The different day in my major care observe, one in all my sufferers requested me to prescribe Ozempic. She had lately given delivery, and her physique had modified.

“I want my body back,” she advised me.

Did her physique actually go away? I questioned, privately. I’ve had quite a lot of conversations like this lately, spurred by the onslaught of media protection of Ozempic and Oprah’s ecstatic endorsement of its benefits throughout a particular TV section she did this week.

My affected person’s blood strain was regular, her labs seemed good. The solely difficulty was that she had gained perhaps 25 kilos during the last two years, most of which she had spent gestating and breastfeeding a brand new human life. It’s an incredible feat, and it is unsurprising that it required a little bit additional adipose tissue.

She had an extended historical past of dropping and regaining weight, and years of relations pressuring her to be skinnier.

“I’m not sure Ozempic will bring you peace with your body,” I steered, gently. Medically, I advised her, I did not suppose she wanted to shed some pounds.

She was undeterred. “My clothes don’t fit,” she complained.

Was {that a} purpose to begin a weight-loss medicine? Increasingly, my sufferers suppose so.

My observe in New Jersey is full of folks determined to shed some pounds, sufferers who imagine their true selves are smaller than the our bodies they really inhabit.

I’ve written publicly about my size-inclusive approach to medicine – I do not direct my sufferers in direction of weight reduction, and I’ve a loyal following of sufferers who come to me particularly as a result of I do not harass them about their physique measurement.

But for each affected person who seeks out my weight-neutral strategy, I’ve ten who’ve been offered the lie that reducing weight will repair each downside of their life. That fantasy is nothing new, but it surely’s been newly medicalized within the period of Ozempic and Wegovy, a category of medicines often called GLP-1 agonists. And sufferers are exhibiting up at my door, anticipating the promised panacea.

Even Oprah, whose physique measurement has been the topic of nationwide curiosity for many years, appears to purchase the hype.

She publicly announced she was using a GLP-1 medication in 2023. And she advised viewers in her prime-time particular that she’s “releasing the stigma and the shame and the judgment” that include residing in an even bigger physique – one thing she will be able to presumably do now as a result of she’s skinny.

She does not cease to ask if perhaps fats phobia is the issue, not fats folks.

I’ve had sufferers cry tears of frustration once I level out that they’re a “healthy” weight and their labs present no proof of diabetes. Instead of being thrilled they’ve acquired a clear invoice of well being, they’re upset their insurance coverage will not pay for GLP-1 agonists.

I’ve had sufferers confess they imagine Ozempic will give them greater vanity, happier marriages, extra power, much less again ache. People appear satisfied this medicine can do all of it.

It’s actually no shock that my sufferers overestimate the therapeutic powers of this once-a-week injection. Our society is obsessive about thinness. We have a diet industry worth many billions of dollars a year, thriving on – and perpetuating – a pervasive sense that our our bodies are by no means ok. When life will get robust or the information will get insufferable, we’re advised to work on ourselves, squeeze in a little bit self-care: a little bit Peloton right here, a little bit intermittent fasting there.

Ozempic suits in completely, a medical answer to all the issues which can be assumed to return with being fats. Rather than fixing discrimination in opposition to folks with greater our bodies, we inform sufferers to repair themselves.

The new weight-loss medicine have a veneer of respectability – medical doctors prescribe them, in any case – that makes them appear completely different from HerbaLIfe or Weight Watchers. But, like all of the weight-loss guarantees that got here earlier than them, they’re being drastically oversold.

Ozempic and Wegovy sales are estimated at $13 billion a year, a real windfall for Novo Nordisk, the Danish pharmaceutical firm that developed the blockbuster medicine. They have a advertising finances to match: the corporate spent $491 million on advertising in the first half of 2023. With budgets like that, it is no surprise my sufferers appear to suppose Ozempic is a miracle drug.

Doctors are maybe probably the most responsible of perpetuating the parable that weight reduction solves the whole lot. My area’s obsession with physique mass index signifies that a lot of my colleagues zone in on weight reduction as a remedy for each ailment.

“Have you thought about losing weight?” medical doctors ask, when sufferers complain of something from insomnia to scorching flashes to foot ache. Meanwhile, my sufferers share tales of missed diagnoses from medical doctors who concentrate on their weight and overlook that fats sufferers may need different ailments. Fat phobia has grow to be so ingrained within the tradition of drugs that it is onerous to see, except you look carefully.

The weight-loss business tells us that if we simply lose a couple of kilos, we’ll lastly be blissful. But this business has created an issue solely extra weight-reduction plan – or extra medicine – can repair. It tells us that the physique is one thing to be tamed for the whole thing of our lives. If we do not keep vigilant, the kilos would possibly come again. So we maintain shopping for dietary supplements, maintain paying the month-to-month charge for weight-loss apps. And we medical doctors go on prescribing Ozempic.

When I made a decision, at age 22, to grow to be a doctor, I imagined long-term relationships with my sufferers, incomes their belief. I did not suppose I’d be complicit in fat-phobic tradition, peddling weight loss program medicine and all of their false guarantees.

Yet the business is so highly effective, it feels onerous to flee. When I recommend to sufferers that Ozempic may not be medically mandatory, they shrug. They say, “Fine, I’ll just get it online,” at any variety of telehealth companies the place sufferers can self-report no matter weight will get them the prescription.

To be clear: I’m not anti-Ozempic. GLP-1 drugs can clear up sure issues. I fortunately prescribe them for a lot of of my sufferers with diabetes or coronary heart illness, and I’m grateful to the researchers who developed them. And I even prescribe them for individuals who merely need to shed some pounds, since supporting their physique autonomy is my obligation as their physician.

But I need them to know there’s rather a lot these drugs do not do.

They do not undo the harms of weight loss program tradition, distorted physique picture and pervasive weight stigma. They do not change the way in which we have turned consuming right into a morality contest, the way in which the pleasure and ritual of sharing meals with our family members has been weaponized in opposition to us. These drugs do not assist us really feel grateful for our our bodies – our bodies that climb mountains, delivery infants, hug grandparents. They do not repair the informal self-hatred that is been normalized in our fatphobic world.

Watching Oprah’s weight reduction particular, I principally felt disappointment. She shared wrenching testimonials from individuals who felt ashamed to depart the home due to their physique measurement, together with one Chicago-area mother who stated folks began treating her youngsters higher as soon as she misplaced weight.

Certainly, GLP-1 drugs helped a few of Oprah’s visitors with their diabetes and altered the way in which the world handled them, however the true downside behind their struggling is not completely medical. The downside is fats phobia.

This stigma is difficult to cope with, however recognizing it – and understanding that Ozempic is a woefully insufficient instrument to deal with it – is an efficient first step. What if as a substitute of making an attempt to shrink ourselves, we tried to vary our biases? What if we constructed a world the place numerous our bodies are appreciated, not medicated to take up much less house?

For my affected person who requested for Ozempic the opposite day, I advised her that it is regular for our bodies to vary form and measurement over time. She met my eye, via tears, and confessed that she felt like her genuine self – her skinny self – was simply ready to emerge.

“What would it feel like to love your body the way it is?” I requested. My affected person did not have a solution.

Mara Gordon is a household doctor in Camden, N.J., and a contributor to NPR. She’s on Twitter as @MaraGordonMD.