By Sarah Laing
Ozempic/Getty Images
The Awful Truth About Celeb Weight-Loss Drug Ozempic
The physical, mental and social side effects of Hollywood's "secret"
Like it or not, the Kardashian family's influence on culture is as vast as a sprawling Calabasas gated community—who among us hasn't developed an inflectionless, flat affect to their speech after a particularly long binge of Keeping Up? But it's likely their sway in the realm of women's body image that historians will be unpacking most intensely in 300 years' time.
It's not because our society's obsession with manipulating our physical self will seem quaint in the metaverse—you'll no doubt be able to change the physique of your avatar for a reasonable fee. It's because the Kardashians—purveyors of waist trainers and skinny teas, popularizers of the BBL and lip fillers—are like proverbial canaries in the coal mine of body-modifying trends, bringing these often damaging tools and ideals to their millions of followers the same way Zara disseminates high fashion ideas en masse.
The rise of body inclusivity and its celebration of diversity in shape and size hasn't loosened the chokehold this family's approach to their bodies has on the popular imagination. In fact, this year has seen it explode, particularly as both Kim and Khloe have appeared noticeably thinner than before. It feels gross commenting on anyone's body, however famous, but there's a point to this, promise.
If you ask Kim—as La La Anthony did on the Met Gala red carpet in May—her weight loss was all down to a regimen she embarked on specifically to fit into Marilyn Monroe's iconic "Happy Birthday, Mr. President" gown. "I was so strict," she told Vogue, describing a concerning regimen of "sauna suits" (as harrowing as you'd imagine), running and, that old celebrity chestnut, eating "clean." But the internet has another theory.
@peoples_pharmacy How did Kim K lose so much weight so fast? Is she on Wegovy/Ozempic/Mounjaro? #glp1 #glp1diet #mounjaro #wegovy #ozempic #pcos #pcosawarenessmonth #mounjarodiet #peptides #semiglutideinjections #semiglutide @Kim Kardashian ♬ Midnight – Prod. By Rose
Kardashian has never commented on it, but TikTok in particular is convinced that she's been using a drug called Ozempic to induce rapid, extreme weight loss. And she's not the only celebrity rumoured to be taking the medication: Apparently, it's so pervasively used that it should have been thanked in many acceptance speeches at the Emmys. "Moguls, reality starlets, veteran film producers and, of course, actors are quietly singing the drug's praises on Signal, the encrypted messaging app mostly used for confidential conversations," according to the movie trade publication Variety. "Hair, makeup and styling teams for celebrities have come to accept the injections as part of grooming rituals ahead of major events." Ozempic, apparently, is the worst kept secret in Hollywood, at least according to gossip blind items, where you'll see speculation that everyone from Mindy Kaling to Oprah to Adele to Rebel Wilson have used it to lose weight, while the raging toddler currently running Twitter, a.k.a. Elon Musk, credits a similar medication, Wegovy, as his "secret." Oh, and fasting.
Whether or not these people have taken this drug, there's no doubt that it has captured a wide swath of the public imagination. If you're on a certain side of TikTok, you can feel like you're the last person on Earth who's not on Ozempic when you're bombarded with celebrity rumours and stories of "regular folk" discussing their experiences using it. It's not just you: Videos tagged #ozempic have garnered 311 million views on TikTok, while #ozempicweightloss is at 125 million views and rising. It's no accident that this is all bubbling up at the same time as a resurgence of the "heroin chic" body ideal of the late-'90s and early 2000s, with images of Kate Moss, Nicole Richie and other ultra-thin celebrities of that time flooding feeds.
If you're on a certain side of TikTok, you can feel like you're the last person on Earth who's not on Ozempic when you're bombarded with celebrity rumours and stories of "regular folk" discussing their experiences using it.
So what exactly is Ozempic? Created to treat people with type 2 diabetes, it's a relatively new drug that "has revolutionized diabetes care," says Andrea Swanson, a pharmacist and assistant professor at the University of Toronto's Leslie Dan Faculty of Pharmacy. "It's very effective at lowering blood sugar levels, and it helps them lose weight. Even more importantly, it prevents them from having heart attacks and dying."
Ozempic, which is approved for use in Canada, is a brand name—its generic name is "semaglutide," like Advil is to ibuprofen—and it's part of a larger class of drugs, GLP-1 receptor agonists, to be pharmacologically precise, that are commonly used to manage type 2 diabetes. More recently, however, pharmaceutical companies have begun studying these drugs for weight loss in people without diabetes. That's where Musk's fave, Wegovy (which is also semaglutide, just marketed differently) comes into the picture. "It's the same molecular structure, but it's being used at a higher dose when it's used for obesity," explains Swanson.
But these drugs are not to be taken lightly. "I would stress that it's not just for weight loss, or weight loss in everyone," Swanson says. "They're specifically being studied in people who are diagnosed with obesity, to the point that it has impacted their health." Think sleep apnea, high blood pressure, developing diabetes, among other challenging health conditions. In the past, these patients may have been treated with bariatric surgery as it was the only available option. "That's why Health Canada is going to let it come to market for those patient populations."
