Soooo yes, glp-1s are an amazing medical discovery for people with serious health problems. As are many other medical advances. But you cannot possibly not have noticed that there actually are a crap-ton of people who are indeed using them just for aesthetics. I could point you to a crap-ton of people I know personally if you have not, and I don’t even live in the States.
And while yes, individual solutions to health issues are fab for the individual, I don’t think anyone who wants to improve shitty food systems, lack of access to medical care, and the appalling cost of things like, yes, GLP-1s is saying we shouldn’t also work on obesity. I think they’re saying that those things CAUSE obesity, along with a whole host of other issues just as important.
Here’s the thing I didn’t say that I wish I did: what if those people doing it for “aesthetic” reasons have control issues or feel like they drink too much? What if it just makes them feel more positively about themselves? Are those disqualifying? I guess maybe what makes me most mad is that it just feels like another purity test.
Of course we should also deal with the upstream issues of health access and nutrition. But also we should be celebrating solutions like Ozempic. It’s a great service to the world that in the 1950s fluoride became widespread in toothpaste instead of deciding sugar usage was upstream and letting people’s teeth continue to rot away. (And eventually was followed with broader public health intervention by adding it to water.) I just don’t think we can ever assume these problems are mutually exclusive.
Look, it’s obviously complicated and, I’d say, a touchy subject for everyone commenting here. Your comment clarifies your post a lot actually, thanks, as I don’t like purity tests either, for anything. But I also don’t like the immense backtracking these drugs have (inadvertently) caused to any sort of body acceptance or healthier lifestyles, and ‘aesthetic use’ is about the nicest term I have for that.
And clearly I got riled up by your phrasing, sorry. This just isn’t either/or, this is both/and: life saving and life improving drugs are amazing, but ‘progressives’ (hi!) can simultaneously celebrate medical advances and try to fix the shit that causes a whole lot of people to need them. Perhaps you’re seeing particularly biased people rag on drugs because they care so much about systemic issues, but most people I read are well aware that both are in dire need of improvement.
Eg my mum is likely going to die of diabetes, long-term obesity, and the complications thereof, not because new drugs couldn’t help, but because she can’t afford them, even on her ass-expensive Medicare. Ie health care access isn’t ’upstream,’ and I see little point to advancing medicine when most people can’t afford it.
Oh but long live fluoride, especially cause it’s free!
What if one of the causes of obesity is the fact that our bodies are not evolved/designed to consume a healthy amount of calories while living in a calorie rich environment that doesn't go through regular periods of involuntary calorie limits? Is it possible that as long as food (or even ingredients) are available above a certain calorie/bulk ratio, some (most?) people simply do not have the natural hormone balance to consume the proper amount of calories without constantly feeling hungry and unsatisfied?
If I've been struggling for years to go from a little overweight to a healthy weight, is taking a GLP-1 RA to help me finally lose 20 lbs (and stop drinking) considered an aesthetic use? (When does being overweight become a "serious health problem" where it's OK to use medicine to help it?) Is it somehow a moral failing that while I used to eat a salad for lunch and was uncomfortably hungry the rest of the day, I now eat the exact same salad and feel great until supper?
What "caused" MY unhealthy weight wasn't a lack of healthy food. It was the fact that I lived with a constant craving and physical discomfort unless I also ate way too much additional calorie-rich stuff in addition to the good food that I have the privilege of having easy access to.
So that’s a whole lot of things that I didn’t bring up. But in my personal opinion, no, I wouldn’t at all say that in that scenario trying a GLP-a is aesthetic. Im actually on Mounjaro myself, and it’s definitely not for a serious health issue, but I don’t think it’s aesthetic, it’s because gaining 38 pounds in 3 years on a small frame because of perimenopause with no other weight loss options helping was making me insane. Which I say only to point out that I think I do understand more reasons for trying a GLP-1 than just obesity / diabetes. I’m sorry if I made that sound too black and white.
My point wasn’t to police who should get access to and can benefit from new drugs, it was that wanting to improve massive systemic problems does not necessitate that a ‘progressive’ person also wants to ignore medical issues.
