What We (Don't) Talk About When We Talk About GLP-1s
I was laboring to convey to my therapist precisely why the thought of taking Ozempic was so bone-rattling, so chilling, and she was listening closely as I grasped for the real heartwood of the matter, offering responses that, till that moment, had felt empathetic. Then, in a tone of counterargument, she said, “Well, people who take it just lose interest in eating. Food’s not that enjoyable anymore.” She shrugged, adding no big deal with the gesture.
Immediately, I felt in my chest that I was going to start sobbing, and I did. It wasn’t the counterargument vibe—banter and repartee are regular, positive, and generative features of our work together.
It took a minute to articulate anything. At first I was simply plunged into the lightless, churning depths of raw emotion. Slowly, though, as my therapist sat quietly and attentively, language cohered.
I said, “But that’s just it. I spent almost my entire life unable to enjoy food. The thought of going back to that is—” My voice broke. I shook my head bitterly, urgently, tears running.
And it’s true. From age two or three to age 36, I did not enjoy food. Food was something I, or others, controlled my intake of, obsessed about, journaled about, tracked in a little notebook and then in an app, and then in a different app—but it wasn’t something I enjoyed. Food was something I feared and sometimes had panic attacks when faced with; I’m not talking about a little nervousness, I’m talking about fullblown panic—shaking, sweating, throwing up and having the shits, a screaming terror obliterating all thought, all reason. Food was something I paid for with exercise or skipped meals. Food was something I relied on to forge bonds with other women; if I had a dollar for each time I, or another woman, made a self-loathing remark as the breadbasket descended to the table… Food was something I snuck. One vivid memory: there was a pan of store-bought, frosted brownies in the yellow cabinet. My thin teenage brother, who, like my thin sister, was allowed to eat whatever he wanted, bought them for himself. He ate half the pan matter-of-factly while watching tv, then put them away. I found the brownie pan hidden behind mustard and ketchup bottles. I used a spoon to take a few bites. I put the spoon in the sink. I got another spoon and took a few more bites. I smooshed the brownies down, trying to spread them and hide how much I’ve eaten. I did this because I was eight years old and on a strict diet, only allowed to eat after working out, and if that kind of regimen is unsustainable for an adult, you can imagine how it was for a second grader; put differently, restriction leads to bingey behavior. Food was something I ate “too much” of. Food was something I consumed so very little of. Food was something I avoided on the day before weigh-in. Food was something I controlled with a fascistic grip. Food was my downfall, I was told, and so I believed. Food was something I watched other people eat, noting how much they consumed. But food was never, ever something I enjoyed.
The fact that, in my late thirties, I clawed a different relationship to food into existence is a miracle. A miracle, I tell you. That I was able, with hard work and help, to begin regularly experiencing food with pleasure, without shame or control or management or a goal or a plan, without the size or shape of my body in mind, is a mystery, a marvel, and a wonder.
Cold, creamy gobs of ice cream. The sour, crackling tang of a salt-and-vinegar potato chip. The fluorescent thwack of a hot Cheeto. The languid slide of chocolate across the tongue. The crisp, dark, sugary, effervescence of an icy Coke. Halloween candy. Holiday cookies. Birthday cake. These are things almost literally made for enjoyment, but I could not enjoy any of them freely until I was almost 40 years old.
Same thing with the stuff on the other side of the spectrum, the “healthy” side: it is hard to take pleasure in the sunshiney burst of a cherry tomato, or the watery emerald of celery, or the lacy, salted edges of a fried egg, or the thick crumble of good Cheddar cheese, and so on, when you’re eating them in order to shrink your body, in order to compensate for something “unhealthy” you ate that morning, in order to earn Thanksgiving dinner, in order to stay below your Points limit, in order to make your hour at the gym count, and so on.
Mainstream culture celebrates the diminishment of appetite and the loss of gustatory delight that GLP-1s produce, but I do not. Because I worked too hard1 to get that delight, and I went too long without it. And because I know the cost of years and years and years without feeling joy or excitement or pleasure when eating: loss.
So in that scary, despairing moment last spring when, in response to a health concern, my doctor said a GLP-1 was an option, and when my therapist suggested that enjoying food less was no big deal, I felt half a decade of grueling work—and the blessing of that work—slipping away. I felt on the brink of a backwards, uncontrollable freefall into Diet Land, a place which, for me, is just shy of lethal. I told my best friend, who's been in AA for 15 years, “The closest way I can describe how I feel is this: It’s like if you had a health problem and they told you the cure was to start drinking again.” If that sounds preposterous to you, walk a mile in my shoes; my sanity depends on total abstinence from restricting food and trying to control my body.
