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Speaker 1: This episode contains distressing themes, including suicide and disordered eating.

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Speaker 1: For twenty four to seven support, please contact Lifeline on

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Speaker 1: thirteen eleven fourteen. You'll find some links to more resources

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Speaker 1: in today's episode description from viral weight loss drug to Hollywood.

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Speaker 2: Punchline when I look around the from I can't help

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Speaker 2: but wonder is Ozembic right for me?

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Speaker 1: Once touted as the breakthrough medication that could end type

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Speaker 1: two diabetes, Ozempic has exploded in popularity, taking social media

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Speaker 1: by storm as a so called miracle drug.

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Speaker 3: This group of drugs for diabetic control have been around

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Speaker 3: for quite a while. Ozembic, however, when it came out,

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Speaker 3: was the one that had this significant profile for weight loss.

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Speaker 1: Over the past two episodes, we've explored the world of

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Speaker 1: weight loss medications glp ones like ozempic, WeGo Vi and

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Speaker 1: Munjaro to understand how they work and their impact on

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Speaker 1: young Australians like Grace. The mobility is insane, the change

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Speaker 1: of perspective is enormous, and Mackenzie I.

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Speaker 4: Was in such a bad place that he suggested I

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Speaker 4: go to hospital stop taking it immediately.

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Speaker 1: We've explored topics like ethics and health as well. As

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Speaker 1: the world of online prescribing. This time, for our final episode,

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Speaker 1: we'll dive deeper into the social ramifications of weight loss

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Speaker 1: medications from the lengths that people go to get them.

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Speaker 3: People will sometimes aim to deceive and it's harder to

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Speaker 3: unmask in the online environment than it is in the

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Speaker 3: face to face.

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Speaker 1: Environment to how they're being talked about on social media.

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Speaker 2: Later on at night, before I'm going to bed, I'm like,

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Speaker 2: why don't I look like that? And those sorts of

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Speaker 2: popping up and they have it for a long time.

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Speaker 1: From the daily OZ I'm Emma Gillespie and this is

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Speaker 1: investigating Ozmpic Part three. Around one in five Australians over

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Speaker 1: the age of fifteen are significantly affected by something called

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Speaker 1: body dissatisfaction. That's according to recent data from national eating

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Speaker 1: disorder charity the Butterfly Foundation. Body dissatisfaction is a term

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Speaker 1: that describes the negative feelings and thoughts a person might

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Speaker 1: have about their physical appearance. The Butterfly Foundation warns body

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Speaker 1: dissatisfaction is a key risk factor for the development of

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Speaker 1: quote many types of eating disorders, along with other conditions

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Speaker 1: such as anxiety, depression, substance use and smoking. Experts say

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Speaker 1: it stems from a perceived discrepancy between an individual's ideal

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Speaker 1: state of appearance and their actual physical appearance. In other words,

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Speaker 1: a difference in how you might want to look versus

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Speaker 1: how you might actually look. The concept of body dissatisfaction

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Speaker 1: is nothing new, but there is a distinct and unique

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Speaker 1: relationship between contemporary beauty standards and the prevalence of social media.

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Speaker 1: Youth mental health advocate Vasha Yajman says the popularity of

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Speaker 1: ozempic speaks to a harmful trend based cycle around appearance

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Speaker 1: and shape.

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Speaker 2: Thinness is definitely back in, and it feels like the

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Speaker 2: entire body positivity body neutrality movement has almost had this

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Speaker 2: regression where it's like, I no, no, no, we're actually back

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Speaker 2: to those sizes that we're trying to get away from,

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Speaker 2: and here's a drug that's going to fix everything. In

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Speaker 2: New York, the average size in a store has decreased,

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Speaker 2: like the sizes on the racks, and I think that

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Speaker 2: just goes to show the impact it's actually having on individuals.

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Speaker 2: And even now when you go to a lot of stores,

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Speaker 2: you'll see that the biggest size that they have in

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Speaker 2: stock sometimes will be a medium.