I think I incorrectly took your comment as "a lot of GLP-1 use is not warranted and what we really should be fixing are the TRUE causes of obesity, which is bad food." That's my bad!
I definitely agree that it's not an either/or, thing! A lot of people do not have easy and affordable access to nutritionally balanced foods (especially when taking food preparation time and resources into account,) and this is something that needs to be improved regardless of what else changes.
I think my only point is that for a lot of people, their gut hormones are just not properly tuned to an environment where they aren't periodically forced to go hungry and that intervening with a GLP-1RA should be seen as a perfectly acceptable alternative to "toughing it out" and "having the willpower" to live in a perpetual state of discomfort.
I just read the Scanlon piece and it's very interesting, full of compelling ideas, and needs an editor. It seems to me your response here is reactionary and reductive without really engaging in her arguments.
I read her piece as one about tradeoffs, and tradeoffs are always about values. She's arguing optimization has shortcuts, and shortcuts have costs. Ozempic is used as an example. You're arguing the shortcuts are worth the tradeoffs. That seems fine too. Maybe write about it as a clash of values?
"Putting aside the core argument ... , this positioning of Ozempic drives me totally nuts. Although Scanlon’s piece is really about something bigger, the Ozempic framing is where I want to focus, because it signals something I think is an even bigger trend in society: the celebration of suffering. Or maybe more specifically, the gatekeeping of new technology in the name of suffering."
I don't think Noah was trying to argue against what Scanlon was saying about trying to over-optimize parts of our lives as a coping mechanism for living in a broken system, or about trying to find easy fixes to very complex problems. I think he was just saying "please don't vilify Ozempic use by literally making it the name of the problems you are trying to describe." At least that's a sentiment that I think he was expressing (and which I agree with.)
Yes that’s exactly it. I was not engaging with the broader thesis (which I have some mixed takes on but generally do agree that there’s a widespread feeling amongst Americans that they’re not in control).
Admittedly I haven’t read Scanlon’s piece yet, but even from your summary of it I did not get the idea it was simply a criticism of people doing something the easy way or for “aesthetics” (merely). I think the bigger idea is that optimization is a very individual, self directed sort of activity. And personal responsibility is very important, but when it’s a whole culture of DIY over anything, it’s unhelpful, because it just hides the systems we’re in—systems we ought to have some say in, but we do not, in part because we demand to be utterly self sufficient.
But also to address the whole “why should things be hard” issue, which I agree, is an important one, there’s another nuance here. I’ve seen a lot of reports that glp-1s like Ozempic mess with human desire centres in general, reducing not only cravings for food but for much of anything. A few good pieces have circulated on Substack on this, I can point them out if anyone is curious, but even a cursory search will yield results. It makes one question what are we, without our desires? And yeah, for some it’s an absolutely amazing technology, especially if their craving is cranked up to 11, but so many are being prescribed these drugs without a proper review of medical history, let alone history of mental illness, depression, etc., that it really begs the question of who this whole “optimization” is for.
Personally, I don’t think all critique of mass adoption of glp-1s is a “good things be hard”, necessarily, though maybe some of that Protestant ethic is peeking through. I do think such tech should be available and accessible, and access to health should never be hard, ideally. But at the same time I think when we make things too seamless, too smooth, too easy, we lose the edge that makes us crave something and work for something and find meaning in that striving and doing in the first place. It’s not an either/ or sort of thing, but a spectrum. There are fundamental skills, too, like doing math in your head, that are building blocks for other, more advanced skills. Yes, you can always use a calculator, but if you don’t need to, you can move on to the next step in logic or problem solving or analysis without stopping—it’s building neural pathways that, sadly, the path of least resistance does not afford.
We can be selective about where we deem the effort useful and generative, and where it’s just a pain. The same goes for easy things. The “ozempification” thesis suggests that it’s not only a kind of myth of personal agency—personal salvation in a burning world, maybe—but also that it’s robbing us of some measure of choice elsewhere. Maybe that’s overreacting, I don’t know, but I think it’s worth thinking about.
Sure, glp-1s can be great for addiction—this doesn’t contradict that I was saying, though, and not sure it contradicts what Kyla was saying either.
