“A New Drug Switched Off My Appetite. What’s Left? Mounjaro Did What Decades of Struggle With Managing Weight Couldn’t. Welcome to the Post-Hunger Age”, 2023-02-03 ():
…Obviously genetics were a factor. (I remember when my uncle died, someone whispered, “My God, how much does this funeral weigh?”) What health professionals call my morbid obesity—that “morbid” is a helpful reminder—is what you see. But it’s a side effect of what I am, which is insatiable. Literally: I never seem to feel full. In practice this means that at certain times of day, I watch in horror as my body reaches for the cheapest, easiest calories nearby—out of the pantry, out of a vending machine, at a party. I scream, “Stop!” But the hand keeps reaching…“Well”, my doctor said, “if you’re not losing weight with Ozempic [low-dose semaglutide], try Mounjaro [tirzepatide].” This one was FDA-approved last May, with an atrocious name. So off I went, from one shot to the other, from Novo Nordisk to Eli Lilly. Whatever.
“Something’s happened”, I told my wife. She is a veteran of watching me try to fix my body. I told her: Where before my brain had been screaming, screaming, at air-raid volume—there was sudden silence. It was confusing. Would it last? I went alone that night to a Chinese restaurant, the old-school kind with tables, and ordered General Tso’s. I ate the broccoli, a few pieces of chicken, and thought: too gloopy. I left it unfinished, went home in confusion, a different kind of sleepwalker. I passed bodegas and shrugged. At an office I observed the stack of candies and treats with no particular interest. Decades of struggle—poof. Apparently the Mounjaro molecule targets the same hormone as Ozempic, plus a second one, so it doesn’t just stimulate insulin production but also boosts energy output.
“I urgently need”, I thought, “an analog synthesizer.” Something to fill the silence where food used to be. Every night for weeks I spent 4, 5 hours twisting Moog knobs. Not making music. Just droning, looping, and beep-booping. I needed something to obsess over, to watch YouTube videos about. I needed something to fail at every night to feel normal. And I was also manic, dysregulated, and wide-eyed, sleeping 5 hours a night, run-walking, with pressured speech; my friends, happy for me but confused, called me “cocaine Paul.” I bought more synthesizers off a guy from Craigslist, meeting him in Bushwick, Brooklyn, with a grand in cash. A body is not designed to lose 25 pounds in 8 weeks, starting during the holidays. Beep. Boop.
With the relief come new anxieties. What if it stops working and I slide back into the vale of infinite noise? Compounding that, these drugs are hard to get, both because of supply chain problems and because they are being prescribed off-label for weight loss instead of diabetes. I can’t get a steady prescription from the pharmacy. I’m developing a rationing plan, stretching from an injection every 7 days to one every 8–9 to build up a stockpile.
I can see my anxiety mirrored in the wave of reactions starting to appear—op-eds, TV segments, people explaining why it’s good, actually, that the vast majority of those using this drug lose a quarter of their body weight. On social media, fat activists are pointing out that our lives were worthy even without this drug. The wave of opinion will not crest for years.
And that’s fair because this is new—not just the drug, but the idea of the drug. There’s no API or software to download, but this is nonetheless a technology that will reorder society. I have been the living embodiment of the deadly sin of gluttony, judged as greedy and weak since I was 10 years old—and now the sin is washed away. Baptism by injection. But I have no more virtue than I did a few months ago. I just prefer broccoli to gloopy chicken. Is this who I am? How long is it before there’s an injection for your appetites, your vices? Maybe they’re not as visible as mine. Would you self-administer a weekly anti-avarice shot? Can Big Pharma cure your sloth, lust, wrath, envy, pride? Is this how humanity fixes climate change—by injecting harmony, instead of hoping for it at Davos? Certainly my carbon footprint is much smaller these days.
…Lately I’m finally less manic. Still losing weight, but much more slowly. Exercising more. At night I play with my synthesizers and watch online classes in music theory. Headphones on, processing all those years of futile effort. As I fiddle with knobs I am sometimes angry, sometimes ashamed, and often grateful. I don’t know how long this post-appetite era will last, or how it will end. Just that, once again in our lives, everything has changed.