This drug is going to have huge benefits for health, well-being and the economy. Why the weird fixation on ways it could reduce corporate profits?
Josh, super excited to read this piece. I’ve been taking Wegovy since April and have gone from 203 lbs to 146 lbs with minimal side effects. This drug has truly been a miracle for me - my confidence is way up, I have more energy, I look and feel better - and all of this directly contributes to my performance at work.
An unexpected effect was the impact it had on my drinking. I went from drinking a bottle a night (!) to maybe a glass a week - what a massive difference not just in my pocketbook but also to my mental health.
I’m right there with you - this drug is a game-changer. You’ll have to pry it from my cold, dead hands. Looking forward to following your journey!
The Pill. That’s what came to mind when I read this. I’m neither a doctor nor a sociologist but it’s seems The Pill was a similarly transformative drug. It changed the destiny of so many women, by easily controlling that which had previously been very challenging to control. That’s what it sounds like when I read your description of semiglutides.
And what did women do with their reproductive freedom? They worked! More of them got jobs, and more of them stayed on the job for longer.
Obviously this will look different with semiglutides in some way (again, neither a doctor nor a sociologist) but it establishes how a single pill unlocked extraordinary economic activity in the not-too-distant past.
All our lives, my brother has been overweight, while I have been thin. We grew up eating the exact same food, and as kids, my brother was much more active than bookworm me. And yet on the same diet, he stayed heavy and I stayed thin. (My mom has been overweight her whole life, while my dad is thin, so a genetic explanation seems likely.)
My brother started taking one of the Semaglutide drugs (not sure which one) several months ago, and he has lost 60 pounds. He looks and feels great and is able to exercise and enjoy life because his knee pain has almost disappeared. The drug sets up a virtuous cycle--the weight loss removes the barriers to exercise and other healthy behaviors, which leads to further improvements in health and happiness. The drug has given him what I have been lucky enough to have naturally.
I am so glad to hear that Wegovy is working for you too, Josh. Once the cost issue is dealt with, there really will be no downside to these drugs.
I love that Josh is talking about this. I know he's written about struggling with his weight and food issues before so I was curious if he was going to take the plunge - and he did! So it'll be interesting if he chooses to continue to write about it as he increases his dose.
I myself am on Mounjaro. As a backgrounder, I'd been a student athlete in high school and college (gymnastics) and worked out regularly after that. As a gay man not in a relationship I felt pressure to look a certain way and there were points during that period in my twenties and early thirties where I verged on developing an eating disorder because I was so compulsive about my food intake. I have a lot of willpower so I was obsessive about counting calories and fat grams while regularly doing 50+ minutes of cardio 6x a week while burning 800-900 calories at the same time, usually preceded by an hour of heavy lifting. I remember waking up from hunger pains sometimes and how happy it made me to be in such control of my body.
As my career advanced and I met my husband keeping my body in top shape mattered less so I allowed myself to eat "forbidden foods" I'd always avoided - things like ice cream, pasta and baked goods. I really packed on some pounds during the pandemic (who didn't) and was diagnosed with hypertension as a result, so I decided to try Mounjaro. I've lost 35 pounds over 6 months and now weight around 180, which is a good amount on my 5' 10" body. I don't have my six pack anymore but I also no longer care. Better yet, as Josh mentions, it's calmed obsessive thoughts about food. Food is still good but I don't think about it as much - and I often have to remind myself to eat. Rather than make elaborate meals I'm sometimes fine with a microwaved sweet potato with cottage cheese (one of my favorite quick meals). I've also begun intermittent fasting, eating only 8 hours a day and not counting calories and it's made that a cinch too.
I have a friend who's also on Mounjaro and she's slightly OCD. She said it has calmed her thought process as well as controlling her eating. We're getting ancillary reports of these drugs lowering people's desires for drugs and alcohol too. In my mind, other than their cost - I think they're miracles. I hope more people try them and experience the same good things Josh and myself have as well.