I don’t hear this said enough so I will say it now: Enjoying food is not ancillary. Interest in food is not collateral damage of being alive. Yes, there is a utility to eating—we must do it or we die. But there is much more than utility. There is all-important, life-affirming, thank-God-for-it sensuality, delight, and enthusiasm.
Whether the pleasure of eating is a gift from God or the universe or science or culture doesn’t matter to me. What matters is that—from the first ancient ancestor to grin after tasting a strawberry—pleasure is a natural, critical part of eating, and to strip food and eating of pleasure is obscene. It is inhuman, better suited to droids and robots than the animals we are, each of our tongues covered in sensory buds like a starry sky. Yes, we human beings need pleasure. We need it. Moreover, as columnist Christine Emba writes, we need to experience embodied pleasure. The idea of pleasure isn’t enough—we need pleasure to bump up against us, breathe on us, rock us, squeeze us, and give us all its textures and temperatures and tactility. We need pleasure’s fiber and grain. We need pleasure in a material sense. Sex does it. Hugs do it. Smoking does it. Working our muscles does it. Hot and cold water do it. Sunshine in your skin does it. Sound waves tickling your eardrums do it. And eating does it, too, three times a day. Pleasure isn’t a luxury; it’s a built-in, essential feature of our being.
This is the main reason I get sad when I see women, and women of color in particular, using GLP-1s for weight loss. Yes, I know: they have a right to do whatever they want with their bodies. (Though, allow me to complicate that a bit: When I consider the celebrities who've endorsed Ozempic, including heroines of mine like Lizzo and Serena Williams, I see two things playing out: (1) the right of every person to do what they want with their body, and (2) the ferocious, constant pressure of anti-fat bias and Eurocentric beauty standards. In our culture, awash as we are in the fever dream of autonomy, we tend to focus on the former rather than the latter. The problem with this is that the former doesn't exist without the latter: There is no reason to choose thinness unless your culture prizes and pushes it. (Remember—a preference for thinness is not universal across human society; it is cultural, full stop.) When we end the GLP-1 analysis at, "Well, she can do what she wants with her body," we deprive ourselves of the insight that comes from unpacking why a smaller body is what she wants.)
But, I digress: I get sad when I see women and women of color draining the pleasure and excitement out of eating because life tends to serve us slightly smaller slices of pleasure to begin with. That we would strip food of its pleasure feels like a doubling-down on the general cultural insistence on distributing pleasure unevenly, and based on dubious distinctions (zip code, gender, race, income, age, etc.). Enjoying food, getting excited about it, relishing it—these are luxuries that should not be reserved for thin people.
I know a common refrain about GLP-1s is that they “quiet food noise,” and for some women this quiet might yield more enjoyment of food. But I also know that “food noise” often stems from attempts at restriction. If you restricted your breathing, you’d have a lot of “oxygen noise,” too. As I read the medical and sociological literature on body weight and eating, and as I read my own life and the anecdotal data of hundreds of women I’ve met in the diet-culture-dropout world, the more peaceful, sustainable way to quiet food noise is to eat intuitively, which is to say, without restrictions, weight and size goals, or moral judgements. This requires skill and practice (though it’s a skill infants have), and there is a learning curve; but it doesn’t require you to lose interest in the joy of eating. (It also doesn’t require you to line big pharma’s pockets.)
I may, someday, face a tough decision. There may come a time when a GLP-1 is medically (not cosmetically) indicated for me. But I hope that time never comes. I hope I never have to go back. I hope I stay in the pleasure forever, and I hope we all find our way there, too.
When I say I worked hard, what I mean is that I (1) stopped dieting and (2) started practicing weight neutral self-care. Practicing over and over, every meal, every day. New language. New habits. New concepts. New bravery. New soul. Flailing and fumbling sometimes, to be sure. But trying again, and again, and again because I could not go back to dieting, or trying to control the size of my body. The only alternative was to commit to taking care of myself in weight-neutral ways and let my body decide how it should look and what it should weigh. (The nitty-gritty mechanics of the journey will be familiar to some: learning intuitive eating, learning about Health At Every Size, learning about fat liberation and body liberation more broadly. I will round up resources I found helpful in a different post.)