Between 2019 and 2022, the number of prescriptions for Ozempic and related weight-loss drugs increased over 2,000%, with over 5 million prescriptions filled in 2022. From their meteoric rise, some commentators have inferred that the regulation of desire cannot be a moral matter. As Maia Szalavitz wrote in a recent New York Times essay, “When drugs can significantly alter weight loss or addiction recovery, it’s hard to argue that the problem is moral rather than medical.” Likewise, in an article for The New Yorker, Jia Tolentino lamented that the discovery of drugs like Ozempic has not caused our culture to see appetites and desires as “biological facts rather moral choices.” In the age of Ozempic, they imply, what was once known as the sin of gluttony should now be seen as a disease, not the result of a failure to control our appetites.

The idea that our desires may be modified by ingesting certain substances, such as alcohol, is not new. What is different about Ozempic and its pharmacological kin is that these drugs purport to regulate the very source of these desires. In particular, these drugs are believed to mimic a hormone called glucagon-like peptide-1, referred to as GLP-1, which is naturally released after a meal to trigger a feeling of fullness. Taking the drug produces the same feeling, and as a result, the desire to eat disappears. Some patients have reported that the drug liberates them from their appetites. The implication is that, with these drugs, we have reached the foundation of our desires. This is what our desires really are—the effects of hormones. By managing the hormone, we can manage the desire.

When Augustine of Hippo famously observed, “Our hearts are restless until they rest in You,” he was suggesting that often our desires for the goods of this world are misdirected and misunderstood. When we desire things like sex, money, or power, we don’t really want them. What we truly want is a kind of goodness only God can provide. From this perspective, desires are a moral matter. They are not to be extinguished. They are to be examined, their true objects to be discerned. Some are to be discouraged. Money and power are not worthy of worship, and food should not be desired as a substitute for intimacy or friendship. Other desires are to be encouraged. A desire for glory could support fighting valiantly for one’s country. Study and learning are nurtured by a love of knowledge and wisdom. Desires are not contingent but integral to who we are. 

This perspective recognizes that our desires are not easily changed or managed. Nor do our actions always follow our desires. Still, it never retreats to simple determinism or fatalism. Rather, it insists that we be held responsible for our actions. To do otherwise would make us less human, less worthy of the respect or dignity that is the source of morality itself. It proposes paths that we can pursue to correct our desires and make our actions more consistent with our desires. From Aristotle’s perspective, this might consist of trying to instill virtuous habits; from Augustine’s, asking for God’s help; or from Freud’s, seeking to liberate ourselves from the dynamics of our psyche through psychoanalysis. If only in the slenderest of ways, our desires and their consequences remain matters for which we are responsible.

The implications for other conditions that have been traditionally understood as matters of self-discipline have been quick to materialize. In The Atlantic, Sarah Zhang reported that the drug has attracted the attention of addiction researchers who are interested in the possibility that it can curb desires for alcohol, cocaine, nicotine, and opioids. Perhaps to follow will be the attempt to develop drugs to regulate greed, the lust for power, and other vicious desires. To repeat, such outlooks are undergirded by the assumption that the brain’s chemistry determines our desires. To change these desires, they assume, the chemistry needs to be changed, not the choices, character, or morality of those who experience those desires.

In fact, the prophets of Ozempic are afflicted with a kind of myopia that requires its partisans to ignore subjective experiences of desire. They imply that we must dismiss any notion that our desires or their consequences can be managed by the will, intellect, or a “higher power,” as suggested in 12-step programs. Yet this is contrary to lived experience. All of us have had the experience of being aware of a desire on which we have not acted, as when offered a second piece of cake. We are able to recognize that we do not always need what we desire, that in some cases, fulfilling our desires would harm us, and that sometimes doing what is best means foregoing—and over time reshaping—our desire.

Likewise, we have discovered that we did not desire what we thought we wanted. Perhaps we learned that their desire for more food was a way to fill an empty social life, not an empty stomach, or that it was not so much sex we wanted from another but a sense of being accepted and loved. Others have come to appreciate the extent to which desire is enflamed by its frustration; few things are more tempting than that which is forbidden. Once the restriction is lifted, the desire fades. Still, others may have enjoyed the fulfillment of changing habits and thereby diminishing their desires, such as taking a route home that does not pass the bakery.

In each of these cases, experience tells us that our desires can be explored, shaped, and redirected. They are not the result of implacable chemical reactions. They are real experiences, the results of careful introspection and insight. Those arguing that Ozempic should rewrite our understanding of desire discount them because a third party cannot observe or measure them. This is a mistake. This insistence on the observable and measurable undermines rationality itself, for the pursuit of deeper knowledge about ourselves and the world is itself a kind of hunger. To see this hunger and its satisfaction as essentially chemical reactions deprives the pursuit of its meaning. Even the conviction that desire is a chemical reaction would have to be understood as the result of a chemical reaction, not as the consequence of a logical or compelling argument grounded in evidence.

The rise of Ozempic threatens to deprive us of the opportunity for insight and self-understanding. Much of the interest in Ozempic arises from just how difficult it can be to regulate our appetites. Of course, this is not a new insight. Paul of Taurus observed, “I do not understand my own actions. For I do not do what I want, but I do the very thing I hate.” Yet his powerlessness to act according to his better desires was not an occasion for resignation or despondency, and he certainly didn’t ask his doctor for a pill. Rather, this observation contributed to a better understanding of himself, others, and God. It was precisely the difficulty of his situation—the limits of his actions—that offered insight. This is the kind of insight that the prophets of Ozempic seek to undermine.

This change in understanding of our desires may cause us to forget the ways our desires can be ordered. The pharmacologic approach to taming desire treats unhealthy or unwanted desires as a brain issue that can be solved by tinkering with our neural circuitry. It focuses our efforts on finding the right pharmaceutical, instead of the path of self-examination. These latter routes are not easy or clear. They pass through some of the more mysterious domains of the human experience. They require discipline, discernment, self-knowledge, and the help of a supportive community. Yet so long as we accept them, the door to respect and admiration, the natural responses to moral goodness, remains open.

It appears Ozempic has the potential to help many who are overweight or obese, which could be a good thing. But claims that it changes our fundamental understanding of desire should be regarded with skepticism and caution. Instead of revealing something revolutionary about desire, the current fascination with Ozempic is more likely telling us something important about the metaphysical assumptions currently at work in our culture. The revolutionary claims about Ozempic are based on a fundamentally materialistic understanding of what it means to desire and ultimately to be alive, one that sees human beings as little more than chemical reactions. This understanding puts little value on introspection and self-understanding, undermines that sense of dignity and respect on which morality depends, and threatens those practices that make it possible to explore, form, and direct our desires. The enthusiasm for Ozempic is like a flashing neon sign, warning us that our underlying convictions about humanity are being pushed in dangerous directions.