole class of weight loss drugs tricks our body into feeling full after a meal, which reduces our appetite. This helps in achieving caloric deficit—the most vital factor in any weight loss journey.

Extensive research around the effects of these drugs along with results have shown that these can help to lose up to 12 per cent to 22 per cent of body weight. A 72-week long study conducted by drugmaker Eli Lilly in 2023 showed that patients taking tirzepatide lost between 15 per cent and 21 per cent of their body weight. “Even though you can spot the results in the first week itself, these drugs have a tendency to cause gastrointestinal side effects, among many more,” says Dr Kothari. Extreme fatigue, nausea, vomiting, and diarrhoea are a few more side effects.

Many endocrinologists such as Dr Sanghani steer clear from prescribing these drugs owing to possible negative consequences. “The weight loss caused by these drugs isn’t only fat loss, it is muscle loss which negatively impacts the metabolism of the body,” she elaborates. Since Ozempic and Zepbound are used to treat a chronic disease like diabetes, their usage is meant to be continuous. She warns that if the drugs are stopped, the weight that was lost “will be regained” because the body’s appetite will go back to normal. 

These extreme side effects aren’t visible with non-invasive weight-loss procedures such as EmSculpt NEO. Contrary to weight-loss drugs which cause a massive muscle loss, this procedure plays a crucial role in reversing the effect. “It typically focuses on reducing fat volume and enhancing metabolic processes without major side effects,” explains Dr Geetika Mittal, medical director and founder of ISAAC Luxe. EmSculpt NEO is a relatively new procedure that aids in fat loss and muscle building at the same time. It uses radio frequency energy to induce intense muscle contractions which drastically improve muscle tone.

She explains that these muscle contractions are equivalent to multiple crunches—as many as 24,000—contouring the body. Areas of the body such as the abdomen, arms, buttocks, and thighs will show results after a few sessions of the procedure. Dr Mittal says that a typical EmSculpt NEO session lasts for 30 minutes and it’s recommended to opt for four to six sessions to achieve optimal results.  

While these weight-loss drugs and procedures seem like a quick fix from the outside, they aren’t meant to be relied on as the solution to a far pressing problem—obesity. Lifestyle management that includes the right level of fitness and correct nutrition are always recommended as a stepping stone by doctors before any drugs and procedures are added to the mix. It’s no secret that there has been reported usage of these for cosmetic purposes instead of their intended use, which can impact the body in damaging ways. However, Dr Thangudu says that a large percentage of people who are opting for these drugs have failed at incorporating the right level of fitness and correct nutrition into their lives. Medical experts believe that the growing popularity of these medications is an opportunity for us as a community to look our biases in the face and address them with compassion. 

This article originally appeared in the Harper Bazaar August-2024 print issue.

Image credit: Pexels

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