My history is very similar to Josh’s - needing to apply a significant amount of mental bandwidth to self-denial and consistent control over my choices, which is difficult to manage (especially in the evening when my brain is done making decisions). My weight range has been comparatively insignificant to some others, but it’s been significant to me.
I started Ozempic about three months ago, and while I didn’t have an immediate reduction in the mental piece - that honestly took a couple months and some dialing in around dosage - the other features of a semaglutide (like slowing digestion) was enough to start the process.
Also, as an unexpected side effect, I’d spent about a year with “undifferentiated” (which is to say unpredictable and non-understood) breakouts in hives, which was taking a whole plethora of anti-inflammatories to keep under control, and those went away immediately. Still no idea why.
Chris, I think you can tell when Matt Levine is expressing an opinion or when he’s conducting a thought experiment, and I thought this piece was the latter. :)
I pretty much agree with this whole piece. Not taking Ozempic, but would in a second if it was affordable. Care to ballpark how long ordinary folks will have to wait on market forces to bring costs down?
From a different perspective, any thoughts on whether some people will start taking it but then give it up because they want their impulses back?
You mentioned you could write more easily on an empty stomach, but have you experienced non-diet related changes to compulsive behaviors?
Though I love to read and listen to Josh, and Ken, because of the clarity and wit of their brains, and have avidly followed Josh as an intellectual and public person for his ideas and articulation thereof, (since I first heard him as host on LRC) this sentence is easily my single favorite thing he's written, and what I most deeply relate to:
"I relate deeply to this — I never forget to eat. In fact, it feels like there’s a voice constantly mumbling in the back of my head “eat eat eat” — and all the efforts in my life to keep off excess weight have involved fighting that voice. When I have won that fight, it’s been through constant vigilance..."
Say what you want about the internet, but 25 years after hearing that crazy dial up modem connection sound for the first time, I am able to read an article that considers pharmaceutical impact on monetary policy through a loanable funds framework. (Although, to be balanced here, I must reluctantly point out you *did* in a somewhat cowardly move sidestep any stance on knock on forex impacts via interest rate parity). What a time to be alive.
Matt Levine writes my other favorite newsletter, so it's exciting to me when I see cross pollination.
I think this class of drugs seems promising. I will flag, though, that we should be prepared for the inevitable discourse about "inequities" and access for "black and brown bodies" and whatnot. Here's to hoping that, as these drugs become more widely available and more broadly affordable, we can get it to anyone who is advised to take it without tedious arguments about who is most deserving, most disadvantaged, whose weight struggles are the result of oppression and whose aren't, etc.
As someone with a similar relationship to food/weight, I'd love to hear as much as you're willing to share about the process of getting - and taking Ozempic.
I'm still baffled that Matt Levine wrote that piece under his own name.
I have enough faith in progress that I’m assuming that these drugs will be available to the rest of us soon. I lost 75 lbs on an ultra low calorie fast diet (meal replacement to go into ketosis) in 2017. I exercise a lot (90-120 minutes a day to maintain that loss but I struggle with food and I would love to think about it a lot less. I gained about 20 lbs during the pandemic and I am not eager to obsess about food to get it off. My doctor thought one of these drugs would be more available within a year so hopefully I can drop that gain sooner than later.
I had not interest in these drugs until I read this article. I don't *need* them, I'm 6' and 180 lb, and I work out or run 3 or 4 times a week. My diet is fine...but I eat too many snacks, too many sugary snacks in fact and I drink too much beer. And I don't like that.
Josh, I wish you success and appreciate your analysis.
If it plateaus, I can say from personal experience that anxiety can keep you thin, though I wouldn't recommend it.
Can you drink alcohol on it? I’m not sold on how this realistically solves obesity. Kinda like Suboxone for opioid addicts? I’m for anything that makes life easier, but I’m skeptical.