'Easy way out' may not be so easy

I've been hearing a lot lately about how it's "taking the easy way out" to use GLP-1s to lose weight. That may be true. But then again, you might be able to say the same thing about virtually every medical advancement. When you boil it down, chemotherapy is "taking the easy way out" of testicular cancer. Penicillin is "taking the easy way out" of a bacterial infection. The MMR shot is "taking the easy way out" of getting the measles. You could be suffering and dying along with everyone else who's had the problem since the beginning of time but, instead, you're over here relying on a chemical shortcut to better health. So lazy. I suppose we like to think that we have more control over these things than we actually do. It's one of the reasons I bristle at the language around cancer: We talk of patients fighting it, being warriors, overcoming cancer, as if it were a martial victory achieved through sheer power of will. And when someone dies, they are said to have "lost their battle" against the disease. What must that feel like for a person with cancer who does everything right — changes their diet, sees a wonderful doctor, goes through the recommended treatments — only to find that there is a substantial portion of luck involved in their recovery? Obesity isn't like having cancer, but as time passes, research has shown that humans also have limited control, ultimately, over their weight. Our bodies, in most cases, look a lot like our biological parents' bodies, and when they don't, there are often medical, social or emotional factors at play. We weigh more than we ever have in the United States, that's true, but we're also taller than we ever have been and have more consistent access to a wide variety of foods than at any point in human history. We have evolved to protect ourselves from starvation, which, for most of the time we have roamed the Earth, was a far graver and widespread problem than was weighing too much. Research has also shown that when someone loses weight, their body will work overtime to get back to its previous set point. For real-life proof, watch the documentary about the contestants on the weight-loss game show "The Biggest Loser," who almost invariably have returned to or surpassed their former weights. At the same time, there are strong societal pressures to be thinner. Anyone who's ever dropped a few pounds and found themselves covered in congratulations knows we richly reward weight loss. But there are some who say that's just the point. We shouldn't be encouraging those false narratives about weight. The writer Lindy West, who's made what's called fat liberation (her words, not mine) a key of her work, told Dr. Sanjay Gupta that she would never take GLP-1s for weight loss. "For many reasons," she said, "but primary among them is that it would not solve any of my problems." She has talked about the emotional component to her eating, and about how those with eating disorders have complicated feelings of shame, self-hatred and despair about their bodies. GLP-1s do not solve those problems, that's true. Those medications also do little to disprove the societal belief that fatness is a result of weak will or ignorance. It's not the same for most other conditions. No one (worth listening to) believes that people with the measles just have lazy immune systems. But what do you do when a hurricane is heading for your house? Do you argue with the hurricane, tell it that it's unfair to target you when you've done nothing wrong? Or do you grab your stuff and get out of there, and deal with the consequences later? For those carrying a significant amount of additional weight, there are undeniable health benefits to weight loss. Argue about the fairness of increased risks of diabetes and hypertension and pregnancy complications all you like, but that won't make them disappear. For my part, I haven't taken GLP-1s, but if my doctor recommended one, I'd strongly consider it. And yes, it's crucial to learn how to eat healthier and move more. Some won't respond to GLP-1s at all, and even if they do, combining the medications with therapy, nutrition education and exercise is likely to create more longstanding, healthy changes anyway. But if a person says that, on the advice of their doctor, they're using GLP-1s to lose weight, we shouldn't judge them or accuse them of "taking the easy way out." Because, sometimes, the easy way out may be the best — or, only — way, too.