Mounjaro and Me

Photo: Jasmin Merdan/Getty Images

Two months ago, I overheard two friends talking about “ozone face” at a party. I only heard the end of the conversation, but it was enough to pick out the tone of judgment in their voices, and the look of horror at the idea of ​​women taking these new “diet pills.”

My hair is standing on the back of my neck and I feel a lump in my throat – I'm trying to say the drug doesn't really age Your face, it's just a change that happens when you lose weight, but I weakened. I'm usually immune to well-intentioned, casual comments about weight and health: from dietary trends to new exercise regimens, from talking about how obese people should be more health conscious to the idea that obesity itself is an epidemic.

But this time is different. Unbeknownst to my friends, I was already on one of these medications. I'm too ashamed to say it out loud, but the meds are working and I'm not sure how I feel about it.

I'd like to say it all started six months ago, but it doesn't.

I've spent most of my life as a “curvy” girl — the “you've got a pretty face” girl — but didn't fit into a standard size until the last few years. As my size has changed, so has the way the world treats me – eye rolls when I get a seat on a plane, being ignored when going out with thinner friends, mean comments from nosy family members, doubting me Promotions were overlooked.

I can write a book, run a newsroom, raise a family, be a good friend, and be on time for everything else, but I can't be thin, and I can't get thinner—and, somehow, it feels like it negates everything else. What's the point of all this success if I'm still fat?

We live in an anti-fat culture where weight gain itself is seen as a personal failure. (On the other hand, losing weight is seen as a sign of sacrifice and commitment—you have to earn It's worth it, as writer Helen Rosner points out). Fat people like me have a harder time getting proper medical care; we face discrimination when we look for jobs and housing; We get ridiculed and humiliated, whether it's teased as children or heckled in public as adults.

Over the past few years, I've found respite in the body positivity movement, which argues that none of us should be shamed or discriminated against because of our size. And I've always tried to love my body: I've refused to try fad diets, follow extreme exercise regimens, and do anything I thought would give in to the stress of constantly troubling my weight and hating my body.

Around the same time I was gliding through the curved divide and into fat land, my father died of complications from diabetes and the ensuing dialysis. He had spent most of his adult life battling obesity-related diabetes and heart disease. . It was not an easy death – and my own recognition, in a way, of my belief that he could have been with us if he had taken better care of his body in ways I hadn't lately made it so. Worse to take care of myself.

Eight months ago, I found myself tired all the time, tossing and turning at night, with a high temperature. I would be out of breath. I eat compulsively and try to take care of myself. However, when you gain weight, it can be difficult to know what you really need and even more difficult to know how to get it.

The thought of going to a health care provider who might be rude to or humiliate me about my weight—not to mention putting me through a cycle of self-punishment that would add to my mental health problems—caused me to run away from my Two years of healthy reality. Finally, one day I woke up exhausted and unable to focus, and I knew I had to take action. I need to do something about my health instead of going back to hating my body.

Six months ago, after some research, I found a doctor, a woman of color who had investigated intergenerational health issues in her own family, who seemed to have a complete understanding of weight and health, and finally made an appointment. My blood work shows I don't have diabetes, but I've done everything you can; my cholesterol is elevated but not to the point where I need meds. I was at the stage where patients are usually encouraged to try keeping a food diary, drinking more water, exercising more, and reducing their calorie intake, all in the name of some sort of daunting weight loss effort that we all know is successful. Works forever anyway. I explained that I knew short-term dieting didn't and wouldn't work for me, but I was struggling to make any meaningful long-term lifestyle changes.

My doctor suggested that I try diet pills.

In particular, she recommends that we try a newer class of drugs — semaglutides or tirzepatides — that were developed to treat diabetes but also have great success in helping patients lose weight. Some, such as Ozempic and Mounjaro, are currently only approved for use in people with diabetes, those at high risk for diabetes, or prediabetes with high glycated hemoglobin (A1C) approaching diabetes), while others, such as Wegovy, are approved for overweight and obese people weight loss. All of these are injections that mimic your own hormones (what doctors call GLP-1 or GIP) that control our hunger and make us feel full faster when we eat. (They're also very expensive for the uninsured, don't even always cover them, and their recent off-label overuse has made it increasingly difficult for people with diabetes to access them.)

She said taking one – she recommended Mounjaro – would help curb my appetite and lower my blood sugar while I slowly made some incremental but permanent lifestyle changes like moving a little each day and eating higher quality food.

Despite my doctor's optimism, I walked out of the doctor's office feeling ashamed of my health. How can I let it get this bad? Am I my father now? And, on top of that, the thought of taking a “weight loss” drug felt both like giving up and a betrayal of the body positivity I was trying to achieve.

When faced with major life decisions, I did what I always do: I started talking to people—other doctors (“This drug is revolutionary”); Does someone need an inhaler for asthma?”); and, worst of all, I talk to straight people. “Do you really need this medicine?” a friend asked me. “you real Tried everything else?

In the process I realized something scary: Not only did I struggle with the fact that my body shape was my fault but the result of my negligent actions, some other people felt that way too.

But after many appointments and many questions, I decided to keep taking the medicine. I knew I needed some sort of intervention to help stabilize my body and my health while I figured out why I was eating my emotions, why I struggled to even go for a walk, and why I considered physical health and self-care It's just about sacrifice. I had to interrogate why I thought I deserved to be sick because I couldn't “control” myself, but I couldn't allow myself to continue to be sick while doing so.

So now I've been taking Mounjaro for a few months and every time I want to refill I have to go to the doctor and talk about how I'm feeling, the side effects – constipation, nausea, some insomnia – are happening and what I have to do with food and my body how the relationship changes. (Since my doctor is a holistic practitioner, and since I've made it very clear that I don't want to work in this area longer than I need to, this is slightly beyond my comprehension.) It's an adjustment. Behavior change isn't impossible; it's really, really hard, and a drug like this should be one of many tools, which for me includes therapy, exercise, and mindfulness.

And I've lost some weight, though not the gigantic ones you read about in some suffocating reports. It gives me some room to breathe between meals—it even helps me crave healthier foods. (This obviously makes greasy, fried and sugary foods harder to digest).My A1C dropped 0.5 points, which is a strong indicator that my genes don't mean I have Living with diabetes has given me a great sense of relief. That's what I've been focusing on – my actual health and the metrics that determine it, even though everyone expects me to just focus on weight loss.

But, perhaps most profoundly, having a drug that regulates my hormones is teaching me that when I compulsively eat, it's not just about inner willpower or self-control. When the behavior started to threaten my health, it was okay to seek help. It was not a personal failure to receive treatment; it was good medical care for me.

There's no doubt that anything touted as a “weight loss miracle” is disturbing because, as writer Aubrey Gordon puts it on Slate the waves recently podcasted, “When we start talking about diet pills this early, it’s usually a bad sign because it means people are more addicted to the weight-loss fantasy.” (Also, it’s worth noting that the long-term effects of these drugs The impact is still being studied.)

What these drugs don't address is the root of the “obesity epidemic” — a culture that continues to hate fat people, a healthcare system that motivates us to lose weight rather than our actual happiness, and a food system that denies us access to overall health food.

But my body alone couldn't make up for it. Perhaps it was my commitment to body positivity and insight into the diet industry that made me hesitate to consider a drug that would cause weight loss. Until I realized that body positivity is also about doing what is right for you and your body, as you can see.Free yourself from the externally imposed shame and sense of impossibility that comes with living in this body and really try to figure out what yes What is best for you is ultimately the key to truly accepting yourself.

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