The key here is actual diagnosis and proper medical supervision. For which a functioning medical system is a must. As things stand, glp-1s are also prescribed via rushed 5-minute phone consultations, to people whose broader medical history isn’t being considered, for example. But in any case, doesn’t really address my point above.
That’s a fair response, and I found your piece critiquing cognitive offloading interesting. I kind of agree? I don’t think of myself as either a techno utopian nor a doomer, to be honest, but I do think that some technologies are not like the others—a distinction that might rest not with the tech itself, but with our specific uses. Which may be a matter of personal choice or structural pressure—but usually both. I guess I’m concerned that with some technologies structural pressure supersedes personal choice, or rather, leaves us little room for it.
Ted Chiang explores some of these ideas around technology and agency in a lot of his shot stories, but a good pair that arrives at rather different conclusions is “The Truth of Fact, the Truth of Feeling” and “What’s Expected of Us.”
I agree we have an issue with valorizing suffering, but I disagree that this exempts scrutiny from either Ozempic or AI.
Ozempic feeds on and fuels a fatphobic society that does enormous harm. Pharma has been in tight with the weight loss industry to create so much fear and pressure ... but longevity researchers have found the ideal weight is, in fact, overweight. I'm sure there are cases where it is medically helpful but it feels like treating a symptom of a deeper malaise, one whose diagnosis would not be individual but economic (food as commodity, food produced as cheaply as possible, people who can't afford to eat well or slowly, sedentary lifestyle, etc) and social (fatphobia, racism, etc). The same may go re: inflammation and addiction. There's a question about attention -- whether we even pay attention to these root causes -- elided here.
Soooo yes, glp-1s are an amazing medical discovery for people with serious health problems. As are many other medical advances. But you cannot possibly not have noticed that there actually are a crap-ton of people who are indeed using them just for aesthetics. I could point you to a crap-ton of people I know personally if you have not, and I don’t even live in the States.
And while yes, individual solutions to health issues are fab for the individual, I don’t think anyone who wants to improve shitty food systems, lack of access to medical care, and the appalling cost of things like, yes, GLP-1s is saying we shouldn’t also work on obesity. I think they’re saying that those things CAUSE obesity, along with a whole host of other issues just as important.
Here’s the thing I didn’t say that I wish I did: what if those people doing it for “aesthetic” reasons have control issues or feel like they drink too much? What if it just makes them feel more positively about themselves? Are those disqualifying? I guess maybe what makes me most mad is that it just feels like another purity test.
Of course we should also deal with the upstream issues of health access and nutrition. But also we should be celebrating solutions like Ozempic. It’s a great service to the world that in the 1950s fluoride became widespread in toothpaste instead of deciding sugar usage was upstream and letting people’s teeth continue to rot away. (And eventually was followed with broader public health intervention by adding it to water.) I just don’t think we can ever assume these problems are mutually exclusive.
Look, it’s obviously complicated and, I’d say, a touchy subject for everyone commenting here. Your comment clarifies your post a lot actually, thanks, as I don’t like purity tests either, for anything. But I also don’t like the immense backtracking these drugs have (inadvertently) caused to any sort of body acceptance or healthier lifestyles, and ‘aesthetic use’ is about the nicest term I have for that.
And clearly I got riled up by your phrasing, sorry. This just isn’t either/or, this is both/and: life saving and life improving drugs are amazing, but ‘progressives’ (hi!) can simultaneously celebrate medical advances and try to fix the shit that causes a whole lot of people to need them. Perhaps you’re seeing particularly biased people rag on drugs because they care so much about systemic issues, but most people I read are well aware that both are in dire need of improvement.
Eg my mum is likely going to die of diabetes, long-term obesity, and the complications thereof, not because new drugs couldn’t help, but because she can’t afford them, even on her ass-expensive Medicare. Ie health care access isn’t ’upstream,’ and I see little point to advancing medicine when most people can’t afford it.
Oh but long live fluoride, especially cause it’s free!
What if one of the causes of obesity is the fact that our bodies are not evolved/designed to consume a healthy amount of calories while living in a calorie rich environment that doesn't go through regular periods of involuntary calorie limits? Is it possible that as long as food (or even ingredients) are available above a certain calorie/bulk ratio, some (most?) people simply do not have the natural hormone balance to consume the proper amount of calories without constantly feeling hungry and unsatisfied?
