Weight Loss Drugs and the Return of Heroin Chic!

Milan Fashion Week, 2023 (via Getty Images)

When the conversation started getting louder and louder about Ozempic and who did or didn't, I wasn't very invested or interested; it felt like another tedious, fantastical answer as a pill or pure mindless hype to take advantage of people's deepest vulnerabilities. Besides, this isn't my fight, and I didn't want to be one of those people who chime into conversations about weight loss with unearned authority and a million "helpful" tips to police someone else's body. Mostly, I regard the nitty-gritty painful details of weight struggles to be best told by those authentic voices that are silenced and drowned out enough by concern trolls; they don't need someone to talk for them; they need to be heard and seen and not be made to feel invisible or unworthy of opinions surrounding the politics of body size and beauty. 

Weight loss miracles and people claiming to have cracked the code aren't new; it is old hat, old blah blah, low this or high that blah blah, it is white noise; however, recently, there has been a newer conversation and a contemporary issue-Ozempic Fever. I am skeptical for many reasons, and I do not like the social ramifications of these new "cures" that have become more apparent in the last two years or so. Do they really have the answer, though?  

Is this latest development a reaction to society attempting to right itself and become more tolerant and less judgmental about the size and different types of bodies in the media? Body acceptance was making inroads, and I hoped our beauty standards would become more humane and inclusive. We were heading in the right direction in allowing women, in particular, to give ourselves a much-earned break from the neverending merry-go-round of what we should look like and what body shape was "in" at the moment like we could simply wiggle our asses, snap our fingers and change our genetics, shapes or bone structures. 

Or maybe die trying. BBLs are dangerous, but it didn't stop women from running to Brazil for this procedure, ignoring the warnings because big rears were the thing, and they wanted to be beautiful and accepted. Some never made it out of surgery alive. Extremes aside, fuller models were now in mainstream fashion shows and magazines, and "imperfections" were beginning to be embraced, and it seemed like we were shutting the door on "fat phobia" and shame. In hopeful moments, I believed it would be a revolution, and instead of ripping off our bras, we would bankrupt Skims. We would burn that shit to the ground and dance around the charred remains like maidens skipping around a Maypole. My glee was short-lived, however.

Gia Carangi, credited with creating "heroin chic" (via Getty Images)

According to Hollywood and the fashion world, the ultra waif is coming back in style. "Heroin chic," aka "the waif," was a disastrous 90s trend, and no one should flirt with a repeat of sickly silhouettes becoming a thing again. Unfortunately, it has come roaring back, driven by the entertainment industry's ever-changing body standard and a demographic too young to recall models dropping dead from drugs or disappearing altogether, used and spent and too tired to continue to starve. We really don't want to see black-market dirty weight loss drugs, starving teenagers in unscrupulous eating disorder clinics, people chain-smoking to blunt their appetites, risky restrictive diets, extreme exercising normalized, or bizarre drastic "solutions" becoming commonplace. 

I remember how it made me feel positively chubby at a size 6, living with a model and running in circles with fashion people. I was told I should drop a little because my butt was kind of big, (not according to Sir Mix-Alot thank you), I had too much chest and I mean my thighs were said to be a little too healthy (read thick)...I even believed it. I caved and walked around looking like a praying mantis with a 300-dollar-a-day smack habit for several months until my hunger and common sense won.

Let's face it, many people can't afford 1300 dollars a month for these weight loss drugs, and they will be left with bootleg alternatives with deadly side effects to try to fit into these newest ideas of attractiveness. It has changed the stakes and upped the danger. Like so much in life, these medications will be held out of reach, with only rich people possessing the ability to buy them while shaping unrealistic societal ideas of attractiveness, desirability, and health. In their manufactured drug-induced images, they will further an already widening divide between a dwindling middle class, affluence, health and wellness affordability. They will make it look easy and warp expectations of what someone "healthy" should look like. It happens constantly, from the Edwardian wasp waist to the past decade's over-plasticized look to what is coming down the pike now: underweight and curveless. 

Recently, many celebrities have begun to retreat from being relatable to embracing filtered, idealized images of effortlessly skinny bodies pap-strolling in all the usual places just in case we hadn't seen the unveiling of their new svelte figures. We should believe that their supreme, superior collective celebrity super duper minds dug deep and found the elusive ability to will themselves to lower weights through hard work and discipline. I am here to shout it to whoever will listen...Willpower is a mirage; when we can't summon it and fail, we are told we simply don't have enough of it. Try harder. It is the kind of sly lie that can torpedo self-worth and make one feel defective, lazy, wrong, or cursed, but it would take a dissertation to give the subject justice, so I will just say if you are reading this and have been beating your self-esteem into a bloody pulp, stop. You are fine. It isn't you. It is the big self-flagellating scam that was normalized with roots in the idea that we must suffer if we are to get the things in life we want. 

