In a society where body weight often attracts harsh judgment, a new class of pharmaceuticals is radically reshaping conversations around health, beauty, and personal worth. Reuters journalist Aimee Donnellan's first book, Off the Scales, provides a compelling and nuanced investigation into this phenomenon, framing the discovery of drugs like Ozempic within the fraught cultural history of body image.
The Stigma of Size and a Scientific Serendipity
Donnellan begins by confronting the pervasive stigma attached to weight, particularly for women. She cites a stark example from 2022, when a columnist for The Times argued that 'fat shaming' was the only solution to the obesity crisis, illustrating a deep-seated tendency to view excess weight as a moral failing rather than a medical condition. It is against this backdrop that the arrival of glucagon-like peptide-1 (GLP-1) receptor agonists feels so revolutionary.
The book thrillingly recounts the scientific journey behind these drugs, a tale filled with chance, rivalry, and dedicated persistence. A key figure is Svetlana Mojsov, a Macedonian immigrant who began postgraduate chemistry at New York's Rockefeller University in 1972. At a time when obesity was dismissed as a simple lack of willpower, Mojsov was fascinated by the biological mechanisms of satiety and metabolism. Her pioneering work led to the creation of a synthetic version of the GLP-1 hormone.
Danish pharmaceutical giant Novo Nordisk later identified GLP-1's potential for diabetes treatment. Their decades of research culminated in semaglutide, a weekly injection that offered superior blood sugar control. During trials, an extraordinary side effect emerged: participants experienced dramatic weight loss, shedding up to 20% of their body mass. Novo Nordisk had inadvertently discovered a powerful, safe chemical treatment for obesity.
A Cultural Phenomenon with Complex Implications
As news of this 'miracle jab' leaked, its use swiftly expanded beyond clinical need. Donnellan highlights this duality through a poignant interview with 'Sarah', a 34-year-old marketing executive. After losing five stone (32kg) on Ozempic, Sarah found her career suddenly accelerating—her professional worth seemingly transformed alongside her dress size. This anecdote underscores a disturbing societal equation: thinner often equals more valued.
The drugs' celebrity endorsement, notably by Oprah Winfrey, ignited a global frenzy. However, Donnellan is careful to avoid presenting GLP-1 drugs as an unalloyed good. She examines the significant side-effects, such as severe nausea, and the trend of non-obese people using them for cosmetic weight loss, potentially jeopardising their health. The author also notes a profound scientific mystery: while GLP-1 receptors are present in the brain, researchers still do not fully understand why these drugs so effectively curb appetite and food obsession.
A Challenge to Free Will and Human Identity
This unknown mechanism raises profound questions. If these compounds can quiet the 'incessant chatter' about food, could they be licensed in future to treat other addictive behaviours related to drugs, alcohol, or gambling? What would this mean for our fundamental concept of free will? Donnellan positions Ozempic not just as a medical breakthrough, but as a rebuke to a century of blaming individuals for their weight and a challenge to our understanding of human desire and restraint.
Off the Scales masterfully navigates the intricate web of science, commerce, culture, and ethics spun by the GLP-1 revolution. It is a fascinating deep dive that insists we look beyond the scales to see the full human picture.
Off the Scales by Aimee Donnellan is published by 4th Estate (£20).
