Johann Hari still remembers the strange sensation he felt two days after he first injected himself with Ozempic.
A doctor prescribed the drug for weight loss — a famous side effect of the Type 2 diabetes treatment — in 2023 when Hari weighed 203 pounds and had a body fat percentage of 32%.
Hari’s grandfather died of a heart attack at 44, his uncle in his 60s, and his father underwent a quadruple heart bypass in his 70s.
Hari didn’t have diabetes and was wary of weight-loss drugs knowing that past options “always turned out to be a disaster,” he says. But weight loss with Ozempic seemed like a way to lower his own heart disease risk.
He noticed the drug’s effect a couple of days after his first dose.
“I woke up and I thought, ‘There’s something weird. What is it?’ I couldn’t figure out what it was. And then I suddenly realized I had woken up and I wasn’t hungry. That had never happened to me,” Hari, 45, a journalist who lives in London and Las Vegas, tells TODAY.com.
“My appetite was just dramatically dialed down from that point on. I was so much less hungry than I’d been before. I felt very full, very fast.”
Hari ultimately lost 42 pounds with Ozempic and then its sister drug Wegovy, which has the same active ingredient, semaglutide, and is specifically approved for weight loss.
He set out to find out all he could about GLP-1 medications — which mimic at least one hormone produced by the gut to signal fullness — in his new book, “Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs.”
Hari shared his insights in an interview with TODAY.com. His answers are edited and condensed for clarity:
TODAY: You call these weight-loss drugs “a mass experiment, carried out on millions of people, and I am one of the guinea pigs.” Why?
Hari: I’m part of two experiments, not just one. I was part of the experiment that made us so much more obese. And now I’m part of the experiment that’s reversing that using drugs.
In my lifetime, we’ve had an explosion of obesity that’s unprecedented in human history. We’ve been physically altered by processed and ultra-processed foods, which have completely taken over our diet and are unlike the food that human beings ate before us. This food is undermining our ability to ever feel full.
The second experiment I’m part of is these drugs. They give you back your sense of being full. But they bring with them some risks as well.
What potential risks worry you the most?
Semaglutide has only been used for a bit more than two years now for people with obesity. We don’t know the long-term effects of taking them. There’s a concern that maybe they’ll have some effect that we just don’t know in the long term.
Expert's take: Dr. Christopher McGowan, an obesity medicine specialist in Cary, North Carolina, says that when patients ask him whether it’s safe to take Wegovy for years, he tells them there are no long-term studies on it. But he notes that GLP-1 medications have been used for more than a decade to treat Type 2 diabetes, “so we do have a very reassuring track record in general with these medications," McGowan previously told TODAY.com.
Dr. William Yancy, medical director of the Duke Lifestyle and Weight Management Center, in Durham, North Carolina, added that after reviewing the research, he is comfortable prescribing Wegovy knowing that a patient might have to take it for years or decades.
“We’re always accumulating knowledge and so that could change down the road, but at this point we have enough information to consider this as a long-term treatment," he told TODAY.com.
Asked if Wegovy is safe to take long-term, Novo Nordisk, its maker, tells TODAY.com GLP-1 medicines such as semaglutide have been used to treat Type 2 diabetes for more than 18 years, and for the treatment of obesity for eight years.
"Semaglutide has been extensively examined in robust clinical development programs, large real world evidence studies and has cumulatively over 9.5 million patient years of clinical experience," the company says in a statement.
"Novo Nordisk stands behind the safety and efficacy of all of our GLP-1 medicines when they are used as indicated and when they are taken under the care of a licensed healthcare professional."
The company also says it work closely with the U.S. Food and Drug Administration to continuously monitor the safety of its medicines.
TODAY: What specifically bothered you?
Hari: For myself, the one risk that I didn’t see coming was the psychological effect. That was really strange. For the first six months I was taking the drug, I was getting what I wanted — I was losing loads of weight, my back pain went away, all sorts of good things happened.
But I didn’t actually feel better in my emotions. If anything, I felt slightly worse. I realized it was about my inability to comfort eat, and how bad that was making me feel.
I went to KFC in Las Vegas and I did what I would have done before I was taking Ozempic — I ordered a bucket of fried chicken. I had one of the chicken drumsticks, and I suddenly thought, “I can’t eat this.” On Ozempic, you can’t overeat. You would vomit. I remember a voice in my head going, “You’re just going to have to feel bad, then.”
You could no longer use food as a stress coping mechanism?
Exactly. That can be a bumpy adjustment process for a lot of people. It can bring to the surface the deep underlying emotional reasons why you ate in the first place.
I realized how much of my eating was about the need to comfort myself — stuffing myself to calm myself. And I couldn’t do that when I was on Ozempic.
The psychological effects made me want to stop taking it, but one of my friends said to me, "You can find a better way to deal with your emotions than overeating."
You say you experienced "surprisingly persistent" side effects. What were they?
The side effects were not terrible, but they were uncomfortable. They gradually diminished over four months.
The day after I would inject myself once a week, I would feel a bit sick. It’s pretty mild.
I had one of the less common side effects — some people feel their heart beats faster. It’s hard when your heart is racing to not feel anxious because your body’s like, something is wrong. So that was, for me, the most unpleasant side effect.
I want to stress that I experienced a lot of benefits from this drug. I went from eating 3,200 calories a day to 1,800 calories a day and not feeling hungry.
Editor's note: The U.S. Food and Drug Administration label for Ozempic states that in placebo-controlled trials of 0.5-1 milligrams of the medication "resulted in a mean increase in heart rate of 2 to 3 beats per minute."
Do you plan to keep taking Ozempic indefinitely?
Yes, because of the heart attack risk in my family, for me personally, the benefits of these drugs outweigh my very real concerns about the long-term effects. Studies show that Wegovy (which contains the same active ingredient as Ozempic) reduces heart attack or stroke risk by 20%.
You have to weigh two sets of risks — the risks of obesity against the risk of these drugs. Obesity makes almost all the health conditions we fear more likely — heart disease, stroke, dementia, cancer.
Expert's take: When considering taking weight-loss drugs such as Wegovy and Zepbound, every person needs to weigh the risk-benefit to themselves, including how continued obesity will affect their health, Dr. Beverly Tchang, an endocrinologist and obesity medicine physician at Weill Cornell Medicine in New York, previously told TODAY.com. She's an advisor for Novo Nordisk, the pharmaceutical company that makes Ozempic and Wegovy.
“For a lot of my patients, I know they have struggled with obesity for all of their childhood and adulthood already, and the benefits outweigh the risks as soon as they start the medication,” Tchang said.
Are these drugs really "magic," as you call them in your book title?
There are three ways these drugs could be magic.
The first is the most obvious: They could just solve the problem. There are days when it feels like that. My whole life, I’ve overeaten. Now, I inject myself once a week and I don’t overeat. It feels like magic.
The second way it could be magic is much more disturbing. It could be like a magic trick. It could be that over time, the risks associated with these drugs outweigh the benefits. I do not rule that out.
The third way is, I think, the most likely. Think about the stories of magic, like "Aladdin." You find the lamp, rub it, the genie appears, grants your wishes, and your wish comes true — but never quite in the way that you expected.
The drugs are such a powerful tool. They're going to have huge and unpredictable effects — positive and negative. That’s why we need to take a beat and really think about this incredible revolution that’s hitting us.
