ER 15: On Ozempic, Diet Culture, and Robobees

Or, why using science as wallpaper is bad.

Hi everyone. Welcome back to the Ethical Reckoner. Today, we’re talking about something that’s been niggling at my mind for a while, which is the diabetes-turned-weight-loss drug Ozempic, but we’re also going to be talking about the broader problem of using science to wallpaper over our problems.

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America has food problems. A lot of them. Our food, ultra-processed and full of added sugars and preservatives, is designed to make us eat more. Our cities and towns are designed for cars, discouraging walking and the daily movement that can keep us fit. These problems manifest themselves in one of the highest rates of obesity in the world, which brings with it a host of individual and public health concerns.¹ With this comes packaged a $71 billion/year diet industry promising to reverse the effects of our unhealthy food ecosystem, but only entrenching further unhealthy attitudes. Diet culture teaches us that being skinnier is better, even to the point of unhealthiness. It encourages moralizing of food and weight—carrots (thin) good, candy (fat) bad—and fuels eating disorders along the way.

Living in Italy has thrown this into sharper relief for me. Italians don’t engage in the BS moralization of food that Americans do.² There are no “good” foods and “bad” foods,³ there is just food, food to be enjoyed. Rather than fret about every bite of food that passes their lips, they just eat. The pasta and pizza and gelato are made with high-quality ingredients. They taste good. And those foods are things to celebrate, not fear, integral parts of Italian culture, what makes it rank as one of the top cuisines in the world. 

There is no “diet” gelato full of fillers and crap that leaves you unsatisfied and wanting another as soon as you’re done. There is certainly no Ozempic. Ozempic (generic name semaglutide) is a drug meant to regulate blood sugar and insulin levels in people with Type 2 diabetes. Because of its side effects as an appetite suppressant—to the extent that it makes food actively unappealing—it has gained a cult following for off-label use as a weight loss drug, creating a shortage for those who actually need it. It’s being called the “Hollywood drug” because of the number of people using it for casual weight loss and the speculation over which celebrities are using it. Weight loss is marketed as a wink-wink side effect of Ozempic; other common side effects include nausea, diarrhea, constipation, stomach pain, and vomiting. In rare cases, it may cause thyroid tumors, pancreatitis, changes in vision, hypoglycemia, gallbladder problems, and kidney failure. Fun! And, this is a lifelong commitment; appetite returns when you go off the drug, and with it most of the weight lost. 

There are two reasons people try to lose weight: for vanity reasons (to look “better”) and health reasons (to feel better). Using Ozempic for vanity weight loss is dangerous and, while the drug is still in short supply, selfish, and it’s a product of our insane diet culture that people are actually doing it. I don’t mean to invalidate anyone’s insecurities, but the reason everyone wants to lose those “last five pounds” is because of our culture that values thinness above all else, and that’s what I’m taking aim at. 

Health is more complicated. Some people should lose weight for health reasons (but see the first footnote: not everyone who’s overweight is unhealthy!). For a long time, we’ve told overweight people that they need to lose weight (even if they aren’t actually unhealthy) and that any failure to do so is merely a failure of will, even though weight loss is a complex equation impacted by genetics, stress, gut health, and many other factors. For those who are struggling with their health, Ozempic-like drugs could be an actual lifeline. But what does it say about our society that, through our food and activity environment, we’ve made people unhealthy, told them it’s their fault, told them they just aren’t trying hard enough, and now are telling them that there’s a silver bullet that can help, but at a cost of their relationship to food for the rest of their lives? It says that we don’t care about addressing any of the underlying issues of our society, and in fact reinforces the moralization and shaming of being overweight: we could change the system, but instead you have to sacrifice this basic pleasure of human existence to overcome the issues we’ve caused you. Who’s lazy now?

This is a prime example of using science to wallpaper over our problems. Instead of trying to change the environment that has caused our health problems, we’re trying to paper over it by eliminating the most fundamental need and desire of our bodies for food. In the process, we’re reinforcing the toxicity of diet culture, that “the skinnier the better” and anything you can do to become thinner, even if it’s to deny yourself not only food but the fundamental desire for sustenance, is worth it. As Ezra Klein said, now that we’ve created an environment of “food abundance and this technological creation of foods that are unbelievably tasty and sugary and salty and palatable… now, we’re having to create very expensive injectable drugs to rework our brains, so we can survive in this food environment that we have created by choice, such that it doesn’t make us sick over time.” His guest acknowledged, “I think all of us would rather live in a world where those problems were not there in the first place. But that’s not the world we live in.” And that is true. But other countries show that it doesn’t have to be the world we live in. Currently, access to whole, unprocessed foods is not universal, especially in America, but we could change the structure of our food system to get rid of food deserts (which are disproportionately found in communities of color and low-income areas),⁴ make the time and space to cook more accessible, expand what’s culturally perceived as “healthy” food, subsidize vegetables over corn, challenge agribusiness monopolies, ban the crap in our food that makes us unhealthy (bringing us more in line with EU standards), stop advertising highly-processed foods to children, and fight fatphobia. We need to create a food system and culture where a) we’re not being made unhealthy, b) we’re not shaming those who are overweight and idealizing skinniness, and so c) people aren’t feeling the need to sacrifice their fundamental desire to eat to achieve an impossible and unhealthy ideal. 