If I've been struggling for years to go from a little overweight to a healthy weight, is taking a GLP-1 RA to help me finally lose 20 lbs (and stop drinking) considered an aesthetic use? (When does being overweight become a "serious health problem" where it's OK to use medicine to help it?) Is it somehow a moral failing that while I used to eat a salad for lunch and was uncomfortably hungry the rest of the day, I now eat the exact same salad and feel great until supper?
What "caused" MY unhealthy weight wasn't a lack of healthy food. It was the fact that I lived with a constant craving and physical discomfort unless I also ate way too much additional calorie-rich stuff in addition to the good food that I have the privilege of having easy access to.
So that’s a whole lot of things that I didn’t bring up. But in my personal opinion, no, I wouldn’t at all say that in that scenario trying a GLP-a is aesthetic. Im actually on Mounjaro myself, and it’s definitely not for a serious health issue, but I don’t think it’s aesthetic, it’s because gaining 38 pounds in 3 years on a small frame because of perimenopause with no other weight loss options helping was making me insane. Which I say only to point out that I think I do understand more reasons for trying a GLP-1 than just obesity / diabetes. I’m sorry if I made that sound too black and white.
My point wasn’t to police who should get access to and can benefit from new drugs, it was that wanting to improve massive systemic problems does not necessitate that a ‘progressive’ person also wants to ignore medical issues.
I think I incorrectly took your comment as "a lot of GLP-1 use is not warranted and what we really should be fixing are the TRUE causes of obesity, which is bad food." That's my bad!
I definitely agree that it's not an either/or, thing! A lot of people do not have easy and affordable access to nutritionally balanced foods (especially when taking food preparation time and resources into account,) and this is something that needs to be improved regardless of what else changes.
I think my only point is that for a lot of people, their gut hormones are just not properly tuned to an environment where they aren't periodically forced to go hungry and that intervening with a GLP-1RA should be seen as a perfectly acceptable alternative to "toughing it out" and "having the willpower" to live in a perpetual state of discomfort.
I just read the Scanlon piece and it's very interesting, full of compelling ideas, and needs an editor. It seems to me your response here is reactionary and reductive without really engaging in her arguments.
I read her piece as one about tradeoffs, and tradeoffs are always about values. She's arguing optimization has shortcuts, and shortcuts have costs. Ozempic is used as an example. You're arguing the shortcuts are worth the tradeoffs. That seems fine too. Maybe write about it as a clash of values?
"Putting aside the core argument ... , this positioning of Ozempic drives me totally nuts. Although Scanlon’s piece is really about something bigger, the Ozempic framing is where I want to focus, because it signals something I think is an even bigger trend in society: the celebration of suffering. Or maybe more specifically, the gatekeeping of new technology in the name of suffering."
I don't think Noah was trying to argue against what Scanlon was saying about trying to over-optimize parts of our lives as a coping mechanism for living in a broken system, or about trying to find easy fixes to very complex problems. I think he was just saying "please don't vilify Ozempic use by literally making it the name of the problems you are trying to describe." At least that's a sentiment that I think he was expressing (and which I agree with.)
Yes that’s exactly it. I was not engaging with the broader thesis (which I have some mixed takes on but generally do agree that there’s a widespread feeling amongst Americans that they’re not in control).
I hope my comment above helps contextualize more: https://whyisthisinteresting.substack.com/p/the-celebration-of-suffering-edition?utm_source=direct&r=2hql&utm_campaign=comment-list-share-cta&utm_medium=web&comments=true&commentId=243769301
Admittedly I haven’t read Scanlon’s piece yet, but even from your summary of it I did not get the idea it was simply a criticism of people doing something the easy way or for “aesthetics” (merely). I think the bigger idea is that optimization is a very individual, self directed sort of activity. And personal responsibility is very important, but when it’s a whole culture of DIY over anything, it’s unhelpful, because it just hides the systems we’re in—systems we ought to have some say in, but we do not, in part because we demand to be utterly self sufficient.
