Johann Hari on the dangers, benefits of drugs

Johann Hari still remembers the strange sensation he felt two days after injecting himself with Ozempic.

A doctor prescribed the weight-loss drug — a notorious side effect of type 2 diabetes treatment — in 2023 when Harry weighed 203 pounds and had a body fat percentage of 32%.

Harry’s grandfather died of a heart attack aged 44, his uncle in his 60s and his father underwent a quadruple heart bypass in his 70s.

Hari didn’t have diabetes and was wary of weight-loss drugs, knowing that past options “always turned out to be a disaster,” he says. But losing weight with Ozempic seemed like a way to lower the risk of heart disease.

He noticed the effect of the drug a few days after his first dose.

“I woke up and thought: “There is something strange. What is it? I couldn’t figure out what it was. And then I suddenly realized that I was awake and not hungry. This had never happened to me,” Hari, 45, a journalist who lives in London and Las Vegas, told TODAY.com.

“My appetite decreased dramatically from that point on. I was much less hungry than before. I felt very full, very quickly.”

Hari ultimately lost 42 pounds on Ozempic and then its sister drug Wegovy, which has the same active ingredient, semaglutide, and is specifically approved for weight loss.

He set out to find out all he could about GLP-1 drugs — which mimic at least one hormone produced by the gut to signal fullness — in his new book, “The Magic Pill: The Incredible Benefits and Disturbing Risks of new weight loss”. Drugs.”

Hari shared his insights in an interview with TODAY.com. His answers have been edited and summarized for clarity:

TODAY: You call these weight-loss drugs “a massive experiment, done on millions of people, and I’m one of the guinea pigs.” Why?

Hari: I’m part of two experiments, not just one. I was part of the experiment that made us much fatter. And now I’m part of the experiment that’s reversing drug use.

In my lifetime, we have had an obesity explosion that is unprecedented in human history. We have been physically changed by the processed and ultra-processed foods that have completely taken over our diet and are unlike the food people ate before us. This food is undermining our ability to ever feel full.

The second experiment I am part of is these drugs. They give you back the feeling of being full. But they also bring with them some risks.

What potential risks concern you the most?

Semaglutide has only been used for a little over two years now for people with obesity. We don’t know the long-term effects of taking them. There is a concern that maybe they will have an effect that we just don’t know in the long run.

Expert opinion: Dr. Christopher McGowan, an obesity medicine specialist in Cary, North Carolina, says that when patients ask him if it’s safe to take Wegovy for years, he tells them there are no long-term studies on it. But he notes that GLP-1 drugs have been used for more than a decade to treat type 2 diabetes, “so we have a very reassuring story overall with these drugs,” McGowan. TODAY.com previously said.

Dr. William Yancy, medical director of the Duke Weight and Lifestyle Management Center in Durham, North Carolina, added that after reviewing the research, he feels comfortable prescribing Wegovy knowing that a patient may need to take it. that for years or decades.

“We’re always gathering knowledge and so this may change down the road, but at this point we have enough information to consider this a long-term treatment,” he told TODAY.com.

Asked whether Wegovy is safe to take long-term, Novo Nordisk, its manufacturer, tells TODAY.com that GLP-1 drugs like semaglutide have been used to treat type 2 diabetes for more than 18 years and treating obesity for eight years. years.

“Semaglutide has been extensively examined in robust clinical development programs, large real-world evidence studies and has cumulatively over 9.5 million years of clinical patient experience,” the company said in a statement.

“Novo Nordisk stands by the safety and efficacy of all our GLP-1 drugs when they are used as indicated and when taken under the care of a licensed healthcare professional.”

The company also says it works closely with the US Food and Drug Administration to continuously monitor the safety of its drugs.

TODAY: What specifically bothered you?

Hari: For myself, the only danger I didn’t see coming was the psychological effect. It was really strange. The first six months I was taking the medicine, I was getting what I wanted – I was losing a lot of weight, my pain went away, all sorts of good things happened.

But I actually felt no better in my emotions. If anything, I felt a little worse. I realized it was about my inability to comfort eat and how bad it was making me feel.

I went to KFC in Las Vegas and did what I would have done before taking Ozempic – ordered a bucket of fried chicken. I had one of the chicken sticks and suddenly I thought, “I can’t eat this.” At Ozempic, you can’t overeat. I’m going to vomit. I remember a voice in my head: “You’ll have to feel bad, then.”

Can you no longer use food as a coping mechanism for stress?

Exactly. This can be a bumpy adjustment process for many people. It can bring to the surface the deep emotional reasons why you ate in the first place.

I realized how much of my eating was a need to comfort myself – stuffing myself to soothe myself. And I couldn’t do that when I was in Ozempic.

The psychological effects made me want to stop, but one of my friends told me, “You can find a better way to deal with your emotions than overeating.”

You say you’ve experienced “surprisingly persistent” side effects. What were they?

The side effects weren’t terrible, but they were unpleasant. They gradually decreased over four months.

The day after I would have an injection once a week, I would feel a little sick. It’s pretty soft.

I had one of the less common side effects – some people feel their heart beats faster. It’s hard when your heart is racing not to feel anxious because your body feels like something is wrong. So that was, for me, the most unpleasant side effect.

I want to emphasize that I have experienced many benefits from this medicine. I went from eating 3200 calories a day to 1800 calories a day and not feeling hungry.

Editor’s note: US Food and Drug Administration label for Ozempic states that in placebo-controlled trials of 0.5-1 milligrams of the drug “resulted in an average increase in heart rate of 2 to 3 beats per minute.”

Do you plan to continue taking Ozempic indefinitely?

Yes, because of the risk of heart attack in my family, for me personally, the benefits of these drugs outweigh my real concerns about long-term effects. Studies show that Wegovy (which contains the same active ingredient as Ozempic) reduces the risk of heart attack or stroke by 20%.

You have to weigh two sets of risks – the risks of obesity versus the risks of these drugs. Obesity makes almost all the health conditions we fear more likely – heart disease, stroke, dementia, cancer.

Expert opinion: When considering weight loss drugs like Wegovy and Zepbound, each person must weigh the benefit against the risk for themselves, including continuing obesity will affect their healthBeverly Tchang, an endocrinologist and obesity physician at Weill Cornell Medicine in New York, TODAY.com previously said. She is a consultant for Novo Nordisk, the pharmaceutical company that makes Ozempic and Wegovy.

“For many of my patients, I know they’ve struggled with obesity for their entire childhood and adulthood now, and the benefits outweigh the risks once they start medication,” Tchang said.

Are these really “magic” drugs, as you call them in the title of your book?

There are three ways these drugs can be magical.

The first is the most obvious: they could just fix the problem. It feels like this for days. All my life, I have eaten too much. Now, I inject myself once a week and I don’t overdo it. It feels like magic.

The second way it can be magical is much more disturbing. It can be like a magic trick. It may be that over time, the risks associated with these drugs outweigh the benefits. I do not rule this out.

The third way is, I think, the most likely. Think of stories of magic, like “Aladdin.” You find the lamp, rub it, the genie appears, grants your wishes, and your wish comes true – but never in the way you expected.

Drugs are such a powerful tool. They will have large and unpredictable effects – positive and negative. This is why we need to take a break and really think about this incredible revolution that is upon us.