Embarrassment is a side effect of new obesity medications.

The social conflict between the desire to treat sickness and the stigmatizing notion that obese people lack the willpower to decrease weight is revealed by Wegovy and other medications.

Eileen Isotalo could always lose weight, but she always put it back on. Her first diet, which she is currently on at age 66, was with Weight Watchers. She continued to attempt diet after diet and purchase so many weight reduction books that she now believes she has more than the entire public library.

She finally visited a weight management clinic at the University of Michigan out of desperation. She was unable to control her hunger despite having sleep apnea and sore knees.

The retired interior design coordinator Ms. Isotalo added, "It's just this drive to eat. When you start to crave food, it almost seems panicky.

"My mental shame was profound," she admitted.

But those urges have vanished since she started taking Wegovy, one of a new class of obesity medications that her doctor at the clinic prescribed. She no longer wears the dark clothing she wore to conceal her physique after losing 50 pounds. She no longer experiences the stigma associated with her obesity, which led her to withdraw from her family and friends.

She still worries that she will be judged for getting injections to address her obesity, like other patients at the clinic, rather than mustering the willpower to lose weight and keep it off.

But she claimed that the medicine "changed my life."

This is "a very exciting time in the field," according to Dr. Susan Yanovski, co-director of the office of obesity research at the National Institute of Diabetes and Digestive and Kidney Diseases. Wegovy and medications similar to it have made this possible.

The Centers for Disease Control and Prevention estimate that 100 million Americans, or 42% of the adult population, are obese. The harsh trap of unsuccessful dieting can be avoided for the first time by obese people, who previously faced a lifetime of medical risk, and who will see their obesity-related health issues lessened along with the weight loss.

But the stink still lingers.

There is a moral element to it, according to Dr. Yanovski. People genuinely think that obese individuals only need to summon their willpower, and they believe that taking medication is the simple solution.

In contrast to other chronic illnesses, obesity is openly visible, according to Dr. Yanovski. Nobody can tell you have high blood pressure or high cholesterol just by looking at you, she claimed.

She continued, "One of the most stigmatized conditions out there is obesity.

Only Wegovy and a related but less potent drug, Saxenda, have so far been licensed for the treatment of obesity; Ozempic and Mounjaro are diabetes medications but also help with weight loss.

According to Wegovy's manufacturer, Novo Nordisk, around 110,000 prescriptions for the medication have been written by doctors in the US. The business just suspended its Wegovy advertising due to high demand.

The Novo Nordisk spokeswoman, Ambre James-Brown, stated, "We can't make enough." Because there are so few supplies, the corporation is only able to sell the medicine in the three countries where its corporate offices are located: the United States, Norway, and Denmark. Most people cannot afford it because of its high list price of $1,349 a month because their insurance does not cover it. However, a growing number of insurers do.

The medications have been developed at a time when studies have shown the dangers of obesity and the ineffectiveness of recommending merely diet and exercise as a course of treatment. Few people can lose excess weight and keep it off with only lifestyle changes, according to decades' worth of research.

Obese people are more likely to develop a number of serious medical disorders, such as nonalcoholic fatty liver disease, which is the most common reason for liver transplants in the US, diabetes, hypertension, high cholesterol, and sleep apnea.

Some of these issues can be resolved by losing weight.

Nevertheless, the notion that people could lose weight if they really tried is still prevalent and is supported by diet gurus, influencers, and a sector of the economy that sells supplements and diet regimens.

Because of the widespread belief that obesity is a lifestyle choice, people who use drugs like Wegovy frequently find themselves in difficult situations.

There are people at the University of Michigan clinic who are reluctant to say they use Wegovy because they believe that doing so is typically seen as cheating, like Ms. Isotalo.

However, Detroit resident Katarra Ewing, another user, readily admits to using the medication to anyone who inquires. She tried diets, but Wegovy was the key to her 90-pound weight loss.

She arrived at the weight loss clinic in a bright green sweater after working a 12-hour shift at a Ford factory. Since she shed the weight, she has more energy, a happier mood, and her high blood pressure is no longer an issue.

She did, however, discover an unanticipated social effect of losing weight when several lifelong friends abandoned her.

Only a very limited number of my actual pals remain, according to Ms. Ewing.

The same thing happens after people lose weight with bariatric surgery, according to experts in the field of obesity treatment, therefore they are not surprised.

Because obesity is such a defining illness, relationships change. Until the friend loses weight, people of normal weight may feel superior to an obese friend, which helps define a relationship. Other friends who also have obesity may use it to strengthen their bonds with one another. That's gone now.

Another problem is that the medicines have a bad reputation for being vanity pills, which has been exacerbated by jokes made by comedians at events like the Oscars and other high-profile occasions.

However, Samuel Simpson believed that losing weight was a matter of life or death when he visited the weight loss center.

Mr. Simpson was frightened that he might inherit the weight and diabetes of his mother, brother, and sister. Each of them passed away at the age of 59 after developing kidney disease, which ultimately killed them all.

He was 58 years old when he made his first appointment with Dr. Amy Rothberg at the clinic. He was overweight and diabetic. His kidneys were beginning to fail even though he was taking large amounts of insulin to decrease his blood sugar.

"I was so afraid," he admitted. Was I going to have to undergo dialysis, just like everyone else? I'd be a footnote.

He started with a diet, and then Dr. Rothberg added Mounjaro, an Eli Lilly medication that looks to be even more effective at causing weight reduction than Wegovy but is only currently approved for use in persons with diabetes.

He has already shed 44 pounds, or 20% of his starting weight, and his diabetes is no longer an issue. He claimed that losing weight "turned my life around."

"I'm not like the roadside preacher, but when someone asks me how I did this, I will tell them," he added. He will respond to people who inquire about how he shed the weight.

The problem was different for Art Regner. He claimed he wasn't ready to turn to medication while serving as the rambling color analyst for the Detroit Red Wings hockey team. But he was disappointed when he arrived at Dr. Rothberg's office. Of the 76 pounds he lost by dieting, he had gained 22 back.

Wegovy or Mounjaro were recommended by Dr. Rothberg, who also serves as the medical director of Rewind, a company that provides diabetes sufferers with counseling. But Mr. Regner believed he ought to possess the determination necessary to complete it on his own. He is aware of the effects of diabetes and is aware that his blood sugar is high.

He was kindly informed by Dr. Rothberg that it was not his fault that he kept putting weight back on after each loss.

She declared, "I believe biology is working against you." "I don't think it's a willpower issue,"

Mr. Regner was unmoved by this. "I believe in myself," he declared. "When I first wake up, I ask the mirror, "Are you going to do it or aren't you?"

The following was changed on June 14, 2023: The list price of Wegovy was incorrect in a previous version of this article. Instead of $13,492, it is $1,349.

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Source: The New York Times: By Gina Kolata