The Gila Monster, Ozempic, and Me: Dream or Nightmare Blunt Rotation?
GLP-1 Agonists, Shame, and the Fight for Self-Worth
Jesus Christ 2005 God Bless America
I should’ve anticipated that my journey with semaglutide compound injections would be one of both love and hate, excitement and fear, unquestioning alliance and fervent rejection. Ozempic and her many spinoffs that keep spawning have pulled the stitches out of a ragged cultural gash, one that felt personal.
I was born in 1994, the perfect timeline to have an eating disorder by the age of 13. I had my queer awakening watching America’s Next Top Model. I saw tabloids of the same celebrities cycling between ‘scary skinny!!!’ and ‘bigger than ever before!!’ from week to week. Watching The Biggest Loser was a family event, which, looking back, feels like a similar experience to the audience in the colosseum during a bloody battle between Gladiators.
I’ve lived through Skinny Cow, Snack Wells, and explosive Olestra shits. At 11, I attended my first Weight Watchers meeting, a canon event for many millennial women, with my well-meaning but misled mother. I even survived Nutrisystem’s gross astronaut food.
I was taught from my earliest childhood memories that my body was not acceptable. Fat was not just undesirable, but it was causing a deadly epidemic. My uncooperative growing body was contributing to the headless walking shots of obese Americans on what seemed like every evening news update for the first decade of the new millennium.
Enter: Skinny Legend, the Gila Monster
(he’s actually quite a thicc boi)
What the world didn’t know was during the early days of this new cultural obsession about weight that a biochemist, John Pisano, and a gastroenterologist, Jean-Pierre Raufman, were about to make a very unexpected discovery. While we sipped our sandy Slimfast shakes, researchers were unraveling the mysteries of the Gila Monster, completely unaware their work would someday intersect with our obsession with weight.
In the past few years, my relationship with my body and with food has vastly changed. I used to believe that a constant stream of self-hatred woven throughout my inner dialogue as an inevitable fact of life. Now, I know that can change, albeit very slowly. Therapy - the right kind of therapy - was what made the major change for me. A second hospitalization due to a bulimia-triggered seizure at the height of the early days of Covid certainly made an impact, too.
I finally stopped fighting my own body and began eating again, for real this time. No obsessive logging or fasting apps, no lemon water tricks, no working out for hours as a punishment for enjoying food. I gained weight. Like the most I have ever. My body had lived in a state of constant dietary dysfunction for most of my life, and now it was getting enough nutrition at a steady pace. I breathed into the change. I bought new clothes. I survived Covid. I dated again. I fell in love. I lived life.
Fast forward to about a year ago. I started to experience extreme lower back pain. I started physical therapy stretches and exercises but nothing seemed to help. It became harder for me to move freely. However, I avoided the doctor for way too long because I was afraid of being weighed and having to face the reality of dieting again, of the constant hunger, the constant self-abuse. Even though everything in my life was better, my mobility began to fail. It was extremely frustrating to get so far with my mental health only to experience the limitations of chronic pain.
There was about a 6 month period of time before I went to a doctor where I reached a very dark place. I felt like my freedom was disappearing before my eyes. I hated going out because I didn’t ever know how bad the pain would be. One time I went to the mall to see a movie with my partner, and by the time we reached the theater, I was literally crying from the pain, trying unsuccessfully to keep it hidden. My flexibility was so limited, and I often felt like I couldn’t walk at all. I knew my weight gain didn’t help, but I also knew that there was something more serious going on. I know plenty of fat people who live active lives, who travel and hike and do all the stuff I loved doing that now felt like a distant memory.
Eventually, I went to the doctor and discovered that the problem was not originating from my lower back, but was because of hypermobility in my hip joints that caused sacroiliac dysfunction and inflammation.
Luckily, I found a really amazing doctor who was able to get to the bottom of what was happening. I started aquatic physical therapy. I got another MRI after getting stuck in the standard-sized one like Augustus Gloop and having to switch to the larger size. I was put on steroids for a brief period and experienced a euphoric relief from the constant pain and stiffness. I knew then that inflammation was a huge part of my issue, and altered my diet accordingly, which is why I’m chugging hibiscus and ginger tea as we speak.
I knew losing weight would alleviate the pain and make moving and exercising easier. The issue with this was that I couldn’t really move or exercise. With aquatic therapy and swim classes at the YMCA, I found a way to move again. Still, I felt stuck and longed for something to speed up my progress, to give me a way back to the world I missed.
After 2 years of mixed feelings, mostly negative, about GLP-1 agonists, I signed up for some well-designed, futuristic app that can get a vial of semaglutide to your doorstep in days. I felt conflicted about starting this medication, hesitant to trade one set of cultural expectations for another. But pain has a way of stripping you of indecision, and eventually, hope outweighed shame.
I was pleasantly surprised during the telehealth appointment with a provider before getting my prescription. I feared some type of cartoonish Beverly Hills experience of normalizing the injection of lizard venom into our fat rolls to lose weight. What I got instead was someone super thoughtful, caring, and interested in my specific experiences and goals.
When the doctor found out that mobility and pain reduction was my motivation for trying the drug, she encouraged me not to pay attention to scales, at least for the first month. She suggested paying more attention to how I feel, how much energy I have, any changes in hunger cues. She said the weight loss will show itself in the way I feel and how my clothes are fitting.
I mentioned hearing about the recent studies on the drug’s impact on inflammation, and she excitedly shared that she had many patients who have seen life-changing results for joint diseases. She shared a bunch of peer-reviewed studies in our follow-up notes.
In a few days, I had a refrigerated vial of compound semaglutide and all the fixin’s for self-administering each dose, in the style of the movie The Substance, waiting for me on my doorstep. No sketchy alleyway entrance or futuristic locker delivery system, thankfully.
