What will the Ozempic World Look Like?

Hunger is one the most powerful and essential ways our bodies communicate with us. Put simply, hunger prioritizes the need for food as sustenance and for survival.

The meaning of hunger has changed greatly due to a transformed food supply for many countries in recent decades. After centuries of food scarcity as the obstacle to survival, humans created societies with bountiful food, more than can be eaten and often with a huge amount of waste.

We aren’t designed to know how to handle excess food. Hunger is an acute feeling intended to focus all senses and thoughts on procuring food. Subtle hunger cues can be harder to assess, but the plentiful food for many people obfuscates hunger cues altogether.

The new world of excess food opened the door to many new approaches and industries aimed at manipulating our dulled hunger cues with the supposed intention of improved health but mostly aimed at weight loss.

These factors include diet culture, the obsession with thinness, unsubstantiated nutrition suggestions and ill-researched medical recommendations. Almost all of these ideas infer that our hunger cues are actually misleading. Instead, these new guidelines purport to show us the best way to eat.

Even though medications have suppressed hunger cues for decades, the new GLP-1 agonists practically turn off hunger for prolonged periods of time. No previous intervention has been so powerful. The advent of the medications—in addition to the over-valuation of thinness and limited attention to adequate nutrition—is posing new hazards to our well-being.

Typically, suppressed hunger led to significantly increased appetite, binging and weight gain. The body overreacts to long periods of undereating with a strong hunger response meant to promote survival. Older medications, Bariatric surgery and dieting all triggered subsequent increased and often uncontrolled hunger. Although people experience this reaction when going off these new drugs, what happens if they stay on them indefinitely?

The jury is out at the moment about long-term outcomes. If there are no unforeseen side effects that lead to pulling these drugs off the market, the GLP-1 agonists and the even more powerful medications coming down the pike are here to stay.

As physicians, we are likely to see people with similar medical consequences as with Anorexia or with other appetite suppressing interventions. Slowed digestion and gastrointestinal functioning is an inevitable and often a permanent result of decreased eating. Chronic malabsorption of various minerals and micronutrients can cause a host of diseases rarely seen in medicine and thus hard to diagnose. Slowed cognitive functioning almost always results from decreased nutrition. And this is just to name a few.

My best guess for the results in a society using this new medication routinely is a generally thinner population with chronic medical and psychological effects from the long-term effects of malnutrition. As much as medicine continues to conflate weight and health, we as a population will talk about getting healthier while in many ways we get sicker. It will be up to the country at large to decide if the sacrifice is worth it.