A REVOLUTION IN weight loss is apparently underway. Last fall, the US Food and Drug Administration fast-tracked review of the diabetes drug tirzepatide-sold under the brand name Mounjarofor weight loss, after a clinical trial showed that people with a body mass index (BMI) labeled "overweight" or "obese" lost as much as 22.5 percent of their body weight on the highest dose. Upon approval, the weekly injectable will be the latest drug in a booming biomedical sector that aims to combat, if not cure, the problem of "excess" weight.
For pharmaceutical companies, the race to market is, as usual, financially motivated. Weight-loss drugs are rarely covered by insurance, and companies are finding plenty of patients ready to pay more than $1,000 a month for tirzepatide and its cousin semaglutide (brand names: Ozempic and Wegovy). Commentators have hailed these drugs as a "medical breakthrough" and a "silver bullet" for obesity; people from Hollywood to the Hamptons want a prescription. Now, doctors-desperate to treat what is widely seen as an "obesity epidemic" are showing interest.
But victorious narratives around drugs like Mounjaro pose a direct challenge to the fat activism movement. For decades, this movement has pushed for social and economic opportunity for people of all sizes using a variety of rhetorical modes-civil rights, fat pride and liberation, and biomedical evidence itself. Many people now know that "lifestyle changes" like calorie restriction and exercise fail to produce sustained weight loss for 97 percent of people and that many dieters end up gaining back more weight than they lost. But what happens to the strength of these arguments when a weight-loss drug seems to work?
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