Psychology is slowly catching up with the fallacy of this hellish, destructive myth. It is being examined. What isn't studied nearly enough is that the science behind successful "dieting" most likely lies in searching through the darker corners of Big Business such as Big Ag, Big Pharma, packing and lacing food with endocrine disruptors like hormones, antibiotics, pesticides, sugar, and unknowns, with a lack of oversight or regulation. Greed is an enormous part of the problem. And these reasons will only be examined if suddenly it isn't profitable to not care; we can be assured that there will be no moral or ethical reckoning about these ugly facts. There will be no research, investigations, or scandals because life "as is" will churn along since the people who could do something will never willingly do the right thing. Some will continue to struggle, and others will continue to get rich, inflicting unknown amounts of damage on the populace.

Mindy Kalig, 2024 (via Getty Images)

The list of privileged Ozempic deniers is lengthy. Everyone in Hollywood says everyone else is on it to drop as little as 10-20 pounds, and I believe it. It is Hollywood, and those people take vanity to the extreme and absurd. Jessica Simpson, Fifty Cent (a rapper FFS), Mindy Kaling, Cristina Aguilera, Kyle Richards tried the big lie, Rebel Wilson fibbed for a while, Khlobacca, Lady Gaga, reality stars, WAGS and and and...the list is probably miles long. My favorite vanity practitioners are in LA, and they can be indiscreet and tell so much gossip I can't wait to go just to get juicy details about celebrities.

One of my favorite doctors in LA is Uzzi Reiss in posh West LA; when I am in California, I will see him and get thorough checkups. His office is smack in the middle of ground zero, where most celebrity dermatologists, estheticians, surgeons, etc, have offices. Dr. Reiss is a down-to-earth man who seems incongruent with his environment, but he is there, and I swallow my distaste for that part of town and go. He's good at what he does, but that's not the point. 

The point is, I never fail to see celebrities furtively slinking around in underground car parks beneath physician suites and outpatient surgery centers for cosmetic procedures. For some reason, it makes me feel superior. I see you, XYZ. That trucker cap is pulled down, and the shades hide nothing. Is that who it is? *cackle* This is how they operate, stealthily, but these fibbers should go to the rooftops. It is a regime with plenty of water and sleep that gives them that unique lift and glow. So if they would go that far, what's jamming a syringe of a liquid skinny maker into their thighs? 

There is speculation that these medications will turn around and slap people upside their heads and cause unforeseen side effects. Probably for those using it to lose 25 or fewer pounds or something, but for diabetics and the truly insulin-resistant women with PCOS and people carrying 50 plus pounds, maybe medicine will help. Maybe this could help people who have battled their endocrine systems since childhood. Perhaps this can offer hope. My prediction is already thin people will start getting sick, give the medications a bad rap, and keep people who need it shit out of luck and push it further out of reach. The pharma companies are complicit in this "shortage," but those using it with low BMIs are helping them.

So, it should feel like business as usual, but it doesn't. This is mainly because these drugs are changing the beauty and health landscape at a dizzying speed, and it doesn't seem to be letting up soon, and I doubt it will. Once these first-generation medications showed unforeseen success, more are inevitably being whipped up in labs with more significant promises to lose more and lose faster.

Calvin Klein print campaign, 1993

This also feels different, more selfish, more narcissistic, and more harmful since it taps into a societal obsession that also slams up against the natural health needs of the people they claim these drugs were made for. Diabetics aren't the ones bringing in the bucks, though. I read stories about people pounding down sweets before doctor's appointments so that their blood work will look like they have diabetes or prediabetes just to get some Ozempic. Will we have to go back to dealing with the people dying to be thin? I tried to be Kate Moss skinny in the 90s, as I related, and it came to a head when I fainted, ending up in the ER looking gaunt and hollow. The sick part is my fashion "friends" told me I looked fantastic in a small size 0. I am nearly 5'9 and I was even wearing some 00s. I no longer looked fit and healthy and I did embody heroin chic and it was taking its toll. The Jamaican nurse looked at me, shook her head and asked me in her thick accent, "What was wrong with you young girls fainting all over the place? Look at you," she continued, "you are grey. You better stop this now you hear?" I did and vowed to be what I am, and if that meant 90s fashion fat, then so be it.

This time, though, there will be more collateral damage; the pendulum is swinging too hard, too fast, leaving some people striving for an ideal that never existed in the first place.

Kate Moss, 1990s (via Genius)