A new weight-loss drug works. Is that good?

This is an audio transcript of the FT Weekend podcast episode: A new weight-loss drug works. Is that good?

Lilah Raptopoulos
The other day, I was watching a promo spot which features Queen Latifah, the iconic actress and rapper, and she’s talking about her struggles with weight loss.

Advertisement featuring Queen Latifah
You still with me? OK good, because we need to have an honest conversation. I played a lot of different characters, but for me, the most important character I can play is the one who loves me for me.

Lilah Raptopoulos
The spot is for a drug called Wegovy. It’s made by the Danish pharma company Novo Nordisk. It’s a new prescription weight-loss medication, and it’s being hailed as a miracle drug. Queen Latifah is its spokesperson. If you wanna lose weight long-term, statistics show across the board that just diet and exercise actually rarely works. There’s also a lot of conversation about whether we should be promoting weight loss at all or if that’s just reinforcing our cultural obsession with thinness. The Wegovy ad tries to acknowledge all of this.

Advertisement featuring Queen Latifah
I’ve experienced being judged by others because of my weight. I know the negative effect it can have on you, but I never let that stop me. And neither should you. Living with obesity isn’t about a lack of willpower. It’s not a character flaw. It’s bigger than that.

Lilah Raptopoulos
The reason I watched the spot is not just because I love Queen Latifah, but also because my colleague Hannah Kuchler shared it with me. She had just reported a story on this drug because this drug works. You inject it every week and it makes you less hungry.

Hannah Kuchler
So the average participant in the trial lost 15 per cent of their body weight. Previous versions of this drug and others were about 5 per cent. So this is dramatically more. And about a third lost 20 per cent, which is about the same as having surgery for weight loss.

Lilah Raptopoulos
There are a few problems: Wegovy is super expensive, it has some pretty awful side effects and a drug doesn’t solve any of the structural problems that cause obesity. Today, Hannah joins us to talk through the implications of this new drug. Then we talk personal style with our fashion editor, Lauren Indvik, who answers all of your questions on how to build a lasting wardrobe that feels like you. This is FT Weekend. I’m Lilah Raptopoulos.

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Queen Latifah is a good choice for a campaign around obesity. African-American women have the highest obesity rates in the US and Americans have among the highest obesity rates in the world. More than four out of 10 Americans are considered obese. The results of the Wegovy trials are unprecedented, and that’s mostly because people are able not just to lose weight, but to keep the weight off. There’s only one catch, which is that you can’t stop taking the drug. So before we dive into the drug, can you tell us what’s happening around obesity in the west and sort of what the health crisis is?

Hannah Kuchler
Yeah, so I think Covid really shone a light on what we already kind of knew was a gigantic problem, which is that the west is getting more and more obese and in fact, it’s not even just the west. Countries like China are also getting more and more obese, and developed countries have had strategies to try and deal with obesity for several years now. And the OECD issued a report just before the pandemic saying none of these strategies are working.

Lilah Raptopoulos
So, Hannah, you wrote a story about Wegovy, which is this new — and I’m using scare quotes here — “miracle drug” (laughs). What is Wegovy like? Can you explain how it works and what the science is around it?

Hannah Kuchler
Yeah. So Wegovy comes from this hormone which we all have in our small intestine and they found it in 1997. And initially they thought, oh, it has this impact on insulin to be quite useful for diabetes. And it was developed into diabetic drugs. And then they started to notice that even when it was in pre-clinical studies in, you know, rats and mice, they started to lose weight.

Lilah Raptopoulos
Oh wow.

Hannah Kuchler
So this was a side effect that they wanted to explore. It took quite a long time because it’s actually the hormone, the naturally occurring hormone, disappears within minutes. So it’s a huge sort of scientific challenge to get it to stick around in the body for long enough. But what it does is it acts as an appetite suppressant. And it plays into this other interesting thing that I discovered during my reporting, which is that more and more scientists believe that obesity is a chronic disease, that actually the heavier you are, the more hungry you are and that your body is trying to keep you at your highest weight.

