Jia Tolentino on Ozempic’s Breakthrough Benefits and Risky Downsides

During his opening monologue at this month’s Oscars, the late-night host Jimmy Kimmel joked about Ozempic, a weight-loss drug that is rumored to be in wide circulation in Hollywood: “When I look around this room, I can’t help but wonder, ‘Is Ozempic right for me?’ ” Developed to fight diabetes, Ozempic and similar drugs are now being deployed far beyond the medical uses for which they were designed—as a tool to control blood sugar for those with diabetes. Lots of people looking to lose ten or fifteen pounds are taking the drug as well. What are the consequences?

The New Yorker staff writer Jia Tolentino reported on Ozempic in this week’s issue, examining the drug’s benefits for those who need it and its impact on those who don’t. Tolentino, who has written about changing beauty standards in the age of Instagram, now considers how Ozempic alters and exacerbates biases about fatness, thinness, and various methods of losing weight. She recently spoke with me for The New Yorker Radio Hour about her reporting on Ozempic, including her efforts to acquire the drug by mail. Our conversation has been edited for length and clarity.

Let’s start with the drug itself. What is it supposed to be used for, and what is it actually being used for?

Ozempic is part of this relatively new class of drugs called GLP-1 receptor agonists. They have existed in some form since 2005, so they’re not totally new, but they are fairly new. Ozempic was first approved, in 2017, as a treatment for Type 2 diabetes. It’s a substance called semaglutide, and the same substance was approved as a treatment for obesity under the name Wegovy in 2021.

How does it help you lose weight? Because that’s what we’re hearing about—we’re hearing about Ozempic as a weight-loss drug now.

Right. These drugs, these GLP-1 receptor agonists, the reason that they help people lose weight is because they replicate a hormone that our body produces naturally, called glucagon-like peptide 1, and this hormone—to oversimplify it, just a little bit—our body produces it after we eat. It lowers our blood sugar, it kind of balances our blood sugar, and it also produces the feeling of satiation.

So it makes you feel full.

It makes you feel full, which is one of the reasons people, quite simply—they can’t eat as much. One doctor that I spoke to compared it to a turkey dinner in a pen.

[Laughs.] But how come I never heard of it a year ago, and now I hear of little else?

One of the things that has made the Ozempic conversation a little bit confusing and misdirected is that the most prominent users are celebrities who don’t ostensibly need it. We all heard about it, probably for the first time, through reports of celebrities that had suddenly lost, like, forty pounds and were posting bikini pics, but saying that it was just because they worked out a lot. It became this big thing in the popular consciousness because of how skinny all these celebrities were suddenly getting, and how people were talking about it: [that] there was this sort of miraculous hormone shot that you could get, and suddenly you would be skinny, which I think is a pretty significant misrepresentation of what the drug actually entails—and, certainly, as you were noting, what it’s actually meant for.

So Ozempic is not something you can take as a pill—it’s an injection?

No, despite all those jokes of “Everyone’s doing Ozempic in the bathroom at the Oscars.” There is a version of a drug like this that can be taken via pill, but [most versions are] a weekly injection. And, crucially, these are drugs that were designed and intended for lifetime use. Obesity and Type 2 diabetes—they’re considered chronic conditions. [The drugs] were designed for, effectively, weekly injections for the rest of your life, to control your weight or your blood sugar. I think that signifies that they’re not meant for casual use. [Users are] not meant to go on it and go off of it. They’re meant for people who are experiencing weight- or blood-sugar-related health issues significant enough that—

So, if you’re ten or fifteen pounds overweight and you want to get down to what you think is your ideal weight, however wise or misbegotten that might be—if you think Ozempic is going to help do the trick, how would you counsel someone after the reporting you’ve done?

A lot of friends have asked me, in reporting this piece. [Laughs.] The thing is, also, it’s quite easy to get this drug.

Consider me one of your friends on this. [Laughs.]

Yeah, I’ve noticed from your text messages, you seem to be quite interested.

Exactly, because I’m sick of the gym, and I want to eat a bagel once in a while.

Well, the thing about this—you might not be able to eat a bagel. There are wild side effects that you get from messing with your most fundamental metabolic processes. A few people vomit and get diarrhea so bad it sends them to the E.R. It’s not this casual thing.

From Ozempic you can get that?

Yeah. You know how, after bariatric surgery, you hear people really can’t eat the same way that they used to, right? They’ll get quite sick if they eat any more than a really small amount. The same is true for Ozempic, and, very specifically, if you eat anything fatty or highly caloric. You will get physically ill. So it’s not the kind of thing where you get a shot and you eat as much as you want forever. You’ll actually get quite sick if you do that. But what I would tell my friends is that there is no large-scale safety data [for people who don’t medically qualify for prescriptions]. These drugs have not been tested in large numbers in people who do not have obesity or Type 2 diabetes. Another, maybe more pragmatic thing is that clinical trials show—as these drugs were intended for lifetime use—that, once you stop using them, the weight does come back on. You’re supposed to get blood work every three months to make sure that your kidneys and pancreas and gallbladder haven’t failed you. Something that came up so often, people would be, like, Should I take it? Is it good or bad? It’s like any technology: it’s very complicated. For some people, this drug might save their lives, and for others it just does not make sense to me to use in any casual way.

You write about the Kardashians in your piece. How did they get to be part of this story?

I think it is an undeniable fact of our contemporary reality that the Kardashians have been—I think I use this phrasing in the piece—they’re sort of the weathervanes of how the winds of the beauty standard are blowing. And they are rumored to have been early adopters. Certainly that has not been confirmed, but they had been famous for a certain kind of body that had become the social-media beauty standard, and they had been known for a look that was significantly curvier, and they just started shrinking at some point in the last two years. A lot of other celebrities have also shrunk, and this is when the drug started to seep into the popular consciousness and people were, like, What is going on?