We’re still processing the pandemic. Covid-19 did odd things to people. Or, rather, government responses to Covid-19 did odd things to people as much as the disease itself. I was one of those people.

　　At the same time, new drugs emerged which are starting to do odd things to civilisation. That they emerged as the world seemed to come unmoored from reality in other respects may turn out to be significant.

　　In 2020 and 2021, I piled on roughly thirty kilos. That’s sixty-six pounds for the non-metric crowd up the back. I went from being a person who’d never been fat in her life to someone who tipped the scales at a BMI of 33. Thirty, note, is the NHS’s official obesity marker for people of Northern European descent.

　　Obviously, I ate the food and drank the alcohol that led to the weight gain. Yes, being confined to barracks didn’t help. My partner and I sat outside in 2020’s glorious spring sunshine and enjoyed a daily tipple, listening to unaccustomed birdsong as we drank. I’d cycled long distances for all sorts of reasons on pretty much a daily basis since early primary school, but now had nowhere to go. Other people I know responded differently. Lorenzo Warby—the Australian writer with whom I share a Substack—used the pandemic to burn his excess weight off.

　　It took me until September 30, 2022, to get sick of being unfit, fat, and immobile. Looking through the retrospectoscope in the eighteen months since then doesn’t reveal a single, obvious moment where I decided enough, although I suspect having to buy trousers in a “big and tall” outlet may have had something to do with it. (If you’re an obese woman who’s also north of six feet, then well-fitted women’s clothes don’t exist.)

　　I started going to the gym three times a week (with this bloke) and lifting weights in 2022’s Sober October. During 2023, every time the editors of this fine magazine saw me for work reasons, I was notably slimmer.

　　I’ve now officially lost 39 kg (85.8 lb or 6.13 stone). Lorenzo Warby (my co-substacker) lost 43 kg (94.6 lb or 6.76 stone). I’m the same weight I was in August 2000, when I passed my Shotokan Shodan exam under the direction of Sensei Keinosuke Enoeda. I raise this to emphasise the extent to which my weight gain emerged from the pandemic. I was active and sporty in my youth, willing to challenge myself to achieve difficult physical goals. Lorenzo, by contrast, has spent a lifetime fighting what he calls “the battle of the bulge” and simply got sick of it. Among other things, the pandemic broke his habit of having breakfast in one of Melbourne’s many excellent cafés.

　　Nonetheless, we both lost our weight the conventional way, using diet and exercise.I mention this because we did so just as Ozempic and Tirzepatide completely upended weight loss methods globally.

　　I hadn’t realised the extent of the change until I went to Tenerife last month for a blast of winter sun (insert stereotype of Brits and their cold rainy island here), and no-one was fat. Or, rather, people were on the way to not being fat or had already lost the lot. And I mean a lot. Thanks to my own weight loss, I know what loose skin looks like (I have a small amount, kept manageable because I lost weight slowly). I saw people in Tenerife’s high-end resorts who werecoveredin loose skin, but without surgical scars. Typically, only bariatric surgery produces such extreme effects. I could draw comparisons because I’d visited Tenerife in the same March weeklast year. At that point, I was halfway through my own weight loss, and there wereloadsof fatties. I was but one of many.

　　This is the sort of sociocultural shift that starts at the top and trickles down and has the potential to upend a great deal of what we think we know about human health and productivity. Many of the ex-fat people my partner took to calling “the wrinklies” during our stay had fine figures and a lovely, upright carriage. One got a sense of how they’d looked when young and trim.

　　From time to time, I’ve wondered why obesity rates are rising globally, including in the developing world. Somewhat incredibly, there are lower and middle-income countries experiencing both an obesity and a malnutrition crisis out there. Mind you, I’ve never had a problem accepting that weight gain generally and obesity specifically often have strong genetic components. Some folk are always going to be fighting the battle of the bulge. This is why the phrase “yo-yo dieting” exists. There’s a difference between people like me who have always been slim before putting on pounds later in life, and people I know at my gym who must rule themselves with a rod of iron to stop the weight creeping back.

　　However, while I’ve always accepted genes are responsible for human traits and behaviour, I’m aware these traits are responsive to social norms and other environmental factors.