Lilah Raptopoulos
Right.

Hannah Kuchler
And so by sort of intervening, taking extra of this hormone, you feel sated and you lose weight.

Lilah Raptopoulos
If you can believe this, scientists still don’t really understand how obesity works. We know there’s a theory called a set point, which is this weight range that your body wants to be. And when you lose weight, your body slows its metabolism down to get you back up there. What scientists don’t know is why your body wants to get back to the set point or what triggers the mechanism.

Hannah Kuchler
This set point thing is just sheer . . . In some ways, it’s just really vicious and it was really moving and impactful to spend time with people who had really struggled with this and felt so misunderstood and devalued themselves because they blame themselves for not having willpower. At the same time that there are these scientific papers out there that are not like . . . They didn’t come about yesterday, but there are people blaming themselves and they don’t understand that like the experts in the field say, this is not your fault.

Lilah Raptopoulos
Mmm. There is a lot of debate about how we measure obesity. Doctors use what’s known as the body mass index. You’ve probably heard of it when you’re getting a check-up. The BMI, it’s just a ratio of your height to your weight. But it was conceived in the 1800s. So the ideal BMI is based on this European man from 200 years ago, which is pretty flat. That said, being very overweight is still hard on your body. It’s correlated with heart disease, diabetes, joint problems. And because our culture has so much stigma around being obese, life can be really hard for people. That can lead to depression, anxiety. So with all that in mind, often people wanna lose weight. So this drug is really effective. And if that’s the case, like, why are we not hearing about it everywhere? Like, why aren’t doctors prescribing it left and right?

Hannah Kuchler
Right. This is not a pleasant thing to take. I mean, an appetite suppressant doesn’t seem so bad, but there’s lots of people saying it felt like morning sickness all the time, that, you know, that they were initially vomiting this, they’d sort of titrated up the drug, that they had a lot of other gastro symptoms like constipation. So this isn’t like a complete walk in the park. Doctors do not tend to learn very much about obesity, surprisingly, in medical school. And so . . . 

Lilah Raptopoulos
Wow.

Hannah Kuchler
This . . . 

Lilah Raptopoulos
Yeah, that seems like an oversight.

Hannah Kuchler
Yeah, it really does, doesn’t it? And so they have to be convinced. A lot of them have the same kind of biases, that it’s a moral failing, it’s a willpower issue. And then finally, you have to get someone to pay for it. This is a drug that’s $1,349 list price a month, which is actually basically the same as the average American rent . . . 

Lilah Raptopoulos
Right.

Hannah Kuchler
Now. But that’s not what anyone would have to pay. But insurers will have to pay and employers will have to decide whether they cover it or not, because at the moment, it’s mainly listed as a lifestyle medication, which is in the category of things like erectile dysfunction medicine.

Lilah Raptopoulos
Yeah.

Hannah Kuchler
But theoretically, if you help people solve their obesity, you stop a lot of very costly diseases down the line.

Advertisement featuring Queen Latifah
Yo, I’m late. Hi, Late. I’m starving.

Lilah Raptopoulos
That’s Queen Latifah again in another promo spot. This one is written like a sitcom scene. There are two friends talking about how hard it is to lose weight, but it gets serious fast.

Advertisement featuring Queen Latifah
Enough. Enough what? You met my mom and brother. We’re big boned. You think I control any of this? Now, that’s hilarious. Nobody’s laughing.

Lilah Raptopoulos
This spot talks about a lot. But one thing it doesn’t talk about is the fact that people in low-income groups are at a greater risk of obesity, at least in the US. Like so many issues, this one is systemic. Junk food is cheaper than fruits and vegetables. There are also entire stretches of poor neighbourhoods known as food deserts, where your only convenient grocery store might be a gas station. All of this, plus a healthy distrust of a sexist society, has given rise to a movement that advocates for body positivity. It’s message is you should love yourself no matter your size, especially because size is probably not something you can control.

