A year ago, I first came across the term “Ozempic Face” in various social media posts and celebrity reporting. The Ozempic Face is, so the complaint, recognizable by sagging facial skin and other signs of ageing – effects of the weight loss caused by the intake of the drug. Semaglutide, sold under the brand name Ozempic, is a drug that lowers blood sugar levels and was initially meant to treat type 2 diabetes, but is now also used for weight loss. Ozempic particularly gained prominence in 2023, when more and more celebrities were rumored to have lost a conspicuous amount of weight in a short period of time – with resulting shortages in supply left people with diabetes struggling to get access. The Ozempic Face is a classic example of how beauty norms are relentlessly unstable and very specific. In February 2023 a Forbes article reported that The American Academy of Dermatology Association “recommends dermal fillers (also known as soft tissue filler) to fix the loss of fat and fullness in the face.” In this scenario, losing fat in the face is undesirable, because it makes one look old, while losing fat in other places, such as the stomach, is desirable, being the driver of the corporeal transformation in the first place. As a fat person who grew up in the 1990s, this kind of ageist and anti-fat talk is quite familiar to me; its paradox does not faze me. As a fat person today, in times in which “body positivity” seems to be everywhere, this kind of talk has made me anxious about the future of fat liberation and, literally, the future of fat people. 

In “Life after Food”, an editorial piece by Matthew Schneier for New York Magazine, the intersection between socioeconomic privilege and thinness is immediately addressed. The journalist begins by quoting thin women who seek the drug in order to lose the last few pounds they have been ‘struggling’ with: “Somebody once told me I had a size-zero personality, and they assumed that I was thinner than I was […]. We don’t talk about it, but everybody knows it. Thin is power.” Schneier later addresses side effects that are not as harmless as the Ozempic Face, namely nausea, vomiting, diarrhea, and constipation, including some no one knows much about—yet: there have been warnings of the development of pancreatitis and a certain type of thyroid cancer. When asked about this, another woman Schneier interviewed responds: “If they said it’s an increased chance of lung cancer, I wouldn’t take it, […] I mean, this is so humiliating, but I’m like, Thyroid cancer’s not that bad?” 

Schneier juxtaposes these statements (that need to be read as results of diet culture and socioeconomic advantages) with his claim that – of course – Ozempic and other semiglutide are “a godsend” for those who need it. Interviewees talk about the freedom they have found in not having to eat much, referring to experiences of serenity they never knew, because they constantly had to think about food. Food, in this article, is presented as a nuisance; food consumption and appetites are deemed avoidable and straight-up wrong or bad. Hunger is never mentioned. Schneier fails to fully grasp what Ozempic can mean to people with a disordered relationship to food and to fat people who just want to exist but can now apparently be ‘healed’ – regardless of the effects. 

Historically, in the United States and other industrialized societies, being thin has been connected to being in control of body and mind, being active, industrious, ‘working for it.’ With weight loss so strongly linked to self-discipline, the promise to get thin without having to work for it, turns the wellness and work-out industries upside down. Jia Tolentino’s article on the ‘era of Ozempic’ for The New Yorker tries to address the moral questions that arise. If anyone can lose weight taking these drugs, then – apparently – we can dissociate morals from eating behaviors: “We might recognize metabolism and appetite as biological facts rather than as moral choices.” In this scenario, a fat body would not signify laziness or overconsumption, but rather choice. Tolentino spends the first third of the article recounting fat stigma in US society over the centuries, but she explains the BMI as if it weren’t a contested formula for so-called “obesity” and only quotes people who explain how “energized and strong” they have become since taking semaglutide. She quotes an influencer who is happy about eating like a toddler, and in the end, she leaves the final words Jonathan Kaplan, a plastic surgeon, who believes fat acceptance is only the result of discomfort and inconvenience: fat people “might have lately felt encouraged to try to accept their heavier weight.” The future that this surgeon predicts is almost bleaker than Schneier’s. Suggesting that fat acceptance and body positivity are escapist movements rather than decided calls for change, Kaplan claims that fat people will cease to exist, knowing they don’t have to be happy with the body they have. 

Indeed, the rise of semaglutide is currently shifting body positivity. For fat activists, this will not come as a surprise. In the last few years, fat acceptance was steamrolled by body positivity. The ‘hashtagization’ of fat acceptance, its morphing into #bodypositivity in most online spaces and the marketplace erased its origins in the fat liberation movement sought by Black People of Color and white activists, now foregrounding mid-sized people and their need for good jeans. Popular culture still chooses to utilize fat individuals and their stories as cautionary and/or spectacular tales of conspicuous consumption and failure. And now there is a drug that seems to finally get rid of fatness, so that those who still remain fat are truly to blame for not getting in line with the thin regime. It has been up to fat creators and writers to oppose this backlash.

Virgie Tovar, in her manifesto You Have the Right to Remain Fat (2018), insists that beauty, sexiness or health do not make a fat person valuable, their humanity does. Informed by intersectional feminism, Tovar challenges the “seemingly innocuous language” of neoliberalism – “self-improvement,” “inspiration,” and “health” – as “symptoms of a larger cultural problem, not least [the United States’] history of unresolved racism, white supremacy, classism, and misogyny.” In order to make her claim about the right to remain fat, she introduces a temporality to fatness. After all, fatness is commonly and currently not imagined as a state of being, but rather as a transitional phase and a problem to be overcome. Fatness, according to alarmist discourse as propagated by films such as Darren Aronofsky’s The Whale (2022), or by reporting of the “end of food,” is not sustainable for the future. Despite the gratifications for compliance (“thin is power”), Tovar calls for a fat futurity when she writes that she imagines herself to be fat in the future, countering the myth of diet culture that promises a future without fatness and keeps consumers hooked by promoting a goal that is never fully attainable: “I conceptualized that in my future I would be free because I would be thin, but I was wrong.” Tovar insists on a future in which oppression is eradicated and freedom is available to all. 

How free can or will people be on Ozempic or other semaglutide? The effects of the ‘miracle drugs’ in the long run can only be imagined right now. What is already very real, however, is the backlash against fat acceptance, the rifts created in fat communities and the re-emergence of an even more pertinent “obesity epidemic” discourse that blames fat people for not complying. Also very real are the ways in which these drugs bind consumers for life. It is assumed that in order to keep thin, people have to take semaglutide “indefinitely.” This translates to indefinite revenue for pharmaceutical companies such as Novo Nordisk, already Europe’s largest company by market capitalization. Fat futurity will need more visibility and more intensity and radicalism to counter this overpowering rise of calls for the eradication of fatness, and respectively, fat people.