For years I had a perfectly workable arrangement with my body.
I would overeat steadily and then occasionally apologise to it with a 5:2 diet. This worked astonishingly well for quite a long time, largely because human metabolism is a badly managed compromise held together with caffeine and denial.
Then, about a year ago, the arrangement stopped working.
Part of the problem was my knees. I had gradually stopped taking regular exercise because they started objecting to the whole concept with increasing hostility. Then came the meniscal injury, which rather settled the matter. There is nothing quite like damaging a knee to make you realise how many parts of ordinary life involve quietly bending it.
That mattered more than I first admitted to myself. Exercise had been quietly propping up the entire arrangement. Once that disappeared, the weight began creeping upward in the stealthy manner peculiar to middle age. One kilogram here, another there, all delivered with the sort of persistence usually associated with direct debits and dry rot.
The irritating thing was that the old tricks still felt as though they ought to work. One fasting day would produce a gratifying dip. Then the next week the weight would come back carrying reinforcements. It was like negotiating with the EU if the EU were made entirely of toast and cheese.
What finally nudged me toward action was a colleague at work. He had been seriously overweight. Not pleasantly portly. Not “built for comfort”. Genuinely huge. The sort of man who appeared to arrive in rooms a few seconds before the rest of him. He went on one of these courses and the transformation was extraordinary. Within months he had gone from looking like a human beachball to a positively svelte human being. Not gaunt or unhealthy. Just suddenly normal sized, as though somebody had quietly adjusted the aspect ratio.
And the odd thing was that he did not seem permanently miserable, which had always been my assumption about major weight loss. He was not sitting there chewing lettuce while staring longingly at a passing pork pie. He simply seemed less driven by food.
Like most people, I had quietly regarded people using Mounjaro as cheats. There is a faintly Calvinist streak in British thinking about weight. If you are overweight, you are expected to suffer nobly while eating celery and staring mournfully at other people's chips. Any solution that does not involve suffering is viewed with suspicion.
But the more I looked into how Mounjaro actually works, the less convincing the “cheating” argument became. It does not magically dissolve fat while you recline on a chaise longue eating Battenberg cake. What it mainly seems to do is reduce the constant food noise and make you feel fuller sooner, so you naturally eat smaller portions. In other words, you are still dieting. You are simply not conducting the process while your brain spends every waking hour screaming about toast.
In that sense it is perhaps less like cheating and more like finally being allowed to play the game without somebody continually shaking the table.
My colleague rather punctured that view. He summed the whole thing up by saying the weight loss had probably saved him £10,000 for a back operation his excess weight was making increasingly likely. That rather reframed it from “cheating” into “preventing your skeleton from filing a grievance.”
And of course it does not stop there. Excess weight sits quietly in the background aggravating half the chronic conditions of modern life. Diabetes, heart disease, blood pressure, sleep apnoea, joint degeneration, fatty liver disease. We often talk about obesity as though it were mainly cosmetic, when in reality it behaves more like a slow systems-engineering failure affecting multiple components simultaneously.
Frankly, he had a point. If I manage to lose 25kg, there is a reasonable chance my knees may improve too. My displaced sacroiliac joint might also stop behaving like a badly aligned shipping container every time I stand up awkwardly. Quite a lot of what we politely call ageing is really just the physics of carrying excess mass around on components that were not designed for it.
Hayley, being a PhD biochemist and therefore professionally qualified to explain why one biscuit becomes a complete digestive policy failure, suggested Mounjaro. After some thought, I enrolled on the year long course with the aim of losing 25kg, partly for health reasons and partly because I would quite like to fit into things without sounding like an elderly deckchair opening.
It is not cheap. The full course will cost me around a grand, which initially felt faintly outrageous. Then I realised I shall probably save half of it simply by no longer wandering into kitchens and emerging twenty minutes later with toast, cheese, biscuits and a vague sense of personal disappointment. By the end of the year the national snack industry may be issuing a profits warning.
Now, I had assumed the interesting part would be the appetite suppression. That is what all the headlines focus on. People eating three peas and then gazing wistfully at a single almond as though it were an excessive indulgence.
But something else happened almost immediately.
I started forgetting to vape.
Not in the usual sense. I already misplace phones, keys, wallets and occasionally entire lines of thought. My organisational system resembles a ship's chandlery after a minor explosion. But this was different.
Normally, if I get into the car, the vape appears in short order. It is practically part of the ignition sequence. Seatbelt, mirrors, engine, nicotine. The brain has welded the whole routine together into one seamless behavioural loop. The other day I drove for over twenty minutes before I even thought about it, which is unusual enough that I actually noticed it.