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Speaker 1: The so called age of Ozepic, has been blamed for

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Speaker 1: a slump in demand for larger sizes. A twenty twenty

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Speaker 1: five report by Vogue Business analyzed the size diversity of

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Speaker 1: models across recent global fashion weeks. It found and plus

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Speaker 1: sized representation dropped to zero point three percent, down from

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Speaker 1: zero point eight percent in twenty twenty four. Mid size representation,

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Speaker 1: so that's models between Australian sizes ten to sixteen, decreased

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Speaker 1: from four point three percent in twenty twenty four to

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Speaker 1: two percent this year.

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Speaker 2: It's not just the use of a zambig, but all

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Speaker 2: the other factors around it as well that are telling women,

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Speaker 2: especially that they need to be a certain size.

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Speaker 1: Vasha is also concerned about how these drugs are being

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Speaker 1: promoted online.

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Speaker 2: We're talking about how these celebrities' bodies have changed, and

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Speaker 2: it's making headlines everywhere. The comments will just be filled

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Speaker 2: with you're doing a subthig, You're taking a sub big,

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Speaker 2: it's a zembig. I think there's two kinds of conversations

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Speaker 2: happening right now. One is that celebrities don't owe us anything.

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Speaker 2: They're under the same pressure as, if not more pressure,

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Speaker 2: being the limelight. And then there's the other conversation where

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Speaker 2: it's like, no, but a lot of people look up

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Speaker 2: to these celebrities, especially young women.

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Speaker 1: Butterfly Foundation spokesperson Melissa Wilton told The Daily Ods that

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Speaker 1: the kind of focus on weight that we're seeing with

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Speaker 1: medications like ozepic can intensify body dissatisfaction, feelings of shame,

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Speaker 1: and contribute to the development or continuation of an eating disorder.

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Speaker 1: Vashi Yajman, who has lived experience with an eating disorder,

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Speaker 1: echoes these concerns and warns there's a dark side to

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Speaker 1: the increased visibility of these drugs.

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Speaker 2: I think the really interesting thing about ozembig or even

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Speaker 2: when I think of botox and filler, at one point

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Speaker 2: it seemed like only the rich or the celebrities had

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Speaker 2: access to it, and now all of a sudden, that

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Speaker 2: issue isn't there anymore. It's almost like your everyday person

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Speaker 2: has access to it. And I think that's where the

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Speaker 2: fear is, that it's fully just infiltrated on normal day

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Speaker 2: to day lives. The person at the gym that you

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Speaker 2: normally see is now on it and has this new

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Speaker 2: transformation that everyone's raving about. And I think that's been

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Speaker 2: the biggest.

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Speaker 1: Worry ozenpic we Go v Munjaro and other GLP one

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Speaker 1: medications may be relatively new, but this fixation Varsha describes

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Speaker 1: is not.

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Speaker 4: Now people can look to the internet, and before they

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Speaker 4: looked to other places. They looked to supermodels and women's

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Speaker 4: magazines and mail order pills and those kinds of things.

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Speaker 1: That's doctor Emma Beckett, food and nutrition scientist and adjunct

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Speaker 1: Senior lecturer at UNSW g On's the current diet culture

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Speaker 1: is amplifying a covert type of fat phobia.

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Speaker 4: Where assumptions are made about fat people and they're not

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Speaker 4: necessarily set out loud, but their thought and they change

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Speaker 4: the way that people think of people in larger bodies,

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Speaker 4: and then that has a knock on effect to how

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Speaker 4: they treat them and the opportunities that they give them.

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Speaker 4: So it really is quite damaging. And when you think

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Speaker 4: about these kinds of spirals of consequence of the way

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Speaker 4: we're made to feel about our bodies and not value

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Speaker 4: our bodies, and then the consequence of how that causes

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Speaker 4: us to treat our bodies and the extreme weight loss,

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Speaker 4: the extreme diets that people attempt, then that just further

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Speaker 4: harms our biology.

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Speaker 1: We'll be back with more of today's episode right after this.

