Life After Food

A diabetes miracle drug has become an off-label appetite suppressant, changing the definition of being thin and what it takes to get there.

- By Matthew Schneier. Photographs by Pierpaolo Ferrari and Maurizio Cattelan

Allison is an actress. When we meet up for coffee-she has an almond-milk cortado-in midtown, something's different about her, but I'm not sure what. She looks like an Instagram version of herself but in real life.

It turns out she's down about ten pounds and happy about it. "Somebody once told me I had a size-zero personality, and they assumed that I was thinner than I was," she tells me. "We don't talk about it, but everybody knows it. Thin is power." Allison isn't alone in seeming to be suddenly, unaccountably slimmer of late. She admitted to me with the provision that I not use her real name-the reason, one that is increasingly common if still not quite openly discussed. For the past month, she's been jabbing herself every week with Ozempic, the heavily advertised ("Oh, oh, oh, Ozempic, to the tune, none too subtly, of the '70s classic-rock hit "Magic") diabetes miracle drug, which works by mimicking a naturally occurring hormone, GLP-1 (glucagonlike peptide one), to manage hunger and slow stomach emptying.

For diabetics, it lowers blood-sugar levels. It also subdues the imp of appetite. The pounds fly off. That's why Allison, who is not diabetic, prediabetic, or even overweight, is on it. Doctors have wide latitude to prescribe drugs off label for anyone they think may medically benefit, and many patients have found doctors-or, failing that, nurse practitioners or medi-spas-ready to certify that they would. Or some, like Allison, find it through a peddler not particular about a prescription or in the web's dark morass.

"Should anyone SUDDENLY APPEAR SVELTE, I just ASSUME IT'S OZEMPIC. However, if they elaborate unprompted on their new diet, THEN I KNOW IT'S OZEMPIC."