You’d be amazed how many clients love to sit there, in my office, promoting a fad. They will have come to see me for weight loss and yet be desperate to convince me that keto or paleo is “the way forward”, that glucose monitoring or cutting out carbs is “a game-changer”, that celery juice is “the answer.”
As a former model before I became a nutritionist [with a clientele that includes everyone from Princess Beatrice, Dame Joan Collins and Charlotte Tilbury to James Blunt and Yasmin Le Bon] I’ve seen first-hand the dangerous methods people will use to get or stay thin. Usually, I’ll laugh off these fads, knowing the worst case scenario is that they won’t work. But I’ve never seen anything catch on as fast and furiously as Ozempic: the “wonder drug” and “magic wand”. And this is one fad I’m not prepared to laugh off, because I believe it may be jeopardising that future.
For those of you who have been living under a rock for the past two years, Ozempic is a semaglutide drug invented to help type 2 diabetics regulate blood glucose levels – with one of the most desirable side-effects in modern medicine: extreme weight loss. To that aim it is now prescribed – and shockingly over-prescribed – off-label. Indeed, it’s currently so ubiquitous that when a colleague or friend suddenly walks into a party 15lbs lighter than they were two months ago, looking wan-faced, dull-skinned, thinner-haired and like they’ve just emerged from a bout of chronic illness, there’s often only the one-word question: “Ozempic?”
There’s a place on the health market for semaglutide drugs, which have been proven to be effective in treating chronic conditions such as diabetes and obesity, and both Ozempic and Wegovy are very clear about their prescriptive guidelines.
It’s the unscrupulous private doctors and online pharmacies who are to blame for the drug’s current abuse. They’re the ones cynically preying on vulnerable individuals who are desperate to lose weight at all costs.
These are not negligible. Besides the literal costs (around £200 a month), there are the side-effects clearly stated on the drug companies’ websites, which go all the way from short-term discomforts such as nausea, vomiting, diarrhoea, abdominal pain and constipation to “possible thyroid tumours, including cancer.”
Still not put off the miracle jab? Try this: what if the drug we’re all so giddy with excitement over was taking years off your life? As someone with a special interest in longevity, who has spent the past two years researching the real, sustainable hacks to a long and healthy life for my new book, 2 Weeks To A Younger You, I’m astonished by the degree to which we are ignoring what may turn out to be the most noxious side-effect of all. So the only miracle as far as I’m concerned is why anyone would be choosing to swap pounds for years, and why those in the know have held back on pointing this out.
To be clear, semaglutide is an appetite suppressant, pure and simple. Yes, it also slows down gastric emptying – a natural part of digestion – which is not bad in itself, but the drastic weight loss we are witnessing in those who are injecting themselves weekly with the drug is caused first and foremost by good old-fashioned calorie-restriction. As one girlfriend marvelled just the other day: “My husband bought me a latte the other day, and I couldn’t even bring myself to drink it!”
There is nothing marvellous to me about that. Anyone with a background in nutrition knows without a shadow of a doubt that drastic, sustained calorie restriction and quick weight loss ages you inside and out – and it’s not sustainable.
It’s a cruel irony that the demographic who have jumped on the Ozempic bandwagon most enthusiastically are the over forties, who should be concertedly trying to maintain or even build muscle mass at that particular time of life. In a process known as sarcopenia, muscle mass decreases approximately 3–8 per cent per decade after the age of 30, with the rate of decline even higher after the age of 60. Yet by stressing the body for long periods of time, you are losing significant muscle mass along with fat, which is in effect speeding up your natural decline. Just ask Peter Attia, the Canadian-American physician who has spent decades studying the science of longevity. “Almost every patient we put on this drug [semaglutide],” he says, “has lost muscle mass at a rate that alarms me.”
That gaunt, wasted look you see in those who have “enjoyed” meteoric weight loss using semaglutide drugs? The sagging jawline, crepey skin and hollow cheeks? It’s so pronounced it even has a name, “Ozempic face”, and a whole host of correspondingly drastic “fix-it” treatments, ranging from fat injections and fillers to full-scale face-lifts. But while the cosmetic surgery industry may be benefiting from Ozempic’s popularity, the fact remains that fat loss in the face is never a good idea, certainly not past 30, and that facial muscular atrophy is extremely hard to undo.
Aside from drastically changing our body composition, with any continuous form of calorie restriction, we inevitably subject ourselves to nutritional deficiencies. I’m not just talking about the vitamins and minerals which are essential for our mood, energy, sleep and cognitive function, but also protein, which is the building block our body needs to create healthy, glowing skin, strong nails and glossy hair, and essential fats. A shocking number of menopausal women are taking “the miracle jab”, apparently oblivious to how it could further mess up their hormones.
Lean muscle isn’t just a crucial factor in helping women through that difficult period of their lives. It protects all of us from an array of conditions and diseases as we age, from joint issues and osteoporosis to Alzheimer’s and poor cognitive function. It also regulates our metabolisms. Yet here we are, pressing fast-forward on the internal ageing process, and potentially inviting a whole host of health problems into our future lives.
Add to this the fact that any form of appetite suppressant does nothing to address either the underlying reasons for excess weight or the quality of your diet, and the benefits of that short-term weight loss are effectively made redundant. Oh, and by the way, when you start eating again – which you will at some point – you will put on weight. Fast.
Looking beyond quick fixes
In my book I refer to a modern phenomenon known as “hedonistic adaptation”. Simply put, without the need to go out hunting and gathering every day and our largely sedentary lifestyles, we have become a bit too comfortable, constantly seeking out new pleasures and stimuli – and increasingly unwilling to confront tough challenges. So it’s easy to see why these fads and shortcuts are so appealing.
Sustainable weight loss should never be meteoric, but I don’t believe it should be a slow, painful struggle either, or that we should be depriving ourselves of all the pleasures life has to offer. That’s why I don’t ban either food groups or alcohol, and why in my book the intermittent fasting I swear by has been broken up into three different plans.
Because while sustained calorie restriction is bad for us, short periods of fasting have been proven not just to promote healthy weight loss, but help with concentration levels, energy, sleep, hormonal balance and, crucially, longevity. And because whether you’re a busy mother of three, an office worker, a pop star or a royal, we should all be looking beyond quick fixes to manageable, sustainable solutions that deliver us from all that mental clutter and leave us free to live healthily and happily for the rest of our (long) lives.
2 Weeks to a Younger You: Secrets to Living Longer and Feeling Fantastic by Gabriela Peacock is out now; £25.