Hannah Kuchler
It’s hard to, you know, talk to people who feel that the drug is, you know, almost a betrayal. Actually, there was one woman who’s quite a leader in the body positive movement who just said she was too upset about it to talk to me. And that kind of hit home. It’s like, wow, this is a huge thing. This is about your identity. It’s like that this company that, you know, does basically obviously it wants to make money and it will make a lot, but it does want this drug to improve people’s health. You see that as someone almost like wanting to erase your identity.

Lilah Raptopoulos
Is it accepted universally, calling it a health crisis and calling it a disease?

Hannah Kuchler
Not universally. It’s definitely, you know, the scientific consensus is that it is a problem that causes lots of other diseases or contributes to lots of other diseases. But of course, there are people who say, one sec, why are we looking at the number on the scales rather than those diseases? You know, treat me for my blood pressure, treat me for my diabetes or whatever. But they worry about us being obsessed with an ideal body image that is far too thin and that for some people, you can be healthy at a larger weight. And there are people that still agree with that. I guess the question is really, where do you draw the line between what’s sort of healthy but not model-esque weight and where you’re getting really serious complications.

Lilah Raptopoulos
So I guess my big question is like, you know, the idea that a drug can go mainstream and make us all thin, is that gonna bring us backwards? Is that going to reinforce the idea that we’re failures if we’re not thin?

Hannah Kuchler
I mean, I think it could, because I think the people can just say, well, there’s an answer to that. Why don’t you get in the answer?

Lilah Raptopoulos
Right.

Hannah Kuchler
I think actually, maybe what bothers me more, though, I . . . you know, I do preface this and it actually, weirdly, has felt sometimes a little bit awkward, as if I’m actually quite a thin person, so maybe I don’t have enough lived experience to take that. You know, I really feel that deeply. But the thing that I do worry about is that we say, oh, there’s a drug for this, so let’s not deal with, you know, junk food, with food deserts, with the lack of exercise, or the fact people are working three jobs and how on earth can they really get to the swimming pool? You know, all those things that we should be changing. And in fact, instead what we have is a system where we have companies who get, you know, rich selling junk food. And then we get another company, you know, making billions off selling a weight-loss drug.

Lilah Raptopoulos
Right. Did you talk to anybody who had ideas about how you can like, address the obesity crisis and also not forget everything else, like do it in a more systemic, holistic way?

Hannah Kuchler
Well, I mean, even the company was saying, like, we’re not here to say this is the answer to everything. And one of the executives was talking about how they, like, sponsor some farm in, you know, community urban farm in Brooklyn, things like that, like. But of course, we don’t expect Novo Nordisk to solve all the problems related to the way food is treated in our culture. Some of the obvious ones, which have been floated many times before are like why, say, in the US are there corn subsidies when there should be subsidies for healthier foods? But solving something like food deserts in a mass way, I think is much harder.

Lilah Raptopoulos
Hannah, thank you so much for joining.

Hannah Kuchler
Thank you for having me.

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Lilah Raptopoulos
Lauren Indvik is the FT’s fashion editor and she may be the most organised person I have ever met.

Lauren Indvik
I pack a list for ten years on my phone. So every time I go on a trip there are keywords, which says something like Paris Fashion Week, four days, 85 to 90 degrees. And then I put down, I list everything I’m packing. And then at the end of the trip, I write notes about what I wish I had packed and what I’m very glad that I packed and what I wish I . . . (laughter) what I should leave home next time. So that way, the next time I go to Paris, it’s 80, 90 degrees. I just pull my old packing list.

Lilah Raptopoulos
Oh my God, Lauren.

Lauren Indvik
And that’s where I start from.

