“She’s definitely got Ozempic face.”
This phrase, incomprehensible to most even as recently as a year ago, has been popping up more and more on social media and in the tabloids. Semaglutide, an antidiabetic drug, is most known by the two brand names under which it is sold: 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 witch hunt: cheek fullness and skin elasticity are analyzed and picked apart in the public domain to determine 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. Instead, it is a critique of how we discuss and moralize semaglutide use for weight loss and how this contributes to fatphobia. Semaglutide shortages, which some have blamed on non-label use by the wealthy, impact those who use the drug to treat diabetes. Reports have emerged that the newfound success of semaglutide at suppressing appetite and inducing weight loss has caused supply issues that could have lethal consequences for diabetics who rely on the drug.
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. Ozempic face, defined by Forbes as describing “the sagging, gaunt look of the facial skin due to the loss of facial fat following drastic weight loss,” is one facet of a wider preoccupation with judging health based on appearance. Obsessions around Ozempic and Wegovy use and accusations that individuals turned to semaglutide for a quick fix for unwanted fat will always circle back to questions about the morality of being fat, contributing to stigma against those labeled “overweight” or “obese.”
Several famous women have spoken out about accusations that they took Ozempic or Wegovy, including Chelsea Handler who admits to trying it under the guidance of an anti-aging doctor. Handler, as well as others like famous trainer Jillian Michaels, argue that it is irresponsible or immoral to take, or stress there are better but harder methods to maintain control over weight and health.
Kyle Richards of Real Housewives fame is one such example. 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’s statements, as well as those of other critics of the drug (see , 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 unexpected persistence of stigma 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. Those who do not play a conscious role in the production of symptoms may be alleviated of blame, but will be labeled 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 medications or related treatments, rather than debates about 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)
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.