The pharmaceutical industry has discovered a miracle substance that is taking the non-clinical market by storm. In a system where thinness is power, each injection promotes aesthetic conformity.
What if there were a substance that promised to make you the best version of yourself? Perhaps the company marketing it would close the 2024 financial year with a net profit of €13.535 billion — 21% more than the previous year. Its sales would grow by 26%, turning the promise of body transformation into one of the most lucrative businesses around.
Danish pharmaceutical company Novo Nordisk has published its annual accounts, revealing that sales of its flagship product, Ozempic, generated revenues of over €16 billion — a 26% increase on 2023 — while sales of Wegovy, which contains the same active ingredient, increased by 86% to €7.8 billion. Both drugs contain the same active ingredient, semaglutide, which was originally designed to control glucose in people with type 2 diabetes. However, its massive diversion to the rapid weight loss market has revealed its true commercial power: the ability to suppress appetite and make the body believe that it no longer needs food.
Ozempic was approved in the United States in 2017 and in Europe in 2018 but did not reach Spain until 2019. Its leap to international fame was not brought about by a clinical trial, but by a red-carpet appearance: at the 2022 MET Gala, Kim Kardashian revealed that she had lost seven kilograms in three weeks to fit into the original dress that Marilyn Monroe wore when she sang ‘Happy Birthday’ to JFK.
This had a domino effect, making the substance the most coveted and available only to the elite, who rejected the empty slogan of ‘body positivity’ when they found the magic potion. Who needs to love themselves as they are? The idea of self-acceptance has been discarded in favour of miracle diets and cosmetic surgery and has returned to the masses. “Welcome to the big night of Ozempic,” quipped comedian Nikki Glaser at the opening of the latest Golden Globes. Exorbitant prices — especially in the United States — and limited access to the drug give the product the exclusivity that the upper echelons of the star system need to perpetuate their lineage.
Rich fat people, poor fat people
Although the aristocratic lineage changes in form and content, its mechanism remains intact. Around 1300, Europe entered the Late Middle Ages, a period characterised by famine, chronic food shortages, and crises such as the Black Death. In this survival-focused context, being fat was a symbol of status, health and abundance. It was proof of safety from misery.
In The Metamorphosis of Fat, George Vigarello explains how the development of Western societies brought about a paradigm shift characterised by ‘increased bodily refinement, greater rigour with curves, and a greater rejection and suspicion of clumsiness’. Vigarello contextualises how European modernity began to denigrate fat people, associating them with burlesque connotations. He points out that ‘large size was increasingly far removed from refinement, while beauty was increasingly identified with thinness and slenderness’.
In 21st-century Western society, a box of four doughnuts costs £2.40. Abundance no longer distinguishes but standardises. The new privilege is having the time and money to plan menus and fill your shopping trolley with kale and wild salmon and being able to go to CrossFit. Thinness — mistakenly assumed to be synonymous with health — is a class issue: it requires resources, planning, and self-control. As demonstrated by the heroin chic of the 1990s and the proliferation of eating disorders, the elite no longer assert their power by filling the table, but by leaving nothing on their plate. In this system, Ozempic is pivotal: a weekly injection hacks the effort–merit–sacrifice equation.
Monstro Elisasue
Nausea, vomiting, diarrhoea, abdominal pain, constipation. These are some of the side effects of Ozempic. But there is another, deeper and less visible effect: the body begins to disappear. Not only through weight loss, but also through a loss of identity. As sociologist Esther Pineda theorises in Bellas para morir (Beautiful to Die): gender stereotypes and aesthetic violence against women, ‘the beauty standards that have been created by men and demanded of women in the context of a patriarchal society are not harmless; on the contrary, they are lethal, as they lead women to feel insecure, fearful, panicked, anxious and depressed about their physical appearance; in other words, they destroy them symbolically and physically.’
Kim Kardashian dixit: ‘I would eat poo if it kept me young.’ One must be willing to do anything in a world where the female body has historically been treated as a problem to be solved, a surface to be corrected, a symbol to be disciplined. The personal becomes surgical, the intimate becomes pharmacological. In this context, body horror has emerged over the last decade as one of the most lucid ways for women filmmakers to narrate the horror experienced through the skin.
Director Coralie Fargeat brings it to life in The Substance, a dystopia where the female body is both victim and product. Elisabeth Sparkle (Demi Moore), a television aerobics star, is fired on her 50th birthday. She injects herself with an experimental liquid that transforms her into Sue (Margaret Qualley), her rejuvenated, slender, desirable version. She alternates between both identities, but each body change deteriorates her original self, which becomes increasingly decadent, ignored, mistreated, dehumanised, relegated to being a container, a kind of Dorian Gray mirror. The horror is not in the experiment, but in its logic. Body horror is no longer a subgenre, it is the operating system, a structure that underpins nations under the same founding motto: no country for fat women.
Ozempic has been instrumentalised and turned into yet another tool of the sexist biopolitical regime that is rooted in the dictates of beauty. Pineda describes this regime as being “constructed and imposed for political, economic, social and commercial purposes in the context of a patriarchal society that views women as objects, and a capitalist system that views them as a commodity. It is a system that demands and promotes aesthetic and bodily modification in women and induces them to be beautiful in order to die”.
‘As in the circus of the heteropatriarchal binary regime, women are assigned the role of the beauty and the victim, and I was not and did not feel capable of being either, so I stopped being a woman,’ writes Paul B. Preciado in Yo soy el monstruo que os habla (I Am the Monster Who Speaks to You). In that same circus, Ozempic is not just a drug, it is a script. One that punishes presence, glorifies obedience and offers a place only to those who erase themselves without leaving a scar. Self-hatred is not a side effect; it is the active ingredient. Elisabeth and Sue are the same violence, the eternal promise of your best version, of the perfect body and the hostility that sustains it. The body that emerges from this alchemy—perfect, slender, obedient—is not a better version: it is a Frankenstein with baby face surgery.