Lilah Raptopoulos
Is there like a light version of that? (laughter)

I’m talking to Lauren because I’ve been thinking about how someone develops their personal style. The world is back in action, and I’ve been looking at my own wardrobe and thinking, which of these items really feels like me? Meanwhile, I keep getting targeted ads on Instagram and I keep buying clothes. But I don’t need more clothes. I need a better system. So I invited Lauren on to help cut through the chaos. She is the perfect person because not only is she extremely organised, but she’s also really pragmatic about her budget.

Lauren Indvik
I really hate spending money on clothes. Like, if I have money, I want to spend it on art, I want to spend it on furniture or like terracotta pots. So I think my personal strategy is like, how do I spend the least amount of money while also looking convincingly like the fashion editor of the Financial Times?

Lilah Raptopoulos
(Laughs) I was going to say, I’m so happy to hear the fashion editor say that they hate spending money on clothes.

Lauren Indvik
You know, I hated how I dressed in most of my twenties. Like, I think I became a fashion editor because I struggled so much with it, but I thought a lot about it and I feel like I had nothing to wear. I’d put something on and I’d go to work and maybe I’d be late because I spent so long trying to figure something out or . . . and I just didn’t feel confident in what I was wearing.

Lilah Raptopoulos
We are not the only ones. I asked listeners to share their own questions with me on Instagram and Twitter, and they poured in. I could barely keep up. This is clearly a topic you all seem to be struggling with too, so let’s get into it.

So I’ve asked you on to help us pinpoint our individual style and then kind of develop a wardrobe around it that feels easy and not exhausting. So first, I’m curious — like how you would define personal style?

Lauren Indvik
Personal style is kind of a new phenomenon. We’re now like in this post-trend era where it’s a bit uninteresting to dress in what’s new or what designers or magazines or stylists or celebrities are telling you to wear. And it’s all about individual expression. But if, you know, if I had to define it, I’d say it’s what you wear to feel like the most exact version of yourself. And that’s really challenging too, actually, because you, who you are and how you think about yourself — that’s always evolving.

Lilah Raptopoulos
So how do you pinpoint what your personal style is? You know, I was talking to a friend and she said that she put on a pair of someone else’s Birkenstocks and was like, I can’t leave the house in these, I absolutely can’t. (Laughter) And I thought like, oh, that’s a good way to understand that — like that is not your personal style. But how do you, how do you figure it out?

Lauren Indvik
Yeah, it’s pretty challenging to think about yourself that with that much distance. You know, I actually had to ask the woman who sits next to me at work what she saw my personal style is because I, I didn’t know she came up with minimal soft tailoring — which I really liked. But I think start with what you feel most confident in. And I think when you wake up in the morning or you’re going out to dinner and you put something on that makes you feel good, take a picture of it and save it in a folder on your phone and then start to look for patterns.

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Lilah Raptopoulos
Lauren did this when she first started looking for her style. When she was wearing an outfit, she felt good in, she took a photo. And when she looked through the photos a few months later, she realised that her perception of her style wasn’t her actual style. She thought of herself as a jeans and sweater person, but she saw photo after photo of herself in long, narrow dresses and flat boots. That’s what she actually felt best in so she started investing more in that. She also looked for features on her body that she liked and wanted to accentuate.

Lauren Indvik
Yeah, I think the first thing you have to do is find out what works on your body. When I see shape, I don’t just mean like apple-shaped or pear-shaped or like one of those sort of magazine formulas. Really zoom in. Like, maybe you have narrow shoulders and you really like your neck. And so like a button-down shirt, just a little bit oversize, is gonna make your shoulders look a little bit wider and maybe you just unbutton it a few buttons and that’s gonna make your neck look longer. And the other thing I do is that I buy, only buy pieces that are really versatile. So when you’re shopping and you’re looking at a colour, you’re like, does this colour go with the colours that are already in my wardrobe? Is this dress something I’m just gonna be able to wear to this wedding I have this weekend? Or can I actually, you know, pair it with a flat sandal for the office?