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Speaker 1: While ozempic is no longer a Hollywood secret, doctor Beckett

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Speaker 1: warns there are still equity issues associated with accessing these

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Speaker 1: drugs lack cost. Right now Australians who take GLP ones

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Speaker 1: for weight loss are spending upwards of four hundred dollars

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Speaker 1: a month.

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Speaker 3: To do so.

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Speaker 1: Affordability was a key concern flagged by tda's audience in

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Speaker 1: a recent ozepic call out on our Instagram. Another consistent

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Speaker 1: theme our audience brought up was the social media debate

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Speaker 1: around the ethics of who should or shouldn't be taking

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Speaker 1: ozempic and how these conversations might be being unfairly thrust

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Speaker 1: upon people who don't want to have them.

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Speaker 4: And I think that's what's happening right now with the

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Speaker 4: weight conversation, with all of the judgment that comes around

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Speaker 4: with do you or don't you take this medication, all

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Speaker 4: of the judgment that comes around what did you eat?

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Speaker 4: What did you do to deserve it? How did you

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Speaker 4: create this for yourself? You know, why are you the problem?

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Speaker 1: Doctor Beckett says that as weight loss medications have become

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Speaker 1: more prominent, so too has a cultural divide between the

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Speaker 1: way we judge good fat and bad fat.

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Speaker 4: The good fat people are the ones who try with

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Speaker 4: diet and exercise and they do the effort, whereas the

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Speaker 4: bad ones are the ones that cheat and use this

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Speaker 4: drug and the kind of tutting you here when people

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Speaker 4: talk about the people who have lost weight and kept

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Speaker 4: it off in this way. Some people love it because

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Speaker 4: it cuts out the noise that comes with food. For

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Speaker 4: some people, first time they've ever been not hungry in

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Speaker 4: their lives. For other people, it ruins their relationship with

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Speaker 4: food and they have no appetite or they might feel

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Speaker 4: very sick.

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Speaker 1: She argues, OZMPIC has created a situation that's essentially impossible

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Speaker 1: to win. In her words, that it's no longer just

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Speaker 1: fat versus thin or body positive verse fat phobia.

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Speaker 4: If you take this drug, you are frowned on for

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Speaker 4: cheating and stealing it from diabetics. If you don't take

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Speaker 4: this drug, then you're frowned on for not taking the

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Speaker 4: options that are available to you. Because there's a group

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Speaker 4: of people who will say, well, obesity is a disease,

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Speaker 4: you should take your medication, and it just makes it

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Speaker 4: more divisive.

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Speaker 1: Both Doctor Emma Beckett and Vashi Yasmann describe this idea

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Speaker 1: of pervasive shame being born out of diet culture. But

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Speaker 1: how does that shame crossover into the way people access healthcare?

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Speaker 1: Since the pandemic, virtual and telehealth providers have become a

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Speaker 1: fixture of the national healthcare system. It means more options

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Speaker 1: for Australians and more flexibility. This extends to the way

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Speaker 1: ozenpic and other GLP ones are prescribed. Patients have the

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Speaker 1: choice do they want to access medication through a face

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Speaker 1: to fee face GP consult or go the telehealth route.

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Speaker 1: But with that added convenience comes new concerns.

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Speaker 4: If these people have started these companies to deliberately sell

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Speaker 4: these weight loss drugs, that says there's a gap. That

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Speaker 4: says when people are going to the doctor and having

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Speaker 4: this conversation with their regular GP, they're not getting what

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Speaker 4: they need.

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Speaker 1: People like Sarah, who decided to go down the virtual

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Speaker 1: care route after hearing about Juniper from a former colleague.

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Speaker 5: She was on it and loving it and stuff.

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Speaker 1: Juniper is the virtual health provider we spoke about on

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Speaker 1: episode two.

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Speaker 5: And yeah just commits me. I guess to look into it.

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Speaker 6: I've looked up Juniper online and then filled out the

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Speaker 6: questionnaire kind of thing, which started with high age weight.

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Speaker 1: Sarah was twenty four at the time.