It's also important to know that semaglutide is designed to be used in addition to other diabetes medications, and lifestyle interventions such as diet and exercise changes. "It's not a magical bullet," Swanson says. "But it is very effective at lowering blood sugars." That's thanks to the "GLP-1 receptor agonist," which mimics a hormone we make in our intestines that naturally releases when we start eating, helping to control blood sugar. "The reason it's linked to weight loss is because the other thing this hormone does is it slows the rate at which food leaves our stomach," says Swanson. "That increases satiety, which makes patients feel full for longer, and they have less of an appetite. The net result is that they don't eat as much, and they lose weight."
So is it safe for people who have not been diagnosed with diabetes and aren't classified as obese to take Ozempic? Someone like, say, Kim Kardashian, who doesn't fit any of the medical criteria? "If we haven't studied it, we don't know if it's safe," says Swanson. She notes that so far it's only been studied two years out for people with type 2 diabetes, with no research yet on what it means to use it for a few weeks for weight loss.
"The other thing is that with every medication there are side effects," Swanson says. And boy, does Ozempic have side effects: nausea, vomiting, diarrhea, abdominal pain and, more rarely, pancreatitis and a potential link to a risk of thyroid tumours, which means people with a family history of thyroid-related cancer shouldn't take it.
"[The side effects] can be severe to the point that people stopped taking it in some of the studies," says Swanson, though she adds that these usually reduce as the body learns to tolerate the drug. Did we mention it's a weekly injection you have to administer yourself? (Or, have your glam squad do for you.)
You also have to take it for the rest of your life or else any weight that you have lost will return. "Because it's used for obesity, which is a chronic disease state, it's meant for long-term use," stresses Swanson, adding that sustainable weight loss, which is complicated by genetics, individual physiology and a host of other factors, must be built on lifestyle.
Another thing that Swanson wants to make sure you know about people using Ozempic "off label": It could cause supply issues for people who need it to manage diabetes. "Although there are not currently any Ozempic supply issues in Canada, some other countries have run into problems with drug availability because of the increased off-label use for weight loss," she says. On TikTok, you'll see that videos of people talking about using it for weight loss are met with comments from people with diabetes saying they can't find it.
@hiamandabutler #greenscreen Part 1 of my Ozempic journey #kardashians #kimkardashian #ozempic #ozempicweightloss #ozempicjourney #weightloss #hashimotos #hashimotosthyroiditis #hashimotosweightloss ♬ original sound – Amanda Butler
In one sense, Ozempic is nothing new. "It just feels like the flavour of the year," says Eva Pila, principal investigator at the Body Image & Health Research Lab and an assistant professor of kinesiology at Western University. "It's just another method or technique that can be used for extreme weight loss."
Like anabolic steroids or ephedrine, "this falls under a broader umbrella of performance and appearance enhancing drugs, and that's something that comes up in my work constantly," says Pila. The damaging effects of these interventions is clear. "Any time someone is behaving in restrictive behaviours to alter the body, and move it more towards societal ideals, there's usually a pretty serious mental health implication to that."
It's a recipe for "eating psychopathology," Pila says, which translates to disordered behaviour when it comes to food and weight and is tied to a lot of physical and psychological consequences. Pila points out that taking drugs like these can make you feel better in the short term because you're closer to that societally approved "ideal" body, but long term there are a host of consequences, including a "cognitive takeover," where hyper vigilance around food consumes your every thought.
"It takes away from people's ability to enjoy life, to connect socially and live a meaningful, rich life with friends, being able to eat a wide variety of food," explains Pila, who says this can also lead to increased anxiety and depression. "Eating is an important part of being human. We've evolved to enjoy the taste of food, for it to be this very deep cultural experience. You're removing that very necessary part of the human experience to achieve a certain appearance or social ideal."
There's a reason people chase "magic bullets" like Atkins or intermittent fasting or Ozempic to achieve this ideal, and it's more than mere vanity. "In our society, being slim does have objective benefits," Pila says, pointing to evidence that higher weight individuals experience more stigma, more oppression and fewer opportunities. "There is actually social capital that comes with living in an idealized body."
Which brings us full circle, back to the Kardashians. "What we see from celebrities is just a manifestation of our cultural values," Pila says. Kim didn't invent the idea of hyper-thinness; she's just benefitting from it, in a magnified way that anyone else who lives in a societally conforming body does.
That's why the "trend" to take Ozempic to chase a certain body size needs to be viewed from a structural, social level. "The weight discrimination and fatphobia that is so baked in is driving a lot of this," says Pila. "Our ability to manage body image concerns on an individual level is very limited if our broader structures continue to perpetuate the same problematic messages. It's never the individual fault of the person who chooses to [use Ozempic]—it's the world we live in."
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As Page Six Instagram posts go, a January 16 image of Real Housewives of Beverly Hills star Kyle Richards, with a caption about her mirror selfie "stripped down to a black bikini," was fairly unremarkable. "The #Bravolebrity appears to be on a health kick in 2023," the caption read, in part. The comments, however, were filled with another theory about Richards' "toned" physique: that she's been using Ozempic.
Ozempic,…