And it turns out this may not be imagination at all. Researchers are increasingly finding that GLP-1 drugs appear to affect the brain's reward and craving systems, not merely appetite. Studies are now looking at reductions in alcohol use, nicotine craving, gambling behaviour and even compulsive shopping. Early clinical trials involving semaglutide have shown measurable reductions in alcohol craving and heavy drinking, while observational studies have suggested reduced addiction and relapse rates across substances including nicotine and alcohol.
In other words, these drugs may not simply make people less hungry. They may make people less haunted by urges. Once you start thinking about it, the same reward mechanisms seem to crop up everywhere in modern life. Social media outrage. Doomscrolling. Online gambling. Endless tribal political rage. The modern economy increasingly appears to run on finding ways to keep the human brain in a permanent state of anticipatory stimulation.
Some people do not merely support populist politics. They consume it compulsively. Every day requires some fresh emotional reward: another betrayal, some new conspiracy, another reason civilisation is apparently ending by Thursday. The outrage itself becomes rewarding. One does occasionally wonder whether these drugs could accidentally end up treating that too.
Imagine it. A man logs onto Facebook intending to type “THIS COUNTRY IS FINISHED”, then halfway through loses interest, makes a cup of tea, and quietly reads an Office for Budget Responsibility report instead. The entire populist movement might collapse by teatime.
What seems to be happening with these drugs is not simply appetite suppression. They appear to reduce what psychologists call salience. In plain English, the brain stops waving little flags saying, “This. Pay attention to this. You want this now.”
Food loses some of its magnetic pull. Apparently so can nicotine. In my case, the vape has not become unpleasant. It has simply become oddly unimportant. And that is fascinating because I already use very low nicotine liquid, which means a fair amount of vaping was probably no longer chemical dependency in the classic sense. It was habit, ritual, tiny background rewards stitched invisibly through the day while driving, making tea, typing, or muttering about politicians.
The vape was less a nicotine delivery device and more a punctuation mark. Now the punctuation appears to be fading.
What strikes me is how different this feels from the old anti-smoking campaigns. Those always seemed based on the assumption that human beings are rational creatures who merely require another photograph of a diseased lung before immediately abandoning decades of conditioned behaviour. Meanwhile millions carried on standing outside pubs in the rain saying, “Terrible habit this,” before lighting another one.
But these new drugs may be approaching the problem from an entirely different direction. Instead of lecturing the conscious mind, they appear to be quietly fiddling with the machinery underneath it. The urge itself becomes less noisy.
It is rather unsettling when you notice it happening in real time. You realise you have not thought about food for hours. Or vaping. Or snacking. Not because you are heroically resisting temptation, but because temptation seems to have wandered off to bother somebody else.
Frankly, if pharmaceutical companies accidentally stumble into treatments for obesity, nicotine addiction, alcoholism, compulsive behaviour and political doomscrolling all at once, it will rank as one of the most extraordinary cases of unintended consequences in modern medicine.
Had my third weekly injection on Sunday. A tiny pinprick in the stomach, which still feels faintly absurd given that it is apparently capable of renegotiating decades of biological programming more effectively than every article beginning with "Ten Simple Fat Loss Tips" ever written by a man called Tyler on LinkedIn.
I've already lost 2.5kg, which is apparently extremely good going for the starter 2.5mg dose. Better than predicted, according to the cheerful little App that accompanies the drug and presumably reports directly to a Californian data centre monitoring my relationship with potatoes.
On the basis of this, Hay, who is a PhD biochemist and therefore irritatingly qualified to have opinions on receptor agonists and metabolic pathways, is keeping me on the 2.5mg dose for the second month. Her argument is that I am clearly responding well already and therefore do not need the standard pharmaceutical escalator ride upwards through the increasingly expensive dosages.
The manufacturers, naturally, are very keen on the ramp-up model. Funny that.
To be fair, there is genuine clinical logic behind increasing the dose. Higher doses do tend to produce greater average weight loss. But there is also a respectable argument for staying at the lowest effective dose while it continues to work, rather than charging enthusiastically upwards simply because a flowchart says so. Particularly when the higher doses introduce an increased chance of turning every meal into a tense diplomatic negotiation with your own digestive system.
So far I have had none of the legendary side effects. No exploding botty. No constipation. No sulphurous belching like a Victorian sewer outlet. My sole side effect has been one entirely deserved episode of nausea after attempting to tackle a baked potato alongside dinner, despite already suspecting beforehand that this was a profoundly optimistic decision.
That seems to be how the drug works. It does not scream at you. It simply sits quietly in the background like a disappointed Edwardian butler saying, "Really, sir? A potato as well?"
Portion sizes have visibly decreased, along with the desire to graze endlessly between meals. There is also something rather odd happening psychologically. Food is starting to move from being a form of low-level entertainment to being merely... food. Which I realise sounds how thin people have apparently experienced existence all along. The smug bastards.
Watch this space. Carefully though, as I might disappear completely.
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