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Speaker 6: According to the classic BMI system, I was technically overweight

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Speaker 6: technically in the realm to be qualified for it, but

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Speaker 6: for some reason I still lied about being a bit heavier.

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Speaker 1: Body mass index or BMI is a traditional diagnostic tool

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Speaker 1: used to measure obesity. As we mentioned in the last episode,

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Speaker 1: it's a metric used by healthcare providers across the board. However,

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Speaker 1: questions about its relevance and accuracy have emerged in recent years.

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Speaker 1: According to findings from a global commission handed down this year,

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Speaker 1: BMI is unreliable as a measure to diagnose obesity when

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Speaker 1: used on its own. The Butterfly Foundation said it rejects

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Speaker 1: the concept of weight or BMI as an indicator of health,

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Speaker 1: and said our society has a very narrow view around health,

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Speaker 1: often attributing it to thin or muscular body shapes in

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Speaker 1: the absence of other indicators that may or may not

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Speaker 1: be realistic. All that being said, BMI does remain widely

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Speaker 1: used by healthcare providers and gps, including Juniper, which uses

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Speaker 1: the metric to screen patients after completing the online questionnaire,

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Speaker 1: Sarah spoke over the phone to a Juniper doctor who

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Speaker 1: told her.

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Speaker 6: You might experience a vomiting, you might get constipated. It

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Speaker 6: was more just physical side effects.

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Speaker 5: Not the mental side effects.

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Speaker 1: She received a prescription for weight loss medication shortly thereafter,

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Speaker 1: now twenty six. Sarah said she lied about how she

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Speaker 1: was progressing to Juniper to ensure they would continue prescribing

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Speaker 1: medication to her. Lies that Sarah claims were easy to

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Speaker 1: get away with and which experts acknowledged can be a

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Speaker 1: common sign of disordered eating behaviors.

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Speaker 5: Super easy to be dishonest.

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Speaker 6: At the time that I applied for it, it was

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Speaker 6: so I would say that I'd lost a lot less

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Speaker 6: than I had.

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Speaker 5: But I was losing it very, very very quick.

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Speaker 6: And then I just kind of became really fixated on

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Speaker 6: how much weight I was losing, So I was weighing

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Speaker 6: myself like two or three times a day, and it

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Speaker 6: really turned into a bit more probably an eating disorder.

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Speaker 1: Experts also say it's it's pretty common for patients to

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Speaker 1: hide certain details from prescribers, but they argue it's up

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Speaker 1: to the healthcare providers to understand what the individual is

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Speaker 1: trying to achieve why they want a drug glycosenpic and

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Speaker 1: why they might lie to get it, as well as

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Speaker 1: why they might choose to go through telehealth or virtual

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Speaker 1: care over their regular GP.

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Speaker 4: Are they going to their standard GP, and their standard

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Speaker 4: GP is going no, no, you don't need that. And

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Speaker 4: you go to the people who are selling them directly

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Speaker 4: and that's their purpose and they go, well, of course

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Speaker 4: you can have that, and so my question is about

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Speaker 4: how do we look at that context.

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Speaker 3: I've got no problem with understanding that some people are

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Speaker 3: sensitive about why they might want to talk to a

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Speaker 3: GP about issues of their health or weight.

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Speaker 1: That's Sydney GP and AMA Public Health Chair Doctor Michael Bonning.

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Speaker 3: We have clinical experience as doctors. You are often able

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Speaker 3: to insure why someone might be sitting in front of

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Speaker 3: you for this, even if some of the things they

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Speaker 3: say to you might be trying to obfuscape what the

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Speaker 3: actual reason is. And that's you know, that's pretty common.

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Speaker 3: Lots of people don't come in and tell us the

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Speaker 3: whole story. That's okay, that's their prerogative. It's a challenge

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Speaker 3: that's harder to unmask in the online environment than it

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Speaker 3: is in the face.

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Speaker 1: To face environment with gps like doctor bonding conceding. Telehealth

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Speaker 1: services present unique challenges for prescribers. Where does that leave

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Speaker 1: services like Juniper, who currently engage registered nurses to prescribe

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Speaker 1: GLP ones For Sarah who takes ownership of her dishonesty.