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But wait, I’m not done. Another example of tech wallpaper, different but somewhat related, is bees. We’re now creating tiny bee robots to take the role of the bees that we’re killing through our unsustainable use of pesticides, insecticides, and the like. But instead of address the root cause, we’re papering over the attitudinal problems that are not only killing the bees but damaging the soil and fostering dangerous monocultures, allowing us to keep doing that. Furthermore, robo-bees are really only a feasible solution for farmers in wealthy countries; 75% of farmers are in developing countries, but are just as dependent on bees. And they would likely pose risks to wildlife who eat them, potentially creating even more ecological problems. Like Ozempic, rather than addressing the root causes of the problem—the idea that we can maximize food production through the brute force of human input—this enshrines the idea that humanity can do whatever it wants to our surroundings at any cost to them, because science will clean up afterwards—and whatever problems that clean-up creates, we’ll be able to fix with more science. The wallpaper layers on, and on, and on.

I don’t mean for this to be an anti-science screed. Science is undoubtably a good thing. I love science and I’m proud to be a computer scientist.⁵ I’m not advocating for a return to the stone age, but for a more careful deployment of science. Ezra Klein asked if having to paper over problems we create with more technology is just a “condition of modernity,” but I don’t think it has to be. Science is supposed to be the way we understand our world, a way to complement other forms of knowledge—it shouldn’t be a monolithic, default fallback to solve all our problems, or something imposed on us by tech bros.⁶ Rather than use it as technosolutionist wallpaper, let’s use it as moulding: as a way to enhance and protect what’s already there or to fix unavoidable problems (like gaps between walls and the ceiling/floor). In fact, science could be used this way for the problems we talked about here: another kind of robot bee would support queen bees to optimize egg-laying and create healthier hives that would be more resilient and effective pollinators. We would still have to adjust our ecological practices to not wipe out all the bees, but this could work in concert with that. As to how to help change food culture, perhaps LLMs and content recommenders could be leveraged to promote healthier messages, or techniques developed to make healthier food more appealing while we transition our bodies off of the hyper-processed foods that have contributed to our problems. We already have a lot of the solutions, though: we’ve known about crop rotation to improve soil health since 6000 BCE; crop rotation reduces pest and disease risks, improves yield, and minimizes the need to dump fertilizer on that eventually leaches into our waterways. We know what foods nourish our bodies, regardless of national origin. We know (or should) that commenting on peoples’ bodies (whether complimentary or not) is not helpful. I fear, though, that the wallpaper will win: the WSJ reported that a new drug Mounjaro could be the “King Kong” of weight-loss drugs, even more powerful than Ozempic, but with many of the same side effects, and efforts are underway to make even stronger drugs. 

Tearing off the wallpaper and looking at what’s underneath is scary, but if the wall has good bones, we can tackle fixing it. It’s scary, yes, but we owe it to ourselves and our communities to try, rather than continuously slapping on layer after layer of wallpaper that will, sooner or later, peel off and expose the rot underneath. 

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Thanks for reading.

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1. This is a sensitive issue, with people arguing that being what is defined as overweight is inherently unhealthy and others arguing that you can find Health At Every Size (the HAES movement). There is scientific evidence to support aspects of both. On the HAES side, you can be “skinny” and metabolically unhealthy or overweight and metabolically healthy, plus fat stigma and discrimination cause physical and mental health issues. (Supporting this, there is wide agreement that the Body Mass Index (BMI) is flawed as a measure of individual health.) That being said, irrespective of metabolic health, overweight and obese people have higher risk of coronary heart disease, and gaining weight is a risk factor for Type 2 diabetes. Both obesity and under-weight are associated with excess deaths, while “normal” and overweight are not—in fact, over-weight is associated with a reduction in mortality compared to “normal” weight, perhaps due to the health benefits of subcutaneous fat (as opposed to visceral fat, which secretes inflammatory molecules). My general position in this piece is that, in general, it is better for one’s health to not be underweight or obese, but that fat-shaming and diet culture are not conducive to either of these goals. 

Also, I have to acknowledge that I’m writing about this as someone who undoubtably has “skinny privilege,” while at the same time noting that I (like the majority of my female friends, and many of my male friends) have been harmed by diet culture in a variety of ways.

2. Yes, there are exceptions to every rule. Italian food culture is by no means perfect or completely impervious to diet culture, and the culture of pride around food may make it harder to talk about eating disorders. But my experience is that things are generally better here. 

3. There are, however, foods that are good and bad to put together, as I learned in a hilarious discussion about the American phenomenon of putting pineapple on pizza. Sweet things do not belong with cheese, apparently, unless it’s honey and ricotta or bleu cheese. I would argue that there should also be an exception for figs, but who am I to tell hundreds of years of tradition what to think.

4. Food access issues run deeper than just food deserts; for low-income families, the potential economic costs of buying, say, vegetables that a child might not like means that it’s safer to fall back on the foods that they know they like, even if they’re highly processed. Suggestions like “replace ultra-processed foods with unprocessed ones” need financial backing to be feasible for low-income families.

5. “Some of my closest friends are scientists” may be too on-the-nose but it is true…

6. Thanks to Isabella Huang for reading a draft and making this point and several others.

Thumbnail generated by DALLE-2 with the prompt “an oil painting of ‘science as wallpaper’”.