If you could take a drug to lost weight easily would you?

Unless you've been living on a different planet for the past few years, you cannot fail to have heard of the new category of super-powerful weight loss drugs like Ozempic and Wegovy. These drugs promise the ability to lose weight effortlessly by directly intercepting and interfering with your bodies natural hormones that impact on hunger - or more specifically, the hormones which determine your satiety ie. when you feel full.

Those who take these drugs (a weekly injection) feel their hunger cravings disappear and, when they do eat, feel fuller sooner and therefore do not eat as much as they would have done previously. The net result is that they lose weight. And in many cases they lose weight quickly.

As I've read more about these drugs, and in particular as I've read the journalist Johan Harri's excellent book on his experience taking Ozempic - Magic Pill (The Extraordinary Benefits and Disturbing Risks of the New Weight Loss Drugs) - I've found myself conflicted about them.

Uneven battle

Like many of you, I struggle to make the right food choices all of the time, even though as a health coach I know far too much about what bad food choices can do to us.

The problem is that every day we find ourselves in a very uneven battle for our health between our best intentions, and the huge multi-billion dollar big food business. These companies invest millions in developing hyper-palatable processed foods that are chemically designed to hit all of our evolutionary triggers for high calorie, fatty, sugary and salty food.

On top of that they invest even more millions in advertising and product placement to ensure that we are exposed to and then crave these foods.

At the moment Wegovy is only available on prescription in this country for those who have a BMI of 35 and at least one weight-related health condition such as hypertension or cardiovacular disease (but with a little bit of internet scrolling you can easily find it available privately at around £130 a month).

Of course how somebody becomes obese and reaches a BMI of 35 is not always the resiult of a straighforward and linear relationship with their consumption of processed foods. There are often many other complex genetic, environmental and psychological factors involved.

But I cannot help thinking there is something deeply unsatisfactory, and perhaps even sinister, about a society where big food encourages us to gorge ourselves on hyper-palatable processed foods, and big pharma comes to the rescue with a drug that can help us reduce our weight.

Side effects

So as a health coach where do I stand then on whether people should take these weight loss drugs?

Well, my starting position is that if you are at risk of severe illness as a result of your weight then you should of course do whatever you can to reduce your weight and reduce it quickly. If a weekly injection does this, then go for it. You wouldn't argue about the efficacy or otherwise of different approaches to fire prevention if your house was on fire, you'd put the fire out as quickly as possible.

But for those not in that situation, I think the arguments are more nuanced.

For a start there is no long term data on the side effects of these drugs. There are potential markers (albeit very small) for an increased risk of thyroid cancer and an increased risk of suicidal thoughts that are being closely monitored.

Then there's what happens when you come off the drugs. The evidence seems to suggest that you put weight back on again when you stop injecting yourself (assuming you haven't fundamentally re-examined your relationship with food). Unless, of course, you're planning to take the drugs for the rest of your life and then there's a concern that their effectiveness will wear off after time.

And finally, and I think most importantly, there is the issue of the underlying behaviours that may have led you to eat poorly and gain weight in the first place. Johan Hari writes at length about this in his book. We know that many of us eat for comfort, to manage stress or anxiety, or even to self-sabotage. The drugs do nothing to address the factors influencing these behaviours.

So where does that leave us?

I do think the advent of these drugs is a really important development in our society. The huge exponential growth in obesity in our country over the past 30-40 years or so is undeniable. The correlation of that growth with the proliferation of hyper-palatable processed foods is also undeniable.

Maybe they will trigger us to start aksing the question as to whether drugs are the answer to our obesity crisis or whether we should be asking ourselves instead about a food culture which allows our kids easy access to cheap, junk food, or where it's easier to feed a family on processed food than healthy, nutrtious whole food.

Would love to hear your perspective on these drugs. Would you take Ozempic if you could?