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Speaker 1: Providers like Juniper could solve many issues by conducting video

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Speaker 1: calls with patients.

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Speaker 6: So they can like actually physically see it's you and

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Speaker 6: physically see what you're claiming to say you are. I

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Speaker 6: know people who have submitted photos and tried to photoshop

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Speaker 6: them to these platforms, So I haven't personally done that,

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Speaker 6: but I do know of people who have just been like, oh, well,

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Speaker 6: it's fine, I'll just pull like a flat filter on doctor.

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Speaker 1: Emma Beckett says, while it might be tempting to say,

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Speaker 1: let's get rid of these telehealth companies, that's not.

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Speaker 4: The our regular gps need to do better about weight

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Speaker 4: because so many people are scared of going to the

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Speaker 4: doctor because they're going to get picked on about their weight,

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Speaker 4: because they're going to get judgment about their weight.

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Speaker 1: That judgment, she argues, risks isolating already vulnerable patients further. Instead,

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Speaker 1: the conversations people are having with their doctors should be

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Speaker 1: centered around tailored advice and improved support.

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Speaker 4: She says, from looking at the whole ecosystem and saying

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Speaker 4: what could we be doing better here? We need big

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Speaker 4: picture solutions. We can't just keep putting out fires and

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Speaker 4: fighting amongst ourselves because that's obviously not getting us anywhere.

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Speaker 1: So where do we start.

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Speaker 4: Most gps don't have a lot of training in nutrition,

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Speaker 4: and one of the things we could be doing better

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Speaker 4: would be giving more people access to dietitians, the people

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Speaker 4: who are trained to do medical nutrition therapy, and most

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Speaker 4: people don't access dietitians because they think they're only for

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Speaker 4: sick people. Making nutrition advice more accessible could actually solve

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Speaker 4: a lot of these problems because people then could learn

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Speaker 4: how to make decisions for themselves in a way that

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Speaker 4: works for them, instead of just getting population level advice

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Speaker 4: and going why am I failing?

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Speaker 1: As a young woman living in recovery from an eating disorder,

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Speaker 1: Varsha Yajman holds concerns about how other young people are

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Speaker 1: internalizing the constant messages they're seeing about weight loss medications.

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Speaker 2: When I'm watching a lot of content or I'm scrolling

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Speaker 2: for a long time. Later on at night before I'm

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Speaker 2: going to bed, I'm like, oh, like, why don't I

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Speaker 2: look like that? And those sorts of popping up and

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Speaker 2: they have it for a long time. So I can

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Speaker 2: imagine somebody who's far more vulnerable, who hasn't had that

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Speaker 2: sort of help in those resources to be thinking thinness

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Speaker 2: is back. I need to be achieving that. And even

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Speaker 2: when you're in recovery, there's so many things around. Oh

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Speaker 2: I'm going to gain some weight, but not too much weight,

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Speaker 2: because I still need to fit the standard.

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Speaker 1: If the healthcare system needs to do more and do better,

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Speaker 1: Varsha says, so to do social media platforms. She doesn't

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Speaker 1: think blanket bands will do much, but rather that content

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Speaker 1: regulation is critical.

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Speaker 2: This type of content is going to be there, so

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Speaker 2: it's about how we regulate that content. And I don't

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Speaker 2: necessarily think that banning any of these platforms is going

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Speaker 2: to solve anything, but actually making sure that social media platforms,

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Speaker 2: who have billions of dollars to actually use resources, create

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Speaker 2: resources for people who are vulnerable to the content on there.

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Speaker 2: And also the government has a role to play. That

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Speaker 2: idea of the duty of care of holding social media

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Speaker 2: companies accountable is incredibly important, and I think this also

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Speaker 2: comes with having more literacy, and this means having education

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Speaker 2: in schools.

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Speaker 1: The experts you've heard from over the last three episodes

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Speaker 1: have detailed an uphill battle to improve the physical and

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Speaker 1: emotional wellbeing of Australians. They've described systemic, long term and

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Speaker 1: pervasive shortcomings across healthcare, social media, pop culture, education and beyond.

