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If you don’t know what ‘food noise’ is, you probably don’t need Ozempic

If enduring weekly injections, nausea and potential muscle loss seems better than being fat, something other than personal choice is at play

The hype surrounding the drugs such as Ozempic takes the focus off the ultra-processed foods that are slowly destroying our health while thickening our waistlines. Photograph: Joel Saget/AFP via Getty Images
The hype surrounding the drugs such as Ozempic takes the focus off the ultra-processed foods that are slowly destroying our health while thickening our waistlines. Photograph: Joel Saget/AFP via Getty Images

Nestlé has just launched a frozen food range to cater to the reduced appetites of users of semaglutide (better known by its commercial names, Ozempic and Wegovy) and tirzepatide (Mounjaro or Zepbound.) Yes, that same company that brought you the Aero bar, Smarties and Kit Kat and in the 1970s, pushed baby formula in the developing world despite links between unclean water used in formula and thousands of infant deaths. In case you think it uncharitable to mention something Nestlé did more than 50 years ago, this year it was revealed that Nestlé adds sugar to baby food in low and medium-income countries but not in Europe.

Sugar is bad for babies. It can pave the way to obesity and cardiovascular disease. But never mind — when you need the hot new weight loss drugs, you can buy a minuscule portion of Nestlé frozen healthy food.

The hype surrounding the latest drugs takes the focus off the obesogenic environment, and off the ultra-processed foods that are slowly destroying our health while thickening our waistlines. This May, the Financial Times (FT) found that US food and soft drinks-related companies spent $106 million on lobbying in 2023. That eclipses tobacco and alcohol industry spending and in fact, is almost twice as much as those industries combined. The FT describes this as a “ferocious campaign” to avoid regulation, using well-worn tactics of “deny, denounce, delay”.

How about we ease off on judgment of anyone using the latest class of weight-loss drugs for not strictly medical reasons?

Why is the demand for weight-loss drugs so high? There is no one easy answer. However, decades of the food industry creating Frankenfood to hit so-called bliss points, that is, combinations of additives, unhealthy fats and carbs that overwhelm the body’s natural resistance to overeating, cannot be unrelated.

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How about we ease off on judgment of anyone using the latest class of weight-loss drugs for not strictly medical reasons? In particular, let’s not judge individuals for not doing things the painful way of eating portions sized for a six-year-old and never touching a carb because chances are high they are veterans of every diet since an undertaker called William Banting popularised low-carb diets in 1826.

Like me, they have probably counted more calories than a 100-year-old nun has counted beads on her rosary. They have felt elation when the scale tells them their body is moving towards acceptability and slumped in dejection when it announces failure, yet again. Time after time, they have defeated the old enemy, avoirdupois, only to watch it creep back, wrap itself around them and attempt to smother them.

If paying lots of money for drugs that if purchased online have a reasonable chance of being fake, injecting them, enduring symptoms like nausea and constipation, and potentially losing vital muscle seems like a better option than being fat, something other than personal choice is at play.

Ultra-processed foods are as damaging to some people’s health as tobacco. Just as some people can smoke and never get cancer, some people can indulge in ultra-processed foods and never get fat

Let’s focus on why they need these drugs in the first place.

Ultra-processed foods are as damaging to some people’s health as tobacco. Just as some people can smoke and never get cancer, some people can indulge in ultra-processed foods and never get fat. But for others, they start the relentless scream of food noise.

Semaglutide and tirzepatide turn off that food noise — the relentless obsessing about food that torments people with excess body fat. (Either you know what that means or you don’t. If you don’t, you are probably thin. Surely this disparity is worthy of non-drug-related research?)

Why do some people never suffer from food noise and just go about their day, perhaps wondering occasionally why their heavy friends don’t just eat less and move more? Meanwhile, members of the same family may look at their skinny siblings and wonder why they got an off switch that makes maintaining a healthy weight easy.

Some people state triumphantly that the fact that the drugs turn off food noise is proof that obesity has a biological basis. All the moralising about fat people being lesser human beings devoid of willpower was wrong all along.

The new holy grail is finding a drug that reduces fat without reducing muscle mass but surely an overweight elephant is waving a question mark in the room

Well, that’s nice, but why? Once drugs like these exist, those questions may never be asked. Just take your semaglutide or tirzepatide, like a good girl, and join the rest of us over here in the corner of the schoolyard where the popular ones hang out.

These drugs also blur the line between weight loss and fat loss. In the original trials for semaglutide, 39 per cent of the weight lost by adults with obesity was lean mass, or muscle, which is vital for maintaining metabolic health. In older adults, sarcopenia or loss of muscle is associated with frailty, falls and other health risks. Furthermore, when people come off these drugs, they primarily regain fat, not muscle. Resistance training and high-quality, protein-focused diets are the only way to avoid it. But these drugs make you lose your appetite so who is going to do that?

The new holy grail is finding a drug that reduces fat without reducing muscle mass but surely an overweight elephant is waving a question mark in the room. Why is there an obesity epidemic in the first place and who profits from it?