The other day I struggled to finish an apple.
I wanted to let that sentence hang there on the page by itself for a bit because it’s so ridiculous. I recognize this. People who say these sorts of things are the ones who have a single slice of pizza on a “cheat day,” and that’s it. They are the half-a-scooped-out-bagel-with-the-thinnest-spread-of-tofu-cream-cheese people. I know these people very well; I’ve observed them up close and personal. When I used to work at the shiny glass tower that houses Hearst magazines, these bagel-scoopers pervaded the cafeteria—and I felt bad for them.
Working at women’s magazines with coverlines like, “Shed 17 lbs in 8 Days with This No-Fail Liver Cleanse!” and articles that went into great detail about how to pose in pictures so you won’t look like the cow you believe yourself to be turned me into a bit of a radical. I very emphatically proclaimed to my own teams behind closed doors that we were not going to do this to women on the internet (my domain). Magazines had screwed with women’s self-esteem for decades, but that could stop with us. I wanted to share what I felt most deeply: There is great joy in food and drink. A ridiculously large percentage of the most joyous moments in my life have happened around a table with food that I, or a loved one, have cooked. We would not be making food—or ourselves—the enemy.
But there I was the other weekend, one day after taking my first shot of Mounjaro (Ozempic’s lesser-known cousin), and a chemical switch had been turned off in my brain. I had injected myself in the fleshy part of my belly on Saturday and prepared for nausea, vomiting, or constipation to come on Sunday. None of those things happened, but by Sunday, I didn’t want food. I’d lost the joy in eating. After taking a bite of an apple, I couldn’t even muster a mild, “Man, this first Honeycrisp of the season is so good!”
My brain firmly told me that I had just eaten a full Thanksgiving dinner and however delicious that piece of pumpkin pie looked, I simply couldn’t fit another bite in me. In reality, I’d only had two scrambled eggs, a piece of whole wheat toast, and loads of water in the 24 hours prior to that apple.
This off-switch wasn’t something I’d anticipated. After my first injection, however, I caught up on articles that detail the lack of “food noise” that other patients have described after taking Ozempic, Wegovy, or Mounjaro. I did not know this when I sat in my doctor’s office discussing what to do about the weight I’d gained over the past two years despite my virtuous eating and intense daily exercise. I was ready for the answer to be a prescription. I also felt guilty that I hoped the answer would be a prescription.
I have PCOS (polycystic ovarian syndrome), and one of the major symptoms is obesity. (A small digression: A recommended treatment for PCOS is “lose weight,” which is one of the biggest gaslighting pieces of advice the medical community has ever given. It’s akin to saying, Oh, your blood sugar is dangerously high? Try making insulin and see if that helps your diabetes.) For most of my adult life, I’ve felt lucky to just be medically overweight, rather than obese—a fat-phobic bias that I have yet to personally resolve.
No one would look at me and say I was fat, but over the past two years, I crossed the imaginary line on the BMI chart into obese. Commentary on the relevance of the BMI scale notwithstanding, normal BMI for someone who is 5’3” is between 104 lbs (this is what I probably weighed in 7th grade) and 140 lbs. Over 169 lbs? That’s obese.
At 47, I’m in the crosshairs of perimenopausal weight gain on top of PCOS—and at my prior year’s physical, my cholesterol had jumped 30 points after I’d cut out red meat and processed foods almost entirely. Another unfortunate complication of PCOS is metabolic syndrome, which increases your risk for cardiovascular disease. My usual diet consists of one to two meals a day of leafy greens, lean proteins, and healthy grains, almost always well under 2,000 calories. I don’t snack. I log an average of 45 miles a week of power walking. I lift weights. It wasn’t my diet. It wasn’t exercise. I was doing everything right, and I was still failing. I needed help.
Rationally, I knew that help had to come from my doctor, but I still felt guilty for needing it. Because it wasn’t just this beneficent, medically necessary thing. I also don’t want my thighs to touch. I want my boobs to shrink back down to a less matronly size. I want an old size 8 dress to zip up and lay smoothly over my midsection. I want to feel comfortable in a body that I recognize as mine. And I don’t want to die of a heart attack.
I’m guessing this internal conflict is pretty common, though I haven’t talked to anyone else on the drugs personally. But I have seen it play out in comment sections of articles about them. Plenty of people say injectable weight-loss drugs are the only thing that has helped quiet their ever-present drive for food. They fixed a physiological mistake in their bodies. And I’ve seen others respond that if they went on X diet, gave Y exercise a shot, never ate a gram of sugar, or simply tried harder, they wouldn’t need drugs. Taking them is a moral failing. I’ve been on both sides of this argument in my own head.
After my first week on Mounjaro, I knew which side I’d landed on in response to comments like, “You’ll have to be on it forever, or else the weight will come back!” and “Do you want to inject yourself for the rest of your life?” The answer was yes, I might have to be on it forever. And no, I don’t mind taking a medication once a week. Easier than a daily one, right?
