Opinion
What if Ozempic is the new orthodontia By
Kate CohenContributing columnist|AddFollowJanuary 18, 2024 at 6:00 a.m. EST
Follow this authorKate Cohen's opinionsFollow
We live in a country that worships thinness and abhors, pathologizes or (at best) ignores fat people. When injectable weight-loss drugs become more affordable, weight loss will become even more obligatory. Being thin will no longer be an accident of birth or a perk of wealth; it will be a requirement of being middle class. Is this what we want?
Anti-fat bias already has a class element, in America at least, where there is a statistical link between poverty and obesity. But the social consequences of being fat in the semaglutide era are likely to get even worse — especially for children.
I think about it like teeth.
When my kids got braces, I knew they didn’t need them for their health, despite the case our orthodontist made for “avoiding future problems.” We weren’t paying for our children to have teeth that worked; we were paying for them to have teeth that looked “right.” The future problems we were avoiding were social, not dental.
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I knew this instinctively, but the science backs me up: A 2020 review found “an absence of published evidence” on the effects of crooked teeth or orthodontics on oral health.
On the other hand, there is evidence that “dentofacial aesthetics plays a major role … in social interaction and psychological wellbeing.” Have crooked teeth? Expect to feel worse about yourself and be treated worse by others.
That is what I, as a parent, was insuring against. Having “good teeth” does correlate with class in the United States, where access to dental care is not guaranteed. The result is that crooked teeth look poor. Or, from the perspective of a middle-class, suburban parent, they look “wrong.”
I’m not proud of acting on this bias. It was my responsibility to ensure my kids took care of their teeth and got them cleaned. The braces, on the other hand — I knew — were pure cosmetic consumerism posing as a universal rite of passage. In the United States, where around 50 percent of children get orthodontic treatment, parents generally pay somewhere between $3,000 and $13,000 to “fix” our children’s appearance starting as young as age 7.
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It’s as if half of us have been persuaded to buy our children nose jobs so they can “breathe easier.”
When my kids were getting braces, I thought about getting my own teeth fixed. But I didn’t. It was far easier for me to resist the pressure to have perfect teeth than to resist the pressure to give my children every social advantage I could afford.
That’s why I worry about the availability of weight-loss drugs.
The Food and Drug Administration has approved semaglutides for children as young as 12, and pharmaceutical companies Novo Nordisk (the manufacturer of Ozempic and Wegovy) and Eli Lilly are testing the drugs for use on children as young as 6. These drugs may be potential lifesavers for children struggling with diabetes. But what about otherwise healthy kids struggling with anti-fat bias?
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Imagine if — to protect their children from the stigma of being fat — parents begin to fall for the lures not of orthodontics (teeth correcting) but of orthomorphics (shape correcting).
Imagine if the moment a child is deemed “chubby” or “husky,” parents rush to their local orthomorphist for a prescription to “fix” them.
Orthodontics cost me money and consigned my kids to a couple of years without chewing gum. Orthomorphics would be far, far worse. Besides weight-loss drugs’ painful and potentially devastating side effects, known and unknown, there’s the fact that they work by making food unappealing. For someone who loves cooking, eating and sharing food, these aren’t just weight-loss drugs. They are pleasure-loss, comfort-loss, joy-loss drugs.
Taking away your kid’s joy in food might be worth it if your child is chronically ill and suffering. But if your child is just fatter than your world thinks they should be? How many parents are strong enough to resist?
And how much fiercer does our culture’s anti-fat bias get as more and more parents give in?
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I always thought I’d be thin if I were rich.
I’d have personal trainers and private chefs, surreptitious plastic surgery and a good PR team to deny it.
Now, it seems, with the advent of semaglutides, a.k.a. the injectable weight-loss drugs Ozempic and Wegovy, I wouldn’t even have to be rich rich. For a not inconceivable amount of money, I could lose the extra pounds that have bothered me ever since I learned they should bother me. I could buy a 15 percent drop in my body weight.
Or rather, “rent.” For the low, low price of … about $1,200 a month for the rest of my life.
True, that’s still a lot, for most of us. But it won’t be long before competition and insurance coverage bring down the cost — not just for people with Type 2 diabetes for whom semaglutides were developed but also for healthy people who simply want to be thinner. Eventually, we’ll be talking less extra apartment and more cable bill. Great, right?
I’m not so sure.
We live in a country that worships thinness and abhors, pathologizes or (at best) ignores fat people. When injectable weight-loss drugs become more affordable, weight loss will become even more obligatory. Being thin will no longer be an accident of birth or a perk of wealth; it will be a requirement of being middle class. Is this what we want?
Anti-fat bias already has a class element, in America at least, where there is a statistical link between poverty and obesity. But the social consequences of being fat in the semaglutide era are likely to get even worse — especially for children.
I think about it like teeth.
When my kids got braces, I knew they didn’t need them for their health, despite the case our orthodontist made for “avoiding future problems.” We weren’t paying for our children to have teeth that worked; we were paying for them to have teeth that looked “right.” The future problems we were avoiding were social, not dental.
I knew this instinctively, but the science backs me up: A 2020 review found “an absence of published evidence” on the effects of crooked teeth or orthodontics on oral health.
On the other hand, there is evidence that “dentofacial aesthetics plays a major role … in social interaction and psychological wellbeing.” Have crooked teeth? Expect to feel worse about yourself and be treated worse by others.
That is what I, as a parent, was insuring against. Having “good teeth” does correlate with class in the United States, where access to dental care is not guaranteed. The result is that crooked teeth look poor. Or, from the perspective of a middle-class, suburban parent, they look “wrong.”
I’m not proud of acting on this bias. It was my responsibility to ensure my kids took care of their teeth and got them cleaned. The braces, on the other hand — I knew — were pure cosmetic consumerism posing as a universal rite of passage. In the United States, where around 50 percent of children get orthodontic treatment, parents generally pay somewhere between $3,000 and $13,000 to “fix” our children’s appearance starting as young as age 7.
It’s as if half of us have been persuaded to buy our children nose jobs so they can “breathe easier.”
When my kids were getting braces, I thought about getting my own teeth fixed. But I didn’t. It was far easier for me to resist the pressure to have perfect teeth than to resist the pressure to give my children every social advantage I could afford.
That’s why I worry about the availability of weight-loss drugs.
The Food and Drug Administration has approved semaglutides for children as young as 12, and pharmaceutical companies Novo Nordisk (the manufacturer of Ozempic and Wegovy) and Eli Lilly are testing the drugs for use on children as young as 6. These drugs may be potential lifesavers for children struggling with diabetes. But what about otherwise healthy kids struggling with anti-fat bias?
Imagine if — to protect their children from the stigma of being fat — parents begin to fall for the lures not of orthodontics (teeth correcting) but of orthomorphics (shape correcting).
Imagine if the moment a child is deemed “chubby” or “husky,” parents rush to their local orthomorphist for a prescription to “fix” them.
Orthodontics cost me money and consigned my kids to a couple of years without chewing gum. Orthomorphics would be far, far worse. Besides weight-loss drugs’ painful and potentially devastating side effects, known and unknown, there’s the fact that they work by making food unappealing. For someone who loves cooking, eating and sharing food, these aren’t just weight-loss drugs. They are pleasure-loss, comfort-loss, joy-loss drugs.
Taking away your kid’s joy in food might be worth it if your child is chronically ill and suffering. But if your child is just fatter than your world thinks they should be? How many parents are strong enough to resist?
And how much fiercer does our culture’s anti-fat bias get as more and more parents give in?
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