　　Famously, educational achievement and weight are both about 70 percent heritable. In the 1970s, thirteen percent of Americans graduated from college. Today, it’s 35 percent. In the 1970s, about 13 percent of Americans were overweight. Today, it’s around 70 percent. Americans’ genes did not magically make them brighter and fatter over the last fifty years. The environment changed, making it easier to go to university. Similarly, the environment changed and made it easier to get fat, so more people did. Environmental effects cut both ways, too. Like obesity, tobacco use is highly heritable (60-80 percent) but the percentage of Americans who smoke has dropped by half since 1982. Smoking is being stigmatised out of existence.

　　Admittedly, the sources and causes of what nutritionists and personal trainers call “our obesogenic environment” are far more complex than what happened to the universities (they simply began to admit large numbers of less intellectually able people as undergraduates).

　　Despite years of being active and a long-term interest in sporting performance—especially in martial arts—there were new things my post-pandemic health kick taught me. I hadn’t known, for example, that the yo-yo dieter or refractory alcoholic of popular stereotype is by no means universal. Many people lose their weight and keep it off, while about three-quarters of people with alcohol dependency overcome their addiction and later resume drinking without negative consequences. I’d always thought one drink’s too many but a hundred aren’t enough was an alcoholic universal.

　　That Ozempic and Tirzepatide are reaching the people who genuinely can’t lose weight and keep it off was brought home to me during a conversation with a pharmacist friend. He lets the local chapter of Alcoholics Anonymous meet weekly in the office above his shop. A devout Muslim who doesn’t drink, he’s always offered this venue on the basis that it’s unfair to expect alcoholics to meet anywhere near pubs.

　　Body positivity campaigns exist in part because they want the rest of us to see the constraintof obesity as a type of oppression.

　　“Some of the people with NHS GLP-1 agonist prescriptions come to that meeting,” he told me the other day. “And since they’ve been giving themselves the weekly shots, they no longer want alcohol and don’t need to come to the meeting.”

　　I thought this was a good thing and said so.

　　“You must understand how astonishing this is. I am a pharmacist, and a pharmacist is only a slightly fancy chemist. These new drugs can change not only your body chemistry but what goes on between your ears in response to that chemistry. I know you are not a believer, but to me, that is miraculous.”

　　In other words, Ozempic and Tirzepatide and various newer, less nauseating GLP-1 agonists coming down the pike have the potential to end or seriously curb most or all diseases of human reward systems. By comparison with this, the much-touted wonders of artificial intelligence look like overrated trivia. (Not much has shown signs of being any good: bad writing, alternative facts, and shite art.)

　　Meanwhile, Novo Nordisk—manufacturer of Ozempic and Wegovy—is in the process of turning Denmark into a pharmaceutical giant with a country attached. Eli Lilly—Novo Nordisk’s main rival when it comes to GLP-1 agonists—is doing something similar with the US state of Indiana.

　　This represents sciencesolving or at least ameliorating a biological constraint,much like the oral contraceptive and childhood vaccines did. Those things upended not only evolved and universal human constants. They also upended the evolutionary adaptions we’d made in response to lacking control over our fertility or losing roughly half of all children before their tenth birthday.

　　The ability to take weight off and keep it off is often moralised: people who can’t do it are weak-willed, the argument goes. What Ozempic and Tirzepatide suggest instead is that while it’s reflective of conscientiousness—yet another heritable trait—self-control is not moral-in-itself. Rather, the lack of it makes one more susceptible to being led into acts determined by others. In other words, people don’t lose weight because they’re more moral, or fail to lose it because they’re not.

　　Relatedly, there’s also a serious problem with suggesting all this scientific and medical innovation is unnatural. Such claims trundle inexorably down the slippery slope to a point where you start arguing against developing a vaccine for the Black Death.

　　By the same token, biological constraints that the oral contraceptive, childhood vaccines, and GLP-1 agonists ameliorate aren’t oppression. You can’t take up your issues about fertility, pregnancy, lactation, and childbirth with anyone other than Mother Nature, and she’s spent billions of evolutionary years deaf to all cries, not just human ones. Arguing with cholera or polio won’t get you far either. You’re better offpreventingboth.Seeing biological constraints as oppression—constraints imposed by one’s pre-installed, sexed body, for example—forms a large part of the modern trans movement.

　　Likewise, a tendency to put on weight isn’t oppression. Like the ability to get pregnant, it comes pre-installed. Modernity has made it easier to enliven the genetic trait, too, which is why so many people are fat. Body positivity campaigns exist in part because they want the rest of us to see the constraintof obesity as a type of oppression.

　　And then, along comes science and sweeps the constraint aside.

　　It’s tempting to slot GLP-1 agonists into a general narrative of technical progress without appreciating how massive a change they will make. The implications are profound.