
Much has been made of Ozempic face. The eponymous visage resulting from monthly injections of a weight-dissolving amino acid has generated endless fodder for social media and the tabloids, which have revelled in the grotesqueries of John Goodman, Robbie Williams and the poster child of the gaunt and ghostly look — Sharon Osbourne. There’s nothing quite as stimulating of schadenfreude as the tell-tale sagging of fat-starved skin, a calamity that might be rectified by fillers such as Sculptra and Restylane, by drinking two quarts of water a day, or, God forbid, by eating lunch.
Despite the risk of public shame and the menace of non-reimbursable insurance cost ($1,349 a month for Wegovy and $1,060 a month for Zepbound), steep demand has sent the stock market valuations of Novo Nordisk and Eli Lilly through the stratosphere of the S&P 500. Not since the debut of Viagra has there been such hype in pharma, raising questions as to whether Eli Lilly and Novo Nordisk can produce enough of the magical elixir, as demand outstrips supply.
As competitors flood the field — most recently, Amgen’s MariTide, yet another semaglutide already in Phase 2 trials — Goldman Sachs analysts estimate that by 2030, the market for such drugs will be worth in excess of $100 billion. The lion’s share will be sold in America, where for hundreds of years the seemingly simple alternative — to eat or not to eat — has been a national obsession. Washington Irving, America’s first author whose fame crossed the Atlantic, invested a great deal of his literary capital describing the young republic’s utter lack of proportion when it came to food. His History of New York, published in 1809, asserted that the earliest political leadership of Manhattan was a Dutch “colony of huge feeders”, in which the burgomasters were “generally chosen by weight”. Their chieftains were “the best fed men in the community; feasting lustily on the fat things of the land, and gorging so heartily on oysters and turtles, that in process of time they acquire the activity of the one, the form, the waddle, and the green fat of the other”.
Today, Americans are no less obsessed with weight. Such disses of the Dutch were the Federalist equivalent of present-day body-image disputes over Ozempic, typified by the hysterical row last month over Barbra Streisand’s intervention as to whether or not Melissa McCarthy was shooting up with the serum.
Despite the morass of scientific explainers, confessional essays and philosophical think pieces, all this food freak-out should be filed under “old news”. Americans have been gaining weight for as long as they have been trying to lose it. Indeed, a few hundred miles north of the turtle-gorging Dutch of Manhattan, the Puritans of Massachusetts were gauging their status as chosen people through their gastrointestinal tract, as Samuel Sewall’s noted in a diary entry from 1690: “Mr Torrey is for a fast or at least a fast first. Mr Willard for a Thanksgiving first. Mr Torrey fears lest a Thanksgiving should tend to harden people in their carnal confidence.”
Thus did binge-eating, spiked with self-induced starvation, find its earliest footholds in the land of milk and honey. The great Puritan divine Cotton Mather outlined the toxic paradox when he asked: “Has not my soul as much amiss in it as my stomach?” Mather’s unflinching investigations of depraved digestions came to all-too recognisable conclusions.
In the case of apoplexy, vomits do a deal of good.
In the case of vertigo, vomit.
In the case of hiccups, vomit.
In the case of nightmares, vomit.
In the case of a coma, more vomits …
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