Is Ozempic a Miracle Drug, or Are Americans Just Fat, Lazy, and Gullible?

Is weight loss really as simple as "calories in, calories out"?

At 46 years old, patient X weighs 325 pounds, placing him firmly in the category of severe obesity. The statistics paint a dire picture: a 50% increased risk of all-cause mortality, a threefold greater likelihood of developing heart failure, and a 40% higher risk of 13 different types of cancer. On top of that, patient X faces the imminent threat of type 2 diabetes, which brings its own cascade of complications, from kidney failure to blindness.

If nothing changes, patient X is staring down a bleak road of chronic illness that will leave him dependent on pharma for a shortened lifespan plagued by ill health.

Patient X represents nearly half of the American population—a country in crisis. Obesity rates are skyrocketing, leading to an avalanche of related conditions like type 2 diabetes, heart disease, cancer, and even dementia and Alzheimer’s. Traditional advice to "eat less and move more" has failed to stem the tide.

Enter Ozempic and its pharmaceutical cousins, offering rapid weight loss and improved metabolic health. But are they the miracle solution they appear to be?

What Is a GLP-1 and What Does It Do?

GLP-1, or glucagon-like peptide-1, is a hormone that plays a key role in regulating blood sugar levels and appetite. When you eat, GLP-1 is released from the gut, signaling the pancreas to release insulin and slow gastric emptying. This not only helps control blood sugar but also creates a feeling of fullness, reducing the desire to eat.

Pharmaceutical companies have harnessed this mechanism to create GLP-1 receptor agonists—synthetic versions of the hormone designed to last longer in the body. The first GLP-1 drugs were groundbreaking for diabetes management, but their potential for weight loss quickly became apparent, leading to their use for obesity treatment.

The History of GLP-1s

In the early 1990s, Dr. John Eng noticed that Gila monsters could withstand long amounts of time between eating, an observation that led to his eventual discovering of the exendin-4 hormone. This discovery in turn led to the development of exenatide, the first GLP-1 receptor agonist with a 24-hour half-life, approved by the FDA in 2005 under the brand name Byetta.

Over the last two decades, researchers have engineered even longer-lasting versions, culminating in drugs with week-long half lives like semaglutide (Ozempic) and tirzepatide (Mounjaro), which combines GLP-1 with an additional agonist. The latest innovation, retatrutide, adds a third pathway, promising even more robust effects.

The Benefits of GLP-1s

If patient X began taking a GLP-1, he would notice increased insulin sensitivity and decreased inflammation, resulting in decreased appetite and weight loss. He could expect to lose around 20% of his body weight in about a year. Patient X might even experience a decrease in alcoholism and addictive behaviors such as compulsive shopping, a reduction in autoimmune antibodies, and reduction in risk for Alzheimer’s, cancer, and heart disease.

Research shows these effects exist independently of weight loss (meaning participants saw these benefits even if they maintained their body weight). By what mechanism these effects occur is still unclear, but researchers have suggested it may be via regulation of our reward system (although it does not appear to reduce desire for healthy behaviors), and by reduction of inflammation and insulin resistance in the cases of autoimmunity and Alzheimer’s, which researchers are now calling type 3 diabetes.

Risks and Side Effects

Does it all seem too good to be true? Serious side effects can include stomach paralysis, depression, and pancreatitis. (Notably, these are all side effects of dramatic weight loss and may not be directly a result of the peptide use per se). More common side effects include nausea, omitting, and diarrhea. Most alarming of, tirzepatide has been linked to medullary thyroid cancer in rats.

All of these side effects can be reduced or eliminated by using the peptides at a smaller “microdose,” explains Dr. Tina Moore, who argues that the negative side effects seen in the population at large are a result of the high doses given in the standard pens issued by Novo Nordisk and Eli Lilly, the pharmaceutical companies behind Ozempic/Wegovy and Mounjaro, respectively. Moore has seen success treating autoimmunity and other conditions using tiny doses of these peptides from compounding pharmacies. She advocates using the lowest effective dose and offers a course for healthcare practitioners to learn how to appropriately prescribe microdoses of GLP-1s.

A Hidden Cost?

Even for those who calculate the benefits of GLP-1s outweigh the risks, skepticism lingers. Intuition whispers: there’s no such thing as a free lunch. What is the hidden cost of these drugs? Are they “cheating” when it comes to weight loss? And what kind of society needs a pharmaceutical crutch to counteract its own excesses?

Let’s tackle these questions one at a time. First, history tells us that there is no weight loss pill that doesn’t also cause us to suffer serious physical harm. Amphetamines brought addiction; fen-phen caused fatal heart damage. Critics fear GLP-1 drugs may follow a similar trajectory.

But at the level of individual patients, the calculus is straightforward. For those struggling with obesity, diabetes, or autoimmune conditions, the potential benefits of these drugs to lower the risks of the top causes of mortality in the US often outweigh the risks.

And yet, if nothing changes in patient X’s lifestyle, are we merely enabling his unhealthy lifestyle and potential food addiction while creating a dependence on pharma to save him from a self-destructive cycle of his own ill-begotten habits?

After all, we know that patient X could just “eat less and move more,” right?

The “Eat Less, Move More” Fallacy

“Eat less, move more” has been the common sense weight loss mantra for decades. This strategy does work in the short term. But strikingly, we know from longer-term studies that this strategy is ineffective, at best resulting in a 2% loss of body weight.