But also to address the whole “why should things be hard” issue, which I agree, is an important one, there’s another nuance here. I’ve seen a lot of reports that glp-1s like Ozempic mess with human desire centres in general, reducing not only cravings for food but for much of anything. A few good pieces have circulated on Substack on this, I can point them out if anyone is curious, but even a cursory search will yield results. It makes one question what are we, without our desires? And yeah, for some it’s an absolutely amazing technology, especially if their craving is cranked up to 11, but so many are being prescribed these drugs without a proper review of medical history, let alone history of mental illness, depression, etc., that it really begs the question of who this whole “optimization” is for.
Personally, I don’t think all critique of mass adoption of glp-1s is a “good things be hard”, necessarily, though maybe some of that Protestant ethic is peeking through. I do think such tech should be available and accessible, and access to health should never be hard, ideally. But at the same time I think when we make things too seamless, too smooth, too easy, we lose the edge that makes us crave something and work for something and find meaning in that striving and doing in the first place. It’s not an either/ or sort of thing, but a spectrum. There are fundamental skills, too, like doing math in your head, that are building blocks for other, more advanced skills. Yes, you can always use a calculator, but if you don’t need to, you can move on to the next step in logic or problem solving or analysis without stopping—it’s building neural pathways that, sadly, the path of least resistance does not afford.
We can be selective about where we deem the effort useful and generative, and where it’s just a pain. The same goes for easy things. The “ozempification” thesis suggests that it’s not only a kind of myth of personal agency—personal salvation in a burning world, maybe—but also that it’s robbing us of some measure of choice elsewhere. Maybe that’s overreacting, I don’t know, but I think it’s worth thinking about.
I highly recommend this very balanced New Yorker piece on the topic. https://www.newyorker.com/magazine/2026/02/16/can-ozempic-cure-addiction
Sure, glp-1s can be great for addiction—this doesn’t contradict that I was saying, though, and not sure it contradicts what Kyla was saying either.
The key here is actual diagnosis and proper medical supervision. For which a functioning medical system is a must. As things stand, glp-1s are also prescribed via rushed 5-minute phone consultations, to people whose broader medical history isn’t being considered, for example. But in any case, doesn’t really address my point above.
I have a longer response above - https://whyisthisinteresting.substack.com/p/the-celebration-of-suffering-edition/comment/243769301?r=2hql&utm_medium=ios - and have written (and studied) quite a bit about the history of technology and the cognitive debt critique: https://whyisthisinteresting.substack.com/p/the-cognitive-offloading-edition?r=2hql&utm_medium=ios
That’s a fair response, and I found your piece critiquing cognitive offloading interesting. I kind of agree? I don’t think of myself as either a techno utopian nor a doomer, to be honest, but I do think that some technologies are not like the others—a distinction that might rest not with the tech itself, but with our specific uses. Which may be a matter of personal choice or structural pressure—but usually both. I guess I’m concerned that with some technologies structural pressure supersedes personal choice, or rather, leaves us little room for it.
Ted Chiang explores some of these ideas around technology and agency in a lot of his shot stories, but a good pair that arrives at rather different conclusions is “The Truth of Fact, the Truth of Feeling” and “What’s Expected of Us.”
It does sucks, but smart people can read under the marketing and understand the real benefits. Yet- yes it sucks.
I agree we have an issue with valorizing suffering, but I disagree that this exempts scrutiny from either Ozempic or AI.
Ozempic feeds on and fuels a fatphobic society that does enormous harm. Pharma has been in tight with the weight loss industry to create so much fear and pressure ... but longevity researchers have found the ideal weight is, in fact, overweight. I'm sure there are cases where it is medically helpful but it feels like treating a symptom of a deeper malaise, one whose diagnosis would not be individual but economic (food as commodity, food produced as cheaply as possible, people who can't afford to eat well or slowly, sedentary lifestyle, etc) and social (fatphobia, racism, etc). The same may go re: inflammation and addiction. There's a question about attention -- whether we even pay attention to these root causes -- elided here.
I just commented on another comment in the same realm, I hope this is helpful additional context: https://whyisthisinteresting.substack.com/p/the-celebration-of-suffering-edition/comment/243769301?r=2hql&utm_medium=ios