I Didn’t Want Weight Loss to Be the Thing That Cured Me. It Did Anyway
Do I owe anyone an explanation about how or why I got on GLP-1s?
Do you know what it’s like to bleed every day for almost two years? I do, unfortunately. In the fall of 2023, I started to notice that my period—normally a blessedly predictable, brief three- or four-day affair that I gave little thought to—was lasting longer and longer, until I could no longer reliably update my period-tracking app or give a doctor the date of the start of my last menstrual cycle with any kind of assurance.
Eventually, this “long period” gave way to a new state of affairs, one in which I bled and bled; sometimes barely at all, sometimes so heavily that I would call my local ER to quantify what counted as an “urgent” amount of blood loss, but usually somewhere in between. I got strangely used to wearing period underwear almost every day and never, ever blithely sitting down on a white couch. After a few months of what I termed my Forever Period, I made an appointment to see my gynecologist.
A kind nurse at my ob-gyn practice relieved me of a fair amount of blood (from my arm this time), and later my online health portal shared the results: I had endometriosis. This news didn’t thrill me, obviously, but it also felt like a relief to hear that there was a name attached to what was wrong with me; as it would turn out, though, that relief was short-lived, as the follow-up pelvic ultrasound and endocrinologist appointment that my gynecologist recommended flipped the script yet again. Actually, my heretofore typical menstrual history and lack of cysts suggested that I didn’t have endometriosis—whoops!—and, sorry, the new doctor didn’t know what I did have, but she had an idea of what might help: losing weight. “Probably around 50 pounds would do it,” the endocrinologist said flippantly.
I left the office with a prescription for Zepbound and a ball of fury in my stomach, refusing to fill the former, while the latter grew and grew as I thought about all the doctor’s appointments I’d sat through (including one at the eye doctor) where I’d been told to lose weight. At that point, I’d been fat—or, more specifically, fat enough to endure medical fatphobia—for about four or five years, so I wasn’t new to the ball game, but this was the first time I’d gone in to see a doctor with an actual, specific problem since gaining a considerable amount of weight in my mid-20s. Was she really content to tell me to “just lose weight,” like it was easy, like I hadn’t spent decades trying to overcome my eating disorder and the last three years of my life working on and eventually publishing a memoir about accepting my fat body as it was?
“How I Made Peace With Hunger and Decided I’d (Probably) Never Go on Ozempic,” blared the headline attached to the excerpt of my book that ran on this website in July 2024. I didn’t choose the headline, but I wrote these words: “I worry that drugs like these provide a quick fix to the messy and often lifelong problem of learning to live in a changeable and desirous human body.” I took care to temper that sentiment with a stated lack of judgment about anyone else’s health-care decisions, but the truth was, I was judging: not necessarily other people (then and now, I simply don’t think it’s my business how anyone chooses to nourish or medicate themself), but the version of me who might have taken GLP-1s as a shortcut. Now, though, I look back at that writing and think…a shortcut to what? Is there really any inherent virtue in losing weight the old-fashioned way (or not losing it at all), and does it make sense to let the possibility of that virtue dictate my medical decisions?
Before I took my first shot of Zepbound a year ago, I assumed that going on a GLP-1 would force me to trade appetite for weight loss, divesting me from my love of flavor and cooking a good meal in exchange for bringing the number on the scale ever downward (if I had owned a scale, that is; the truth is, I haven’t had one in my home since the anxious, soft-anorexic days of my early 20s, preferring instead to do my weigh-ins at my doctor’s office).
This chronic loss of appetite when taking a GLP-1 is absolutely the case for some people, but it hasn’t been the case for me—at least not yet. Like so many other people dealing with disordered eating who go on GLP-1s, I find “food noise” of the intrusive variety to be dramatically quieted, but I’m still excited to make ravioli at home or go out for a steak dinner with friends or get In-N-Out (with a pup patty on the side for my dog) on a road trip. I haven’t experienced negative side effects of any kind, and honestly, I experienced more appetite-zapping and anhedonia from increasing my Vyvanse prescription a few years ago than I have from Zepbound thus far.
This is the part where I start to panic about sounding like a shill for Big Pharma, and also where I come out to you, the reader, about how I’m paying for my GLP-1s. The answer is simple: I’m not, my mom is. Zepbound currently costs me about $400 a month, which is an amount of money I simply don’t have to spare; no version of the medication is covered by my insurance (which I’ve confirmed with an endless stream of stymying calls with representatives who always need me to know that they’re “trying to help”).
At first, I was hesitant to accept my mom’s generous offer to cover the cost of my medication for the same reason I was hesitant to fill the prescription in the first place; I didn’t want to feel like a failure, to admit to myself or to anyone else that I couldn’t (1) keep fighting for a solution to my menstrual woes that didn’t stem from weight loss, (2) lose weight the so-called “natural” way, or (3) even afford my own GLP-1s as a supposedly independent and fully employed 32-year-old adult. Does it feel complicated and sometimes infantilizing to need a monthly influx of cash from my mom, who—together with my dad—supported me throughout my upbringing and should, by all rights, be done with that part of her parental duties? Absolutely, but the truth is, she has the money, I don’t, and at a certain point, refusing her help—or, for that matter, refusing to try GLP-1s out of some sense of apprehension that was vaguely but not quite rooted in fat liberation—began to feel churlish.
Let’s circle back to the Big Pharma and fat-liberation parts, because they’re important. There are many, many valid reasons to be skeptical of how GLP-1s are currently being mass-marketed in the U.S. and around the world, but you’re never going to hear me argue against the drugs becoming more affordable; I believe all health care should be free (or, failing that, at least not ruinously expensive), and I know most people don’t have the luxury of texting their mom for a Venmo’d cash infusion when they’re prescribed a drug that might help them but that they can’t afford on their own. In no way do I think Lilly, the manufacturer of my Zepbound, cares about me or any of the other patients it makes a profit off of, but being put off by the omnipresence of thin-is-in rhetoric in GLP-1 ads (which, to be clear, I very much am) doesn’t feel like a reason to hope that anyone else’s path toward getting the medications—if, indeed, they find them to be beneficial—should be any more difficult than it has to be.
During my year on Zepbound, I’ve lost about 50 pounds, just like my doctor instructed me to. As of about four months ago, my Forever Period has stopped, replaced by a cycle that looks more like the straightforward one I had before I gained weight. I can’t possibly emphasize enough how good it feels not to bleed every day anymore—to be able to wear normal underwear, to swim, to go to the Korean spa, to have a one-night stand without fear, or to feel less concerned about my constant bleeding’s potential fertility ramifications—but at the same time, I’m pissed off that my doctor’s tossed-off, fatphobic-feeling advice seems to have worked.
I’ve made my tenuous peace with being someone on GLP-1s, but I don’t want to be a “weight-loss success story.” I’m fat now and I’ll still be fat even if I lose another 50 pounds, and I don’t want to reabsorb the messages I worked so hard to shed about body size being inherently tied to worth—which I fear I might if I keep losing weight. Then again, wasn’t the main tenet of the fat activism I wrote so glowingly about in my book is that my body is mine? Do I owe anyone an explanation about how or why I got on GLP-1s? Am I unconsciously trying to present myself as a “good” GLP-1 user—unlike the many thin people who use the drugs to get thinner—and can I really call myself an advocate of body liberation if I’m drawing a mental line in the sand about who is allowed to benefit from these drugs and why?