It should be obvious to us that the “eat less move more” strategy has utterly failed to provide us with a healthier population, and yet this myth persists. In reality, the complex systems of our bodies are just not that simple. We could do a deep dive on the biochemistry of why that is, and perhaps that is a good topic for another post (Leave a comment and let me know!). For now, suffice it to say that the chemical reactions that take place inside our bodies when we drink 1200 calories of Pepsi are radically different than those which occur following consumption of 1200 calories of nutrient-dense proteins, healthy fats, and fruits and vegetables.

In the health and wellness space, anti-Ozempic sentiments abound. We have the intuition that obesity is a natural problem that ought be resolved with natural solutions. This intuition seems simple enough, but fails to recognize that the obesity we face today is a decisively unnatural problem. The difficulty we have in losing weight and maintaining weight loss is a result of chronic overconsumption of non-food chemical “obesogens” designed to be addictive.

The failure of “eat less, move more” reflects a broader systemic issue. Our environment is flooded with ultra-processed foods, and misinformation about nutrition abounds— often perpetuated by the very organizations tasked with bringing us critical information about what leads to health. The weight-loss industry profits from ineffective solutions, while the healthcare system manages—rather than cures—chronic disease.

GLP-1s might represent an “unnatural solution,” but they do so by addressing the biological mechanisms driving obesity. As Johann Hari argues, our house is burning down. The fact that we need to rewrite a safer building code to prevent future fires (by fixing our food environment and dietary guidelines) doesn’t mean we don’t also need to be reaching for the fire extinguisher.

If patient X can claw his way out of the pit created by Big Food and reduce his reliance on Big Pharma by making use of a tool that will increase his lifespan and reduce his risk of diabetes, heart disease, cancer, and dementia, what exactly is the problem with making use of this short cut?

Or is weight loss only an admirable feat for those who suffer miserably to achieve it?

If we laud the successes of those who achieve weight loss via calorie reduction through restrictive diets or intermittent fasting, why take this tool off the table — particularly when research suggests it has a higher likelihood of long-term efficacy?

Then again, much of the weight loss achieved through the use of GLP-1s evaporates when the drugs are discontinued. It may be that the vast majority of these drugs are being used to mask, rather than resolve, underlying habits that contribute to lifestyle diseases. Are these drugs just another way to create lifelong dependence on Big Pharma?

GLP-1s Done Right

The best-case scenario for patient X, should he decide to use a GLP-1, would be if he used the medication as a temporary tool to implement lifestyle changes that are otherwise extraordinarily overwhelming or practically too difficult for him to maintain his commitment and sustain his motivation.

One of the primary benefits cited by GLP-1 patients is decreased “food noise.” They report that once-pervasive compulsions to overeat and nonstop obsessive cravings go quiet. Patient X should take advantage of this food freedom by cutting out refined sugars and fast/processed foods, shifting his focus to nutrient-dense whole foods that are minimally processed. The drugs can clear a space for him to detox from his food addictions and reset his cravings by allowing him time to adopt new habits and retrain his body to crave foods that are truly nourishing.

He should also be intentional about resistance training and eating enough protein —about 1 g/lb. of bodyweight — in order to maintain lean muscle while in a caloric deficit. If he were to simply cut calories without making these changes, he would still see weight loss, but a significant amount would come from his muscle. (That scenario is a disaster both for weight loss and long-term health as lean body mass is a key driver in both metabolism and longevity.)

If patient X were to use a GLP-1 at the lowest effective dose to achieve a healthy weight, decrease risk of all the aforementioned conditions, and implement lifestyle changes to create lifelong habits before weaning off the medication, he could dramatically improve his quality of life, health span, and lifespan without creating a lifelong reliance on pharmaceuticals.

Who Benefits—and Who Doesn’t?

In reality, patient X is likely already dependent on multiple lifelong drugs to manage the chronic conditions that come with obesity. From statins to manage cholesterol to high blood pressure meds to blood sugar regulators like insulin and metformin, the patient who stands to benefit most significantly from a GLP-1 is already a lifelong dependent on pharma — multiple times over.

This means that, ironically, the biggest threat GLP-s pose is to Big Pharma itself. The greatest financial incentive to keeping Americans sick comes from processed food manufacturers (The Economist has pointed out that as Ozempic becomes more widespread, shares in fast food are falling fast) and those portions of Big Pharma reliant on treating complications of obesity and diabetes. There is no money in healthy patients (or dead patients), but chronic disease means lifelong customers. In the battle for the drugs that most effectively manage those conditions, the makers of Ozempic appear to be winning.

Are GLP-1 drugs a miracle, or are Americans just looking for an easy way out? The answer is much more nuanced than an algorithm-driven click-bait culture would lead us to believe. These medications offer hope for millions struggling with chronic conditions, but they are not without risks. More importantly, they highlight the need for systemic change in how we approach food, health, and medicine. Until we address the root causes of the obesity epidemic, GLP-1 drugs will remain a powerful—but imperfect—solution to a deeply entrenched problem.

Diving Deeper

Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight Loss Drugs by Johann Hari

Drs. Mark Hyman and Tina Moore discuss GLP-1s with Calley Means

Drs. Andrew Huberman and Craig Koniver discuss peptides, including GLP-1s

Naturopath Dr. Tina Moore on micro dosing GLP-1s for autoimmune conditions

Benefits beyond weight loss with PA McCall McPherson

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Health Swap

Swap out your microwaveable popcorn for non-GMO organic kernels that you pop on the stove (we buy ours at WalMart). By taking just a few extra minutes to prepare your snack, you can skip all the ultra-processed obesogens and BT-toxin containing GMO kernels by opting for the stovetop version. Make sure you skip the toxic seed oils and pop in coconut oil or grass-fed butter, lard, or tallow.

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Books: Mama Prays | Reclaiming Motherhood from a Culture Gone Mad