This column was first published in Malta Today

“You can never be too rich, or too thin” is a famous quip often attributed to Wallis Simpson, the divorcée who led King Edward VIII to abdicate the throne.

It is a maxim which many people (especially women) continue to live by, despite the many protestations to the contrary that we should all accept ourselves as we are. Of course we should strive to be self-accepting, as living with constant angst about our appearance can be exhausting and mentally debilitating. But there is also an inherent contradiction and a stark reality in Western culture which cannot be denied: that no matter how much some try to pedal the body positivity movement, with larger-sized celebrities doing their best to convince us that they embrace, accept and even celebrate their physique, there is no getting around the fact that practically everyone you talk to has tried (or is trying) to lose weight.

In fact, it has not gone by unnoticed that some of the very same Hollywood stars and singers who loudly and unapologetically proclaimed “this is me, take it or leave it” are now playing a different tune. Just to name two examples: Lizzo, who made hot pink leotards famous, is now half her size. Meghan Trainor, who in her break out song celebrating her curvy figure called All About that Bass sang “yeah, it’s pretty clear, I ain’t no size 2” has now also shrunk …and has changed those lyrics to “yeah, it’s pretty clear, I got some new boobs”. Please note that by the standards of us ordinary mortals, Meghan would not have been considered obese but for the celebrity scene….she was.

Oprah Winfrey, Whoopi Goldberg, Kelly Clarkson, Sharon Osbourne, the list goes on and on of famous faces who have all shed a drastic amount of weight in a short time and the common factor is that they have all taken weight loss injections (although some initially denied it).

Before I am jumped on by the politically correct “you cannot say that” police, this is not a case of “shaming” people for their weight and then “shaming” them again for losing it. As someone who has struggled with my weight for years, I am in no position to shame anyone. Clothes which don’t fit any more, shopping which becomes an exercise in futility and results in a foul mood, unflattering photos quickly deleted in dismay – I have been there, done that. The truth is that, as a society, we cannot avoid the topic of fluctuating weight even if we try, because it is the first thing we immediately notice about someone. So when we see well-known people first saying one thing and then doing another, it is impossible not to point out the hypocrisy.

I include myself when I say that we are all looking for that ultimate magic key which will allow us to eat what we like without worrying about the consequences. It is not just about appearance either because the alarming health complications which are compounded by being overweight cannot be ignored. We all know them by heart, but they bear repeating: from high blood pressure, high cholesterol, diabetes and heart disease to joint and knee problems because of the excessive weight as well as respiratory issues such as sleep apnea and asthma. Any doctor will tell you that the more medical issues a person has, the higher their risk is for a stroke, a heart attack or other diseases. Carrying around so much extra, unnecessary fat is just not good for us, period.

Intellectually, most of us know this – actually doing something about it? Ahh, that is the clincher.

We can try to explain away weight gain in a hundred million ways, from a slow metabolism to genetics, but the formula will always be: calories in, calories out. Unless we are burning more than we consume, we will pile on the weight. Is it harder for some more than others to adhere to the discipline required to keep their weight in check? Do we sometimes turn to food for emotional comfort eating rather than hunger? Do we find ourselves snacking out of boredom, even though we are full? Yes, to all of these. When I hear people saying they “forgot to eat” I look at them as strangely as if they had suddenly sprouted another head. Others can easily push away their plate leaving half their meal unfinished because they have had enough. I admire those who can always order a salad. Then, there are the rest of us, who see pizza on the menu and our resolve promptly flies out the window.

So when news comes along of what sounds like a magic solution, a simple injection which mimics the hormone in our brain that suppresses appetite and reduces cravings, the temptation is real. I get it. No effort required, a quick jab and that’s it. We have all seen the dramatic results and it clearly works (although the jury is still out about potential long term side-effects).

However ( and this is a big ‘however’), I find it extremely disconcerting that our Health minister of all people has actually announced that Ozempic is the answer to our obesity crisis, claiming that past efforts have fallen short. “We plan to introduce weight loss injections for patients who have a BMI of over 35 and who also have a condition or disease that is associated with obesity,” he said. The conditions he mentioned are hypertension, congestive heart failure, severe arthritis and sleep apnea.

This announcement was disappointing on a number of fronts, primarily because I am not sure what ‘past efforts’ he is referring to. Has healthy, nutrious food been made more affordable? Are new parents educated on avoiding too much sugar and junk food in their children’s diet? Do we promote walking as much as we should or is everything geared around using our cars? Is there a nation-wide policy to give priority to physical education in every school?

If we look at nations which have a low obesity rate such as Japan and South Korea, the common factors they share are healthy diets which discourage overeating of processed food and active lifestyles. In contrast, the dysfunctional relationship which the West has with food, leading to a myriad of eating disorders, goes hand in hand with our obsession with overconsumption in all its forms. In Malta, we have a disproportionate number of McDonald’s outlets (9 at the last count) and pastizzi shops on every corner. Every single event throughout the year is peppered with stalls selling fried food and the most popular restaurants are those which offer large portions. Moderation of any kind is not really in our vocabulary.

With one of the highest obesity rates in the world, we need to seriously tackle this problem – if only to lessen the strain on our healthcare system because of all the illnesses which are a byproduct of over-eating. The solution, however, has to be a long-term, sustainable one which promotes a complete lifestyle change. What the Health minister is suggesting is just a quick fix, the real repercussions of which are still unknown, and which might create further health complications in the people who will be lining up for the injections.

And above all, the million dollar question is, what will happen when they stop taking the injections?