Manu Joseph: Why drugs that eat our hunger won’t cause a revolution

Doctors are taking these drugs too, which is a good sign. Not that they are paragons of health, but they know how patients respond to the drugs and so it suggests they consider them safe. Meanwhile, society is bracing for a behavioural revolution. A certain leanness—a non-muscular kind in middle-aged people that I already associate with these drugs—might become another motif of wealth. At the moment, the drugs are for the affluent, but that can change over time. There is even a view that once these drugs go off patent and generics flood the market, they may hurt the restaurant business. 

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I doubt that. I think their impact will be modest. People do not eat because they’re hungry, especially the rich. Even most of the poor no longer eat out of necessity alone. Nobody eats maida noodles and biryani out of hunger. For most people, eating is a form of entertainment. Even a source of happiness. Many people can bear the period between meals because they know food is coming. Many keep eating through the day because people do a lot of what is fun. Also, food is the most legit drug addiction. 

Some years ago, Silicon Valley fell in love with a powdered food called Soylent. Just add water and drink. It was engineered to provide all the nutrients the body needs. As the product didn’t ship to India, I found an Indian version of it. I carried packets everywhere. I was sorted, I felt. I liked the idea of just drinking food and being done with it. I had defeated an ancient cultural force that had entrapped me through what I always viewed as an obsolete mode of nutrition. 

There is nothing wrong with Soylent, but its revolution never took off. People realized that life, as we’ve built it, revolves around food. Meals are where we meet. Efficiency is not the point. In fact, if we are efficient at all, it is in matters other than food, so that we can lavish our time on food. 

At first glance, drugs that kill appetite may appear to be different from a tasteless drink that merely has everything the body needs. The drugs don’t replace food. People would still eat tasty meals, even if they eat less. They would meet friends over meals, but leave most of it on their plates. At first, people will be alright with it. They are having it all, they might say. Tasty food, but in forced moderation. Eventually, though, they would have had enough of it. 

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Semaglutide and Tirzepatide cannot address the underlying reasons why people eat and overeat. Imagine a pill that makes you want to watch less TV. Let us assume it works. What is the alternative to not wasting time on boring entertainment, an oxymoron that is the reality of the times? Actually, there is something that makes you want to watch less TV, and that’s TV itself. Yet, people have nothing better to do. It is the same with food. Without food, life is so dreary to most people that they will eat even if they don’t feel like eating. This is something they already do, anyway.

Here is what will happen. These drugs will make the fit fitter. People who already work towards health or beauty will be the true beneficiaries of this medical intervention. Others will do things like having only desserts for meals, arguing that they are going to have little to eat anyway. 

Eventually, they will find ways to malign these drugs. They will have exaggerated complaints about their side effects and romanticize ‘natural’ hunger. They will insist the body knows best. If it is asking for food, they will say, and if ‘nature’ is demanding food, then there must be some reason; how can we let ‘chemicals’ come in the way of natural appetite? Never underestimate the things sugar can make people do.

The effectiveness of these drugs raises an interesting question: If suppressing appetite still leaves a person healthy, then is normal eating just a form of overeating? How much food does a person really need? 

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Probably far less than what most people eat. Statistically, on any given day, we over-eat or under-eat because, outside of theory, balance is not a real thing. Under-eating has its own risks. Muscle growth, for example, needs protein beyond the reduced consumption these drugs would induce. Strong muscles aren’t just about vanity, they help regulate metabolism and maintain our health. 

Also, when the body faces an energy deficit, it does not simply burn fat. It switches some things off. Based on its own logic and hierarchies, it starts conserving energy by cutting what it considers less important. Like one’s immune response. Or skin quality. Or hair health. It adapts to scarcity by becoming stingy with its resources. 

The same could happen here. People may stay lean but become weak, metabolically and bodily. We may then have unfit people who look thin. We may not understand what’s been lost either. That will take years to discover.

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If some people believe they look good just by taking a drug, they may stop working out if they have never enjoyed it. That would be a disaster. Exercise doesn’t just burn fat. It does things modern life does not give us. Our true health is not what we appear to be, but what the body knows it has gone through, what it knows it can endure. 

The author is a journalist, novelist, and the creator of the Netflix series, ‘Decoupled’