Injecting Hope and a Dash of Venom
In the 90s, researchers studying the venom of the Gila Monster—a venomous and surprisingly resourceful desert dweller—discovered peptides that could stimulate insulin production. By 2005, their work led to GLP-1’s FDA approval, a breakthrough no one expected when they began studying this elusive lizard.
Pisano and Raufman didn’t set out to discover a peptide that changes the human body and mind when they began their research on the elusive Gila Monster but they did, and now we’re here.
When I am overcoming an internal struggle of some sort, my automatic and nearly irresistible coping mechanism is to learn as much as I possibly can. I’m guessing my instinct is that I can ‘logic’ my way out of anything. Although I rarely solve my internal struggles by reading peer-reviewed articles, I’ve found it’s not about the destination but about the friends, or trivia facts, I learn along the way. I do think in this case, this impulse to understand ozempic led me to challenging my own flawed beliefs about weight, health, and medicine.
I thought about trying ozempic, or something similar, for months before I talked about it to another soul. I go to a weekly therapy group centered around eating disorders, and I couldn’t bring myself to talk about it. I didn’t even tell my partner until the first vial of semaglutide compound was on its way to my doorstep. A part of this is my own unhealthy reliance on hyperindependence and not talking about the important stuff when it matters. I’m working on it. But my ‘weirdness’ around my decision to try semaglutide came from years of struggling with my weight, multiple inpatient trips to the hospital for eating disorders, and a very bumpy journey towards healing my relationship with food.
When Ozempic arrived on the scene in 2021, I felt like I had met the final boss of diet culture. Slimfast and Nutrisystem were both gross food-like organic matter we consumed. Phen-phen and Redux were just amphetamines sold as diet pills, nothing new. But Ozempic is something completely novel, something Americans, especially young American women, have been clawing at the walls for since we were preteens. It wasn’t a supplement, it wasn’t a pill. This was diet culture, injected right into your subcutaneous tissue.
Untethering from Shame
My body is incredible, and it’s survived so much. Recognizing that my body can heal, time and time again, feels like reclaiming something that shame tried to take from me.
Shame is an extremely powerful force. It moves markets, starts wars, and unfortunately in many cases, decides the future. Shame can run a person’s life through manipulation and control. I’ve come across it time and time in my research.
The root of diet culture is shame, and that powerful force has controlled my life since I was old enough to remember. It controlled my mother before me, and her mother, too.
For 20 years, the pop culture and media zeitgeist has been producing some of the most potent and lucrative shame in the form of anti-fat bias, diets, the fashion industry, medical procedures, prescription drugs, and even selling back our own attempt to overcome this shame in the form of the body positivity movement, hyperfast fashion e-commerce, and the wellness industry.
Maybe I’m reaching. Maybe this is my way of coping with a decision I still feel weird about. But I feel that this journey I’m on with semaglutide is helping me untether my relationship with dieting and shame to my actual physical body and health. What if untethering from shame wasn’t just a personal journey but a collective one? What could we create if we stopped measuring our worth in pounds, calories, or dress sizes, and started seeing our bodies as vessels of possibility instead of problems to solve?
In late-stage capitalism, capitalizing on shame is an all-encompassing force—but it doesn’t have to define every innovation. Medications like semaglutide are born from the same system, but they also offer something radical: the potential to restore lives in ways beyond weight loss.
There are early studies showing that the drug is effective in rerouting cravings of all kinds, and is starting to be used to treat SUD, including addiction to drugs and alcohol, but has even shown results for gambling and shopping addictions. It’s treating arthritis and giving people the ability to move freely after years of pain and immobility. There is promising emerging evidence that it’s effective in treating Dementia, Alzheimer’s and ALS. It’s impact on the brain is just as compelling as it’s impact in the body.
In my second week after starting a very low dose of semaglutide compound, I had one of the best weekends I’ve had in over a year. I still had moments of debilitating back and hip pain, but they were fewer and farther between. NSAIDs actually felt like they did something to reduce the pain and give me mobility. I had more energy and could move more freely. Most importantly, I felt real and irrefutable hope, for the first time in a long time. Hope, I’ve found, is the only force more powerful than shame. Maybe taking a GLP-1 agonist isn’t me punishing my body, but helping it reach its full potential.
What would our lives look like if we stopped letting shame dictate our choices—about our bodies, our health, or even our worth? My body is incredible, and it’s survived so much. Recognizing that my body can heal, time and time again, feels like reclaiming something that shame tried to take from me. That feels more powerful to me than saying my body is beautiful, or sexy, although I do feel that way at times. Untethering my physical body from my worth, from the shame of diet culture, has taken 30 years, and I’m still figuring it out. However, with a little help from my murderous and kinda cute lizard friend, the Gila Monster, I get closer every day.
I’ll close with a great quote from one of the main characters in the foundational research of GLP-1 agonists, Dr. John Egan.
“I think the fact that we have been able to take this substance found in nature and consider applying it in such incredibly diverse ways—to treat diabetes, to possibly treat neurological disease—adds to the growing body of support for a link between the endocrine and nervous systems. This research also demonstrates a new way to think about therapeutics. Instead of ‘one drug, one disease,’ we should think of designing drugs that impact multiple diseases.”
Sources:
https://www.jbc.org/article/S0021-9258(20)71275-5/pdf
https://www.nia.nih.gov/news/exendin-4-lizard-laboratory-and-beyond
https://aaic.alz.org/releases-2024/glp-drug-liraglutide-may-protect-against-dementia.asp
https://jamanetwork.com/journals/jama/article-abstract/2817996
https://pubmed.ncbi.nlm.nih.gov/34018075/
https://www.mdlinx.com/article/could-ozempic-treat-gambling-addictions/4CnIta6slQbcoUdKq7dtnB