The Issue With Merit-Based Stigma Surrounding Ozempic

Ozempic has become a common topic of debate since its rise in popularity over the past few years. One common argument against the use of Ozempic is that it is the “lazy way out” for people who want to lose weight without the effort implicit in dieting and exercising over a sustained period of time. This has always particularly bothered me.

The notion that Ozempic is bad because it is “lazy” stems from a flawed understanding of merit — a virtue already  highly contested and often misapplied. Some fitness gurus and pseudoscientists online, as well as people I personally know, have rallied to the cry that people who don’t lose weight the right way — meaning naturally — shouldn’t be able to lose it at all. This is a glaringly silly and apathetic reason to bar people from good health and self-confidence.

According to Merriam-Webster, merit is defined as “a person’s qualities, actions, etc. regarded as indicating what the person deserves to receive.” Given this definition, we may also say that merit is inherently comparative and always implies a relation between a subject and one or numerous other subjects: “X is more/less deserving than Y” or “the most qualified candidate.” 

This definition has a built-in claim about what ought to follow from one’s qualities or actions. At risk of getting too philosophical, I do believe this urgently begs a question: Why should certain qualities entitle someone to rewards? In what cases should or shouldn’t merit be considered? The fundamental arguments in favor of and against the claim that Ozempic is lazy center around these questions.

Merit is easily understood when it applies to sports. The classic example of an unmeritocratic decision is when one kid gets the starting position over another, more talented kid because the former is the coach’s son or daughter. When considering what’s best for the team’s success — how to win most straightforwardly — and how fairness is equally applied to every athlete, the starting players should be chosen solely based on their merit, which in this example is a combination of natural athletic talent and acumen for a specific game. 

The example above makes a simple case in favor of merit, but the problem arises when merit is haphazardly applied to far less trivial scenarios. Being obese or moderately overweight for an extended period of time is not just a matter of how one feels about oneself or how one is perceived by others; it is a serious health issue that has devastating implications if left unaddressed. 

In cases related to one’s long-term well-being, is merit really worth so much attention? If one makes the case that weight loss is solely a matter of merit — that only those who earned their weight loss “the hard way” deserve it — well then one obviously implies that some people do not deserve good long-term health and confidence. I don’t believe that is right.

The “Ozempic is lazy” argument seems to follow from the assumption that people are overweight solely due to their personal habits. However, if one reframes the question and considers substance abuse instead of being overweight, then the claim that Ozempic is bad because it is lazy — that weight loss and good health are matters of merit and can be deserved — becomes ridiculous and practically immoral.

One would not say to somebody whose long-term health has been jeopardized by cigarettes that they should refuse modern solutions like nicotine patches or medications such as varenicline because they need to “figure it out themselves” and “stop being lazy.”

What if this cigarette smoker got cancer? Would one be justified in telling this person not to pursue chemotherapy, despite having the means to access it, because their addiction merited getting cancer and thus they do not deserve treatment? Absolutely not.

It’s ludicrous to say that, despite the fact that such relatively accessible, life-changing solutions exist, one should neglect those solutions as a matter of principle — that if one must rely on the crutch of exogenous relief that doesn't require grueling work, one is doing a disservice to oneself by granting oneself undeserving gratification. 

To hold this belief is no different than believing that those struggling from addiction should stay addicted if they cannot overcome addiction solely through their willpower. It seems laughably obvious that when considering one’s physical and mental health — the crux of one’s livelihood and happiness as a human being — one should not be morally condemned for taking a medically appropriate, lower-friction path to improve one’s life. 

The point is not to equate obesity with addiction, but to highlight that similar biological vulnerabilities can undermine simplistic willpower narratives in both cases. After all, not everybody who struggles with weight loss is entirely responsible for the state of their health. 

This position neglects intangible factors that may be playing a significant role in the addicted subject’s circumstances, namely genetic dispositions to addiction. CT Jones, a writer for Rolling Stone, reports that “patients who weigh more often struggle to receive accurate and helpful medical attention from doctors, often being told to lose weight instead of having underlying genetic or historic factors examined.”

Just as people can be genetically predisposed to addictive substances, so, too, can people be disproportionately prone to becoming overweight or obese. For example, it’s common for people who become addicted to nicotine, in any of its forms, to have very fast nicotine metabolism. The faster one clears nicotine from one’s system, the more frequently cravings return, which leads to a vastly higher dependence risk compared to those who metabolize nicotine slowly because they’re satisfied for longer. 

There is a laundry list of medical and biological reasons why some people struggle to lose weight far more than the average person, and why solutions like Ozempic aren’t just convenient but are, in fact, beneficially life-changing. 

Some individuals can inherit abnormal appetite-regulation genes such as reduced leptin sensitivity, the satiety hormone, or increased ghrelin release, which makes people feel more intensely hungry more often. These kinds of medical characteristics, which the individual is not at fault for possessing, can pose great challenges when it comes to dieting properly and maintaining caloric deficits. 

Intuitively, it’s going to be much easier for somebody to lose weight when they practically never think about food and naturally eat smaller meals to achieve satiety than somebody who constantly feels like they’re starving and, after having eaten a full meal, feel as though they have only eaten half of one. 

Moreover, some individuals have a dramatically slower basal metabolic rate (BMR). This causes one to lose far fewer calories at rest and experience a stronger metabolic slowdown or crash while in a caloric deficit, actively combating the whole premise of dieting. 

If one were to pair a slower-than-average BMR with something like abnormal insulin receptors, which can cause faster formation of fat cells, more rapid visceral and subcutaneous fat storage, and increased hunger, it becomes clear to see how not everybody can simply eat less and exercise more to obtain meaningful results. 

There are serious questions about cost, long-term safety and overprescription of Ozempic and similar pharmaceutical solutions to weight loss. My argument is not meant to address every concern, nor is it meant to argue that everybody should take it. I’m targeting one specific argument I staunchly reject: Using Ozempic is morally suspect because it avoids the supposedly “earned” route of diet and exercise.

When merit is taken from questions of sports and job hiring and applied to questions of long-term physical and mental well-being, it becomes a gatekeeper that looks not just confused, but cruel.

In addiction and in being overweight or obese, behavior, biology and environment interact. Modern medicine has produced treatments that reduce suffering, yet there remains a temptation to moralize willpower. Society collectively rejects — rightly so — the idea that someone deserves to suffer because they couldn’t, or chose not to, quit addiction “the hard way.” We must do the same for those who are overweight and obese.