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Speaker 1: But I beck It says things can change.

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Speaker 4: One thing that I see a lot currently is the

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Speaker 4: younger generation thinks the solution is to not talk about weight.

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Speaker 4: The weight is a taboo topic. If we make it taboo,

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Speaker 4: then we just set up a whole extra set of

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Speaker 4: standards and assumptions. And so we've got this double standard

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Speaker 4: about what we focus on and what we talk about.

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Speaker 4: It can't just be we wish diet culture wasn't there.

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Speaker 4: It's making things hard. We have to actively have the

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Speaker 4: conversations that say, is this a diet culture moment? And

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Speaker 4: how do we resist that? And you know, the only

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Speaker 4: way we fix that is by having better conversations. Let's

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Speaker 4: talk about what we can do as a society together

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Speaker 4: to help people be in the position to make the

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Speaker 4: choices that work for them in their bodies. And their lives.

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Speaker 1: As experts and advocates continue to push for important conversations

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Speaker 1: and safer practices, a growing number of young people trying

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Speaker 1: to figure out what their long term relationship with drugs

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Speaker 1: like ozempic will look like.

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Speaker 6: It's definitely fully unlocked, something new. I've lost like probably

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Speaker 6: twenty kilos. I don't feel any better than I did

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Speaker 6: prior my whole life. I was comfortable and like confident

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Speaker 6: in who I was and everything, and couldn't really be

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Speaker 6: further from that. Now I spent like three hundred bucks

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Speaker 6: a month on the medication, and now you spend like

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Speaker 6: five hundred bucks.

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Speaker 5: A month on therapy. It's an expensive lesson.

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Speaker 6: You know.

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Speaker 1: Some will be on GLP ones for life. For others

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Speaker 1: the financial or physical toll will be simply too great.

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Speaker 1: But for the many Australians like Sarah who sit somewhere

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Speaker 1: in the middle, the future remains uncertain.

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Speaker 6: I'd be lying if I said I didn't still really

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Speaker 6: tightly moderate what I eat. You know, I weigh myself

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Speaker 6: every single day. Yeah, it's been really hard on the

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Speaker 6: other side of it, and it's really hard to I

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Speaker 6: guess not. I don't want to say word relapse because

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Speaker 6: it's not like it's an illicit drugg or something, but

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Speaker 6: it's true. It's really hard to kind of not try

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Speaker 6: and just go back on it. I'm still really scared

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Speaker 6: of putting it back on, so I guess I would

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Speaker 6: love to have a supply, but I can't afford it,

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Speaker 6: and it's I know how bad it is for my

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Speaker 6: mental health, but it is definitely a bat all.

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Speaker 1: Thank you so much for listening to part three that

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Speaker 1: wraps up our series investigating Ozenpic. We hope you enjoyed

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Speaker 1: listening to it. If you did, it would mean so

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Speaker 1: much if you could share it with a friend, leave

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Speaker 1: us a review, subscribe and follow wherever you're listening. It

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Speaker 1: really helps us get the word out so that we

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Speaker 1: can keep making more original investigations into the future. If

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Speaker 1: this episode raised any issues or concerns for you, help

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Speaker 1: is available twenty four to seven through Lifeline on thirteen

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Speaker 1: eleven fourteen. For eating disort of support, you can contact

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Speaker 1: the Butterfly Foundation on one eight hundred eed hope that's

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Speaker 1: one eight hundred double three four six seven three.

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Speaker 5: My name is Lily Maddon and I'm a proud Arunda

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Speaker 5: Bunjelung Kalkudin woman from Gadighl country.

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Speaker 4: The Daily oz acknowledges that this podcast is recorded on

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Speaker 4: the lands of the Gadighl people and pays respect to

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Speaker 4: all Aboriginal and torrest rate island and nations.

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Speaker 5: We pay our respects to the first peoples of these countries,

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Speaker 5: both past and present.