“She’s definitely got Ozempic face.”

These words, which would be incomprehensible to many even a year ago, have been popping up more and more on social media and in the tabloids. Semaglutide, an antidiabetic drug, is most well-known for being sold under two brand names: Ozempic, approved for type 2 diabetes treatment, and WeGovy, a higher dosage approved for weight management. Few likely knew or cared about Ozempic prior to the discovery that those taking it experienced reduced appetite and weight loss. Speculations about Ozempic use often accompany images of older female celebrities, many of whom were already thin but have recently reemerged after undergoing further, drastic weight loss. The conversation feels reminiscent of a modern witch hunt: cheek fullness and skin elasticity are analyzed and picked apart in the public domain to decipher who is guilty of unearned weight loss and thus deserving of public shame.

This article is not a defense of celebrities or of non-prescription use of semaglutide. Semaglutide shortages, which some have blamed on non-label use by the wealthy, impact those who use the drug to treat diabetes. What is important about these discussions is the widespread preoccupation with determining how someone came to be at their current weight or in their current body, and the moral judgments made about whether that body is deserved. Obsessions around Ozempic use and accusations that individuals turned to Ozempic for a quick fix for unwanted fat will always circle back around to questions about the morality of being fat, contributing to stigma against those labelled “overweight” or “obese.”

Some of these famous women have spoken out about the accusations that they took Ozempic. Many repeat the refrain that it is irresponsible, or stress that they would never need to use Ozempic since they already maintain control over their weight and health through other methods.

Kyle Richards of Real Housewives fame is one such example, as she stated in an interview that she “cannot stand people saying [she’s taking Ozempic] because people that know me know that I’m up every day at like 5:30 a.m., 6 a.m. at the latest… I’m in the gym for two hours. I really put a lot of effort into my diet and exercise and taking care of myself, so when people like to think I took the easy way out, it’s frustrating” (emphasis mine).

Richards’ statements, as well as those of many critics of the drug, fixate on the concept of a merited body. Taking Ozempic is seen as admitting a fundamental weakness, refusing to learn sustainable habits or self-control in favor of a quick fix. On the other side of the debate, proponents of the prescription of semaglutide for the treatment of “obesity,” in a move reminiscent of early debates around depression and prescription medication, argue that its efficacy could have a destigmatizing effect. Dr. Susan Yanovski encapsulates this viewpoint in her interview with The Atlantic, repeatedly stressing that “Obesity is not a failure of the will,” but rather “a complex chronic disease.”

Both perspectives contribute to a sense that you must either be deserving of good health through proper management of the self or must provide a medical justification to absolve you of responsibility in your failure to be well. Kathleen Lebesco captures the tension inherent in medicalization as a strategy for stigma management, arguing that “medicalizing or pathologizing a condition can help to remove blame from the individual, but… it actually extends the reach of moralizing discourse” (76). The reasons for this are explained in part by Laurence J. Kirmayer in his discussion on the moralization of psychological causation. Kirmayer explains that those who are seen as capable and complicit in causing the symptoms of their illness may be seen as mentally competent but as failing morally. On the other hand, those who do not play a conscious role in the production of symptoms may be alleviated of blame, but will be labelled as mentally weak (71).

Access to information and resources that promote individual health is valuable. The way we frame the use of these resources and the judgments placed upon those who “fail” to make use of them can often counteract any measures taken to help individuals mitigate their own experiences of pain or illness. We must heed Metzl and Kirkland’s call to “politicize the phrase ‘health status’ by emphasizing the ‘status’ part: health and the appearance of health confer status on some and take it away from others” (200). Celebrities with perceived Ozempic face may face the momentary discomfort of unwanted tabloid speculation. The stigma placed upon fat bodies as signs of moral or mental failure, however, persists far beyond the lifetime of a celebrity gossip piece. Our attention is much better used when focused on differential access to such medications or related treatments, rather than debates around who deserves to be thin in a world that abhors fat.

Cover Image: The U.S. Food and Drug Administration, Weight-Loss Ad (FDA 154), 2012. (https://upload.wikimedia.org/wikipedia/commons/thumb/6/60/Weight-Loss_Ad_%28FDA_154%29_%288212182572%29.jpg/640px-Weight-Loss_Ad_%28FDA_154%29_%288212182572%29.jpg) 

Works Cited:

Kirmayer, Laurence J. “Mind and Body as Metaphors: Hidden Values in Biomedicine.” In Biomedicine Examined. Eds. Margaret M. Lock and Deborah R. Gordon. Dordrecht: Kluwer, 1988, pp. 57-93.  

Lebesco, Kathleen. “Fat Panic and the New Morality.” In Against Health: How Health Became the New Morality. Eds. Jonathan M. Metzl and Anna Kirkland. NYU Press, 2010, pp. 72-82.

Metzl, Jonathan M. and Anna Kirkland. “Conclusion: What Next?” In Against Health: How Health Became the New Morality. Eds. Jonathan M. Metzl and Anna Kirkland. NYU Press, 2010, pp. 195-204.