Big Smile, No Teeth: Here’s a Faustian deal for you

It's a hit with the weight loss crowd even though it reportedly makes your face lose fat and, thus, look older. We have apparently invented the zombie drug, and the waiting list for it is very long, says the columnist. — 123rf

WE’RE on the road to living longer! Scientists announced this week that semaglutide, the active ingredient in Ozempic, may slow biological ageing. Researchers found it reduced ageing markers in clinical trials, marking the first evidence that the drug can influence how fast the human body gets old. Remarkable news. Groundbreaking, even.

But what are semaglutides and what is Ozempic exactly?

You’ve probably heard of Ozempic, the weight loss miracle drug. It was developed by Danish company Novo Nordisk as a diabetes medication – it regulates blood sugar by mimicking a hormone that tells your body it’s full. Simple enough.

Except somewhere along the way, people started losing enormous amounts of weight on it, which is the golden goose – I mean, take a pill, lose weight?

Then Hollywood got involved, and then it was everywhere. In the United States, demand got so large that a shortage occurred and a grey market opened up. A company called Hims and Hers started selling compounded versions of semaglutide – essentially generic Ozempic –  for US$49 (RM200) a month, compared with the branded version which was selling at just under US$1,000 (RM4,093) per month last year.

Hims and Hers’ stock went from nowhere to nearly US$70 (RM286) a share.

Then the US Food and Drug Administration declared the shortage over, said compounded versions were no longer permitted, Novo Nordisk sued Hims and Hers, the US Department of Jus-tice got involved, and the stock fell 78% in a month.

The reason for all of this fuss is that Ozempic does things nobody fully anticipated. It suppresses appetite, yes. But it also reduces alcohol cravings, which researchers discovered more or less by accident when patients started reporting they just stopped wanting to drink.

It reduces compulsive behaviours more broadly. Across social media users have reported less gambling, less online shopping, less pornography use. The drug seems to dampen dopamine release so these behaviours no longer reward you as much. Great? I mean, yeah. I think.

There is, however, a catch. There is always a catch.

It’s called Ozempic face. When you lose significant weight rapidly – and Ozempic users lose a lot, fast – somewhere between 25% and 40% of that weightloss comes from lean muscle mass not fat. The face, which relies on a layer of fat to maintain its structure, loses that scaffolding. What remains is hollowed cheekbones, sunken eyes, dark circles, deeper wrinkles, and skin that sags around the jaw and neck.

The overall effect, as doctors describe it, is that people tend to look older than they are.

The drug that slows your biological ageing makes you look like you’ve aged dramatically. This is not a metaphor. This is the actual trade-off on offer. Users who started Ozempic to look better report looking into the mirror and not entirely recognising what they see. A doctor quoted in one report described the result as a deflated, gaunt look especially around the cheeks, jawline, and under the eyes.

Multiple American plastic surgeons have reported a surge in patients seeking facial fillers specifically to reverse what Ozem-pic did to their face after the drug did what they wanted to their body.

So Ozempic helps you drop weight, slows ageing, kills compulsive behaviours but makes you look like you were interned in a prison camp for a few years. A Faustian deal if ever there was one: drop the pounds to look great but hollow out your face so you’re not looking that great?

The other thing is users describe eating as simply something they do to live. Sitting down to enjoy your favourite meal? Gone. I would even say that with the culling of compulsive behaviours, Ozempic makes a room of your favourite things feel meh.

So let’s take stock of what we have. A drug that removes your appetite, that renders inert the pleasure of eating as well as other pleasures. A drug that hollows out your face. A drug that, according to this week’s research, slows your ageing.

No appetite. Hollow face. Technically, live longer than expected (but would you want to?). I am not a doctor. I am not offering medical advice. I am simply noting that we have apparently invented the zombie drug, and the waiting list for it is very long.

Big Smile, No Teeth columnist Jason Godfrey – a model who once was told to give the camera a ‘big smile, no teeth’ – has worked internationally for two decades in fashion and continues to work in dramas, documentaries, and lifestyle programming. Write to him at [e-mail] and follow him on Instagram @bigsmilenoteeth and facebook.com/bigsmilenoteeth. The views expressed here are entirely the writer's own.