We’d never warn someone with depression who’d done everything possible to “be happier” not to use an antidepressant because if they stop taking it their depression could come back. Same goes for high blood pressure medicine, or insulin, autoimmune biologics, or any of the other medical miracles that keep us alive.
When I left my doctor’s office with the medicine he’d pulled out of his mini fridge, I felt both giddy and terrified—also a little like a criminal with a thousand-dollar package under her arm on the subway. In the four days between my appointment and the day I planned to start it, I went down every Mounjaro rabbit hole on the internet. I read scientific papers, news stories, personal essays, and subreddits. I unfolded the prescription insert and pretended like I remembered chemistry as I studied the diagram of its molecular structure. Mostly, I worried.
I have no fear of needles. I injected myself with much scarier intramuscular ones when I did IVF (infertility: another life-altering PCOS symptom). The friendly-looking injectable pen wasn’t intimidating. When the day came, I took a breath, pressed the pen to my skin, then pushed the injector button and held it for 10 seconds. I immediately wondered how fast it would work and if I was going to have a deadly reaction to it. (Anxiety: PCOS symptom number three, if you’re keeping track.) I headed out on a walk to calm my nerves. By that evening, the Thanksgiving-fullness feeling had arrived and I opted for a very gentle scrambled egg dinner, focusing on the nutritional value of whatever I ate, as advised.
The next morning I woke and grabbed an apple on my way out the door for a five-mile walk. When I bit into it, I knew it technically tasted good. The tart/sweet/crisp flavor profile was there in full effect. But I’d become aware of a sort of gross sensation of having food in my mouth. I didn’t want to swallow. I kept dutifully eating it until halfway through, telling myself that my body needed fuel. I held the half-eaten apple in my hands for a few blocks, debating whether or not I had it in me to eat any more. As I made myself finish the second half, I wondered what the hell I had done.
Later that afternoon, I walked into a theater to see a movie and out of habit I asked myself if I wanted anything from the concession stand. As quickly as the thought entered my head, it disappeared. Soon I was in my seat: no popcorn, no candy, no remorse. Then I watched a movie about a perfect woman not feeling good enough. Such irony.
This is how the rest of the week progressed: I never thought of food; I never got hungry; I made myself eat small, nutritionally dense foods; I kept up my usual exercise, and the scale ticked down by about a pound a day. What was happening was not just a calorie deficit. I did intermittent fasting for five years and was in a calorie deficit nearly 80 percent of the time. (I jokingly called this “my baby eating disorder.”) Even when I did that, the scale didn’t budge.
I got a notification from my Apple watch five days into the week saying that my workout heart rate had a new trend. Starting on Day 1 of taking Mounjaro, my heart rate moved into the calorie-burning zone. I was doing the same damn thing I used to do, but prior to this drug, it would remain at a lazy 105-110 during most of my workouts. Now I was easily getting into the 130s. My resting heart rate remained exactly where it’s always been, so my heart rate hadn’t been raised across the board. It was as if my metabolism had been turned on. My body was suddenly taking what I ate and using it to its utmost. I wanted my body to keep working this way. I wanted it to work like a normal person’s body works.
After the first two weeks, I still didn’t know if or when I’d stop. I wasn’t sure if I’d reach an ideal weight, like someone without PCOS or in perimenopause. Or would my body keep shrinking away? I really didn’t know the answers to these questions and could only imagine the day I’d have to consider them. Until then, I silently celebrated the seven pounds that magically melted away.
My closest friend asked me if it wasn’t a little sad that I’d lost the joy of food—a question I’ve been considering seriously. The first week or so on Mounjaro was an absolute revelation: Holy shit, I love this drug! I felt superhuman: beyond food. Oddly, I didn’t feel unhappy or deprived.
I know it sounds like I’ve drunk the Kool-Aid of weight-loss drugs, and maybe I have. If things keep going this way, I might be fine with losing food-joy for now.
I went to a cocktail party after being on Mounjaro for a week, and as we sat around my host’s table laughing our asses off with a gorgeous plate of snacks in the middle, I realized I hadn’t reached for any—not because I was afraid eating a piece of cheese would add to my weight problem, but because eating didn’t occur to me. Talking and laughing and enjoying my friends were the only things on my mind. It was one of the best nights I’ve had in a very long time.
Postscript: Lili follows up with a little bit of a reality check in A Month of Mounjaro, Part 2: Oh Shit, This Is Bad and shares the conclusion and fallout from taking this weight loss drug in A Month of Mounjaro, Part 3: Well, Shit.
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Lili Zarghami lives with her teenagers in Brooklyn. She’s been writing for and providing editorial direction at women’s websites like Redbook, HGTV, Better Homes & Gardens and more since the turn of the century. She can remember the addresses of all the places she was a latchkey kid but has no idea what her email password is.
