The latest trend now is weight loss in a pill — or a shot. As society has just started shifting stigmas to include larger bodies into the definition of beauty, we’re also seeing a huge increase in fast-tracked weight loss. And in spite of this frustrating societal irony, who is regulating this thing? Doctors and prescribers are in charge of dispensing these miraculous drugs to struggling patients and while I trust their ethics and judgment, I worry that we need more firm restrictions on their ubiquity, especially among youth. A study from Michigan Medicine found that the number of youth (ages 12–17) who receive GLP-1 medications off-label for weight loss from 2020–2023 increased by over 500%. While obesity is a rising concern nationwide and often a cause of the modern deadly diseases today, is this really ethical medicine?
The big names Ozempic, Wegovy and Mounjaro are glucagon-like peptide-1 receptor agonists (GLP-1RA), which is its fancy word for simply delaying gastric emptying. The food sits in the patient’s stomach for longer, helping them feel full faster and longer, ultimately leading to significant weight loss. However, this is an off-label therapy, meaning Ozempic — also known as semaglutide — was approved by the Food and Drug Administration to help with type 2 diabetes but was unofficially found to also assist with weight loss. But the drug doesn’t do anything biochemically convoluted. It simply reduces the transit time of digestion and at life-saving dramatic rates.
Ozempic can be immeasurably beneficial for those who have struggled with weight. It reduces Body Mass Index, lowering risk of cardiovascular diseases. In youth, even a small decrease in BMI significantly lowers risk of obesity in adulthood. Physicians then advocate for aggressive use of Ozempic in children as young as 6 years old, to adults as old as 25 years old. In spite of medical benefits, I’d argue this isn’t ethical medicine. These approaches boil a child down to their BMI, avoiding the effects on the child’s self-image and ability to adapt. These aggressive approaches should be kinder and more personal: why is the child struggling with their weight? Will lowering BMI now actually promote whole health into adulthood? It may actually be avoiding greater social, environmental or economic concerns at home. Medicine teaches us to look at causes, why can’t we here?
I worry that we should be teaching young students how to be autonomous who learn to take charge of their health, instead of teaching injection. Youth should not be taught to view their bodies as medically alterable at will. Kids should not look in the mirror and see their growing bodies as ill or diseased, as a prescription may incline. Kids should not ditch healthy self-control and long-lasting exercising habits for pounds shaved off. Students are moral sponges, who need time to learn such moral self-regulation. If I was told as a teenager that my slightly overweight body needed injection for my future cardiovascular health, I may have cried.
I worked as a medical assistant in an endocrinology clinic for a while, so I got intimate with these drugs, their reputation and their representatives at Big Pharma. Patients who I met ranged from middle-aged women who sobbed trying for years to get weight off to older women going through menopause who need a fix now before they look in the mirror tomorrow. And it was mostly women, too. I felt for the girls who looked beautiful in their clothes but complained in watered eyes that their bodies were fat or worthless or unrecognizable. And I listened as the prescriber desperately wanted to help her. So, tired of offering exercise and diet strategies to frustrated ears, she reached for the Ozempic brochure.
We reach an impasse: prescribers want to see their young patients happy and healthy but Ozempic and Mounjaro don’t actually help them with dignity, determination and self-compassion. This classic dilemma in medicine is the doctrine of double effect. Prescribers offer themselves excuses for mental ease by arguing that whatever emotional anguish this child may suffer is worth the years they’ll earn off of reduced risk of cardiovascular diseases. This should bother you. Medicine is not simply about reducing risks — it’s about promoting autonomous and free well-being. Teaching a child or a young adult that they should medically alter their body does not lead to a free life.
Our bodies change, especially women who go through hormonal changes or menopause and we should be proud of aging. Weight change is a reflection of yourself and a moment for one to introspect about their habits — not in any way a determination of identity or worth. This moral distinction is the breaking point of prescribing Ozempic and others. Where patients require greater help at losing weight for serious comorbidities, Ozempic can start lives. But it must be a last resort, especially for morally malleable students. I understand each patient’s unique story requires a unique direction, however Ozempic may be avoiding a problem of physicality and contributing to negative self-images. But we need role models. Schools and parents should similarly learn to demonstrate how students can be active in the long-term without medication. These habits will spill into adulthood. We learn in youth how to view and love our bodies and urging overweight medical intervention is simply an outdated medical practice.
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Zaina Jasser is a junior studying physiology and philosophy with a minor in music at the University of Arizona. She enjoys conversations about ethics, trying new cheeses and metal rock and wants to work in medicine one day.
