Rethinking Willpower: Understanding obesity in a new era (#378)

The rise of weight-loss medications—GLP-1 receptor agonists like semaglutide and tirzepatide—has ignited a storm of admiration, hope, skepticism, and discomfort.

These drugs promise dramatic results and have already transformed the landscape of obesity treatment.

Welcome to the world of GLP-1s, better known by their brand names: Ozempic, Wegovy, and Mounjaro.

These medications are based on a powerful idea: mimic a naturally occurring hormone that helps regulate blood sugar and appetite. GLP-1, or glucagon-like peptide-1, is an incretin hormone produced in the gut. It stimulates insulin release, suppresses glucagon, slows the emptying of the stomach, and—crucially—acts on the brain to reduce appetite and increase satiety. In effect, it helps turn down the volume on the internal hunger signal.

Some newer agents, like tirzepatide (found in Mounjaro), go further still by also targeting GIP receptors—glucose-dependent insulinotropic polypeptide—amplifying both weight loss and blood sugar control. Originally developed for type 2 diabetes, these medications are now FDA-approved or prescribed off-label for people with obesity, including those without diabetes.

This isn’t niche anymore. In the United States alone, more than 24 million people are projected to be on GLP-1 drugs by 2035 as awareness grows and insurance coverage expands. A condition once blamed on poor choices and lack of willpower is now increasingly recognized as a biological imbalance, deserving of medical intervention.

Where the story ends, nobody knows—but the story’s origins are far more surprising than most people imagine. It all began in the Sonora Desert, home to one of the few venomous lizards on Earth: the Gila monster. These slow-moving reptiles were the unlikely stars of a 1959 horror film The Giant Gila Monster.

Behind the Hollywood fiction was a scientific breakthrough. In the 1980s, researchers analyzing Gila monster venom discovered a peptide strikingly similar to GLP-1—and began exploring its potential. A fishing expedition with astonishing results. That peptide became the template for the synthetic compounds now found in Ozempic and Wegovy.

And yet, with progress comes complexity. These drugs don’t just melt away fat—they reshape the relationship between the brain and food. One mysterious effect scientists are still trying to understand is how these drugs reduce “food noise”—the constant, intrusive mental chatter about eating that many people with obesity describe. Silencing that internal monologue might be one of the most profound benefits, though we don’t yet fully understand how it works.

Meanwhile, adverse effects—some cosmetic, some clinical—are emerging. Social media has coined the term Ozempic face, describing the gaunt, hollow look that can occur as facial fat and muscle are lost alongside body weight.

Doctors now recommend pairing these drugs with dietitian support and strength training, to ensure patients get adequate protein and preserve muscle mass. And like all medications still in their infancy, long-term effects remain under investigation. While early studies show reduced risks for heart attack, stroke, and kidney disease, the full picture is still forming.

The Discipline Dilemma: When Biology Meets Morality

For decades, weight loss has been framed as a moral battle: calories in, calories out, and the belief that if you just tried hard enough, the pounds would melt away. It’s no wonder that those who’ve succeeded—through years of self-denial, routine, and raw willpower—might feel blindsided by the sudden arrival of a drug that does much of the heavy lifting.

But here’s the truth:

Many people didn’t fail at weight loss.

They were failed by biology.

They were trapped in a cycle of intense hunger, low satiety, and metabolic resistance. GLP-1 drugs don’t bypass discipline; they enable it by finally silencing the overwhelming chemical signals that sabotage effort.

This shift forces us to confront an uncomfortable truth: effort isn’t always enough, and biology isn’t always fair.

Not a Free Pass—A New Kind of Challenge

Even on these medications, weight loss isn’t effortless. Most patients experience nausea, fatigue, and gastrointestinal side effects. They must still make dietary changes, build strength, and navigate the emotional terrain of a shifting identity.

The work isn’t eliminated—it’s just made possible.

And then there’s the cost. These medications can be prohibitively expensive without insurance, creating a new kind of inequity: a health breakthrough available to the few, not the many. That’s not freedom. That’s a systemic challenge society must address.

What We Gain When We Let Go of Judgment

It’s tempting to hold on to old narratives: that thinness equals virtue, that weight loss should hurt to count, and that drugs are somehow cheating.

But those ideas are outdated—and cruel.

What if instead, we honored all forms of health-seeking behavior?

The marathon runner and the weekly-injector. The yoga student and the person walking for the first time in months.

What if medicine's job was to reduce suffering, not preserve struggle?

This isn’t about letting people off the hook.

It’s about finally handing them a way forward.

Rick’s Commentary

The results are exciting.

But the emotions might be complicated.

These drugs bring the promise of relief—but also stir questions of fairness, identity, and effort. What happens to the meaning of discipline when a weekly injection can achieve what decades of dieting couldn't? And what do we do with the quiet sense of resentment that bubbles up when someone else reaches a destination we crawled toward, uphill and in the rain?

These are not just medical breakthroughs. They are cultural, emotional, and moral disruptors.

The future of GLP-1 drugs is still unfolding. Long-term effects, accessibility, and their influence on culture and self-image are all questions still being written.

But what’s clear is this:

These medications are not a shortcut around hard work.

They’re an invitation to re-imagine it.

In a way, they don’t undermine discipline. They just shift where discipline starts—not in the trenches of endless hunger, but in the steadier ground of possibility.

So maybe the next time we feel that flicker of resentment, instead of asking, Are they getting off easy? 

We might ask:

What kind of world do I want to live in?

A world where struggle is the only currency of worth?

Or a world where science helps us all carry a bit less weight?

#bunyipsbooks beyond