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Lilah Raptopoulos
Lauren has all kinds of tricks, and you don’t have to be extremely organised to follow them. Like, do that thing where you take a photo when you’re wearing an outfit you love and save it in a folder so that next time you have to get dressed for something, you don’t have to reinvent the wheel. You can just wear that same outfit or tailor all your pants and skirts to the same length so that you can wear all your shoes with all your clothes. Or if you’re a man and want to play with fashion, but not excessively, experiment with colours and patterns, but keep a standard silhouette.

OK, Lauren, so let’s get into listener questions. The most common question by far was basically how to build a wardrobe that’s gonna last a long time without an exorbitant budget. One listener named Cindy from London said: “As a fresh graduate, it is so hard to find something that’s affordable and durable. Please enlighten me.”

Lauren Indvik
Yeah, it is really tough. I felt both chronically poor and badly dressed for most of my twenties in New York because what you wear in university — like it’s just not suitable for working in an office. What I would urge you, Cindy, to do is to buy a very few high-quality pieces that you need and that you can also imagine yourself wearing 10 years from now. In the industry, we call these investment pieces and there are things that you’re gonna wanna wear all of the time and are gonna make everything else that you own look good.

Lilah Raptopoulos
Like what?

Lauren Indvik
Invest in accessories. Like if you are wearing a white T-shirt . . . 

Lilah Raptopoulos
And Levi’s.

Lauren Indvik
And Levi’s just great jeans, and you pair that with, like, a really good fisherman’s sandal or like a black ankle boot and, like, silver hoop earrings. And then, you know, you just you have to just not be afraid of repeating again and again, again. I had this Paul Smith blazer that I used to wear four days a week like year-round. I mean, right. And you know, I think I bought a Burberry coat when I was 21. It was $400 at Saks on discount. And I wanted to throw up at the time . . . 

Lilah Raptopoulos
Yeah.

Lauren Indvik
Like I still wear that coat. And so I sort of I think if I was in my twenties now trying to get dressed, what I would actually do is figure out my favourite brands. I would go to the store and try on everything, figure out what the sizes fit me and and the shapes. And I would go try to buy those pieces second-hand.

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Lilah Raptopoulos
Lauren suggests you try keeping a spreadsheet of all the clothing you buy. It’s sobering, but it helps you start to get more focused.

Lauren Indvik
Let’s pretend, for example, your clothing budget is $100 a month, which is $1,200 a year. So instead of buying four dresses that are OK and, you know, maybe some blouses, another pair of jeans, maybe take that budget and buy one really nice dinner dress that you wear to every dinner that you go for that year. And, you know, it’s gonna work with the sandal, it’s gonna work for a mule. And then maybe you buy a second-hand cashmere sweater from the Real on The RealReal, which is about $300. And I think also keep a list of what the gaps in your wardrobe are and only let yourself buy from that list. Don’t buy that third green blazer. I just bought a second green blazer by accident. But you’re probably gonna find out you’re spending more on clothes than you think you are because you kind of just like buy a T-shirt here or a pair of trousers here and it was on sale. And once you start adding them up, you’re like, Oh, my God. I mean, I once, I think my record year, the year I started, I had bought over 80 pieces of clothing.

Lilah Raptopoulos
When you are looking for these pieces that you need, Lauren suggests quality over quantity and quality over brand name. Look and touch what you’re actually buying and think about whether it will last.

Lauren Indvik
When you’re shopping, pay less attention to the label and more attention to fabric quality. Because I think there are plenty of luxury brands that make perfectly average T-shirts for extraordinary amounts of money. And you can sometimes find terrific cashmere, actually, in high street shops. And I still wear cashmere jumpers I bought over a decade ago in Topshop, in other stories. It isn’t about brands, it’s about going in and finding, I think, what are these brands good at? Or the other way to think about it is if like, your list is like, I want a black V-neck cashmere sweater, it’s like, well, what is the best version of that black V-neck sweater? Finding it and then finding the one you can afford. I mean, we could have a whole podcast actually on knitwear quality and how to figure out whether it’s gonna pill. Actually, I’ve talked to cashmere specialists about this. It’s actually really hard. The best thing you can do is just try to flip it inside out and just rub it a little bit to see if it starts to pill. But honestly, across the gamut, things, things do pill.

