How an Obession With Self-Care Paved The Way for Ozempic

The craze over the popular semaglutide drug is the end result of a self-care economy selling everything — but offering no real solutions.

In the six years since Ozempic’s release, the drug has grown from a relative newcomer on the market into a dominating force in the weight loss industry — one inspiring a handful of similar medications, including Mounjaro, Wegovy, Rybelsus, Victoza, and Sanxeda. But as this new wave of diet options continues to grow in popularity, Ozempic isn’t just becoming a lesson on how to lose weight. Drug companies are picking up where the trap of self-care failed — and it’s working. 

While self-care is often associated with mental health, taking advantage of vacation days, or putting on the occasional 99-cent sheet mask, the internet’s definition of wellness has evolved into becoming the best, most productive, most gorgeous version of oneself, achieved through hard work, determination, and enough cash to buy dozens of products. Combined with the ubiquitousness of social media focused on imagery, self-care isn’t just a buzzword. It’s a marketing tool, a state of mind, and, according to McKinsey & Company, a $1.5 trillion economy. It’s also exclusionary, both monetarily, and by elevating restraint into a moral virtue. But the fact that Ozempic — a medical injection that costs almost $1,000 a month without insurance, which often doesn’t cover it — is thriving in an era of wellness defined by alternative practices, pricey treatments, and pseudo-science isn’t an accident. It’s the direct result of an over-bloated framework of self-care, one that made willpower the end-all-be-all — and saw a majority of women left behind in the process. 

First released in 2017, Ozempic is part of a class of semaglutide drugs known as GLP-1 antagonists. Injectables Ozempic and Mounjaro, as well as the oral tablet Rybelsus, are only approved for treating type-2 diabetes in adults, while Wegovy is approved by the FDA for weight loss. GLP-1 drugs mimic natural GLP-1 made in the intestines, hormones that regulate blood sugar. While the drug was originally developed to treat diabetes, the side effects of keeping people full longer and decreased appetite made Ozempic a popular choice for weight loss. Since 2021, demand for Ozempic has doubled — an estimated 370,000 people are on it — the drug and others are currently under a national shortage. But the rising usage of the semaglutide options has sparked major conversations on whether weight plays an outsized role in what doctors consider a healthy body; and what wellness culture — usually defined by discipline and a long, arduous process — looks like when there’s seemingly easier (but no less expensive) alternative. 

Christy Harrison is a registered dietician and the author of The Wellness Trap, a book that explores how diet culture and disinformation took over wellness spaces online. She tells Rolling Stone that the most modern iteration of wellness and self-care culture has linked itself to weight loss at all costs, but uses rhetoric around taking care of your body rather than just wanting to look good.

“Wellness culture equates muscularity and particular body shapes with health and morality and promotes weight loss and body reshaping as a way of attaining higher status even while elevating people who don’t match a positive picture of health,” Harrison says. “[They say] ‘You’re doing this for your health, you’re doing this to be the best you can be.” 

Harrison notes that one of the biggest failings of self-care is that it convinces large swaths of people that the only thing standing between them and success is willpower, marketing that is mirrored online. Much of the self-care content on sites like Instagram and TikTok succeeds by showing idealistic or unattainable standards of beauty or health, and convincing large swaths of followers that they too can achieve this goal, all without disclosing the financial and time freedoms that allow that health to take places. The first answer to these unattainable goals was the return of the body positivity movement, Harrison says, which prided itself on the celebration of all body sizes. It was followed by the body neutrality movement, which means accepting your body even if it’s a size or shape you wouldn’t prefer. Now, Ozempic is being marketed where self-care left off, as a way to take control of your wellness without blaming yourself. 

The Ozempic craze has also tapped into one thing self-care hasn’t adequately answered: the existing gap in health care for cisgender women. Marketing surrounding weight loss and health is largely targeted toward women. At least 81 percent of Wegovy users, the version of Ozempic approved specifically for weight loss, identify as women, according to Novo Nordisk. And the large majority of vocal Ozempic supporters and influencers online all have a battery of hormonal syndromes, like endometriosis, polycystic ovary syndrome, or chronic thyroid issues — all of which can cause rapid weight gain, or difficulty losing weight. These influencers have built platforms on using Ozempic to treat their hormonal weight loss, and anecdotally have created narratives that the drug is succeeding where prior healthcare alternatives failed. 

Dr. Daniel Ginn, an OBGYN at UCLA Health, tells Rolling Stone that getting a diagnosis and treatment for people with endometriosis, PCOS, or other related pelvic disorders can be extremely challenging. According to Ginn, it takes on average seven to nine years to diagnose endometriosis, a process that can leave people desperate for alternatives. 

“I’m definitely biased because by the time patients get to me, I do believe them,” Ginn says. “And I also hear the same story eight times a week or more that someone’s had symptoms that had been present for a very long time and either weren’t taken seriously or were missed or ignored in the first place. And it’s heartbreaking. We cry a lot in [the] clinic, because I get to see patients feel heard for the first time, which is a privilege and also gutting because it shouldn’t have to be that way.”

“The ground has become fertile for wellness culture to develop because there are so many [legitimate] issues in the conventional health care system,” Harrison adds. “People with conditions like autoimmune diseases or PCOS or things that are poorly understood and not adequately treated. People with those conditions want some sort of solution.” 

Even as a prescribable medication, Ozempic has also helped people channel self-care’s distrust of Western medicine into a tangible disregard for doctors’ warning. Since the official shortage of Ozempic began, the Federal Drug Administration has issued multiple warnings about compounded semaglutide, a generic version of the drug that people can obtain from compounding pharmacies or telehealth sites. But the practice has continued, with TikTok videos sharing how to get cheaper and compounded versions online overwhelming doctors encouraging people to listen to the FDA warning on TikTok. And according to a recent report from Fortune, there’s a network of “financial incentives and payments underpinning” a large majority of the Ozempic-themed content on TikTok — which incentivizes influencers to post more about the drug. Online, taking Ozempic has come to represent taking your health into your own hands, even if it means you have to disregard your doctor’s advice in the process. But Harrison tells Rolling Stone that as more problems with the self-care economy are exposed, she hopes people will address the societal issues causing them rather than running to a new solution. 

“I think it’s sort of pernicious for wellness culture to say you need to take time for yourself, and the way to do it is by losing weight or eating this restrictive diet or by doing this exercise program or whatever,” Harrison says. “The larger systemic issues are not being addressed or taken into consideration. People are made to feel guilty for not doing self-care when there are real systemic pressures making that difficult. I think if we could collectively  work to change those things, we’d be a lot better off than having individual moms and parents and people targeted by rhetoric that they need to take their self-care into their own hands.”