Lilah Raptopoulos
Wow. OK, thank you for telling me that. I was gonna say, should we do a whole episode on that? (Laughter) But that itself is good. Uhm OK, Oliver Leach said I would love to know about when to refresh your wardrobe and how to sustainably get rid of items and when to hold on to pieces?

Lauren Indvik
I love Oliver’s question because it’s clearly, he’s a very conscientious human being. But I think, you know, the question with getting rid of things is like, how do I ensure that someone keeps wearing this and it doesn’t end up in landfill or on a boat to Africa? And so I think the first question is like, what can I sell on second-hand websites? Because if someone buys it again, they obviously really want it and they’re probably gonna wear it again. And I think The RealReal is the best luxury second-hand sale site ever. And they sell everything in a week, so I do that. And then I think from there, you know, only add pieces when you have a gap, which is like you’re getting dressed in the morning and you just like, I don’t have any sandals that go with this or I really need a waterproof jacket because I am getting soaked every day on the way to work. That’s when you refresh.

Lilah Raptopoulos
Right. I got so many more questions. You wanted to know must-haves for men’s wardrobes. Lauren says invest in a nice puffer. You wanted to know how to find a mid-range shoe? She says just buy the expensive shoe and then resole it for years. And for all of you asking for ethically made socks and T-shirts that aren’t expensive, she’s sorry to tell you that you’ve got to pay.

Lauren Indvik
People baulk a lot at price. You have to think about when you’re buying things that are really inexpensive — those brands are making cost cuts. Where are they making those cost cuts? And it’s often on labour standards.

Lilah Raptopoulos
Yeah.

Lauren Indvik
Not all brands, but a lot of times. So think. We know when you are paying a bit more, it’s usually for a good reason.

Lilah Raptopoulos
Lauren, this was amazing. Thank you so much. And please come on again soon.

Lauren Indvik
This was really fun. Thank you.

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Lilah Raptopoulos
That’s the show this week. Thank you for listening to FT Weekend, the podcast from the Financial Times. Next week I’m inviting writer Elif Batuman on. She wrote The Idiot and a very buzzy novel that recently came out and I loved called Either/Or. We talk about what it’s like to look back at the nineties from the point of view of today, post-#MeToo. I also speak with one of our own, my colleague Esther Bintliff, who has been deep in research on the art of giving feedback. Please keep in touch with us. We love hearing from you. You can email us at ftweekendpodcast@ft.com. On social media, the show is on Twitter @ftweekendpod and I’m on Instagram and Twitter at @lilahrap. I’m always asking questions and posting stuff that feeds into the show, like your fashion questions, on my Instagram. Links to everything mentioned today are in the show notes alongside a link to the best offers available on a subscription to the FT, including 50 per cent off a digital subscription that is very good and a great deal on FT Weekend in print. Those offers are all at ft.com/weekendpodcast. Make sure to use that link.

A reminder that the FT weekend festival in London is coming up. It’s on Saturday, September 3rd. It’s at Kenwood House on Hampstead Heath and it’s a really beautiful affair. You can buy tickets at ft.com/ftwf. That link and a discount code for £20 off, specifically for FT Weekend listeners, is in the show notes. I am Lilah Raptopoulos and here is my talented team. Katya Kumkova is our senior producer. Lulu Smyth is our assistant producer. Our sound engineers are Breen Turner and Sam Giovinco, with original music by Metaphor Music. Niamh Rowe is our intern. Zoe Sullivan is our contributing producer. Topher Forhecz is our executive producer, and special thanks as always, to Cheryl Brumley and Renée Kaplan. Have a lovely weekend and we’ll find each other again next week.

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