Leonard Janke's Reviews > Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

Overall Rating: 4.75/5.0

How a Book on a Controversial Subject Ought to be Written

Johann Hari's Magic Pill addresses the hot and controversial topic of the new weight loss drugs. I found it exceptionally well written, to the point where I would say it exemplifies how a book on a controversial topic ought to be written.

After reading some books, you feel you have got to know the author well enough that calling them by their first name seems more appropriate than by their last. To me, for example, Sam Harris is just "Sam." Such is also the case with Magic Pill. What makes the book an exemplar is that Johann does not shy away from discussing the deeply personal aspects of his experiences with using Ozempic for weight loss, but also the objectivity with which he writes.

Books on controversial subjects, even by highly educated authors, tend to become propaganda these days. Although you would hope that being tied to scientific findings would mitigate this, controversies in recent years over things like climate change and mRNAs have disabused many of the notions that objectivity is possible. Johann's presentation of arguments for and against GLP-1's should, however, restore hope that objectivity is still possible.

Overview of Contents

Magic Pill is presented as a personal recounting of Johann's weight-loss journey with the help of Ozempic. Along the way, he describes his first awareness of the drug when he noticed that celebrities had actually lost weight during the Covid pandemic rather than gained it. Johann explains how his diet had been, to put it mildly, a poor fast food-centric one to the point of consciously flaunting how bad we know it is for you and, instead, diving, seemingly as deeply as he could, into consuming as much as he could, as extravagantly as possible, and even centering a friendship around this rebelliousness.

Despite this, Johann was eager to learn as much as he could about the new drugs and, although with some ambivalence, try them himself. Johann takes us through the history of the first discovery of GLP-1, how obstacles to its natural deterioration after only a few minutes in the body were overcome, its early use with diabetics, and its slow approval for weight loss. Johann also liberally shares what he believes led him to become the junk food addict that he was.  

Johann believes that a combination of factors was at play with him: a conflict between his mother, who grew up in a processed/junk food culture, and his strict Swiss chef father, who was for decades enraged by the culture but ultimately succumbed to it to a degree himself. Johann also describes the processed food industry and how what you may think qualifies as food hardly deserves to be called that. Johann accounts how, far from being prepared in a" big kitchen," the ingredients are piped through a factory and mixed together. They have neither the color of food initially, nor the texture, nor the taste. Indeed, before additives, the taste is metallic. After recounting this, you will never see frozen lasagna and pizza in the same light again, and you will certainly have an incentive to avoid it!

Next, Johann describes studies in rats showing permanent alterations to rats' feeding behavior after having been exposed to processed food. Although it is correct to note that it would be a non-sequitur to conclude that the same must happen to humans, very recent research is starting to show permanent alterations to human brains after they have been hooked on processed food. Indeed, this is consistent with the personal accounts of those who have been. The high calories just do not satiate. Although the exact mechanisms are unknown, Johann relates some conjectures that not needing much chewing (which perhaps the brain counts as part of knowing when to send satiated feelings), and low protein content are part of the problem.

The book also discusses various research into the psychology of overeating. Some of the psychoanalytical conjectures, although unsurprisingly to anyone familiar with the approach, seem far-fetched. Others, such as those around evolutionary psychology, seem more plausible, although, even here, they only partially come together from the, perhaps, oversimplified presentation.

Weaved throughout the book is the story of the conflicts Johann feels about taking the drugs. Mostly, this centers around the risks involved in very long-term side effects. Johann's concern here is that since most people gain back the weight rather quickly once they are off the medication, they are likely to need it for life. To support the notion this leads to unknowns, Johann explains that the mechanism for how GLP-1’s work is likely a combination of physiological and psychological. He gives the example of how it was not known when antipsychotics were introduced that they would lead to increased rates of dementia for those who needed them for life.

Johann is only somewhat less concerned with the sociological effects the drugs will have. He is especially apprehensive about children and adolescents and teenage girls in particular. Will even those who do not have weight problems of significant concern or even any at all, or even those who are underweight, feel they should take them? The concerns are forcefully driven home by Johann's recounting of the story of his niece telling him that she wanted to take GLP-1s, even though she was very far from needing them. Johann also recounts the story of a tongue-lashing he received from a friend in London about her thoughts about Johann's true motivations for taking Ozempic. Was it really primarily a health concern for him since he is on the low end of the range of those for whom it is recommended, or did he just want to look good?

The Book's Strengths

As mentioned, the book's primary strength is its objectivity in presenting the differing points of view on the new drugs. Johann's recounting of the rebuke from the friend in London even helps the reader objectively evaluate Johann's own objectivity. When an author does that, it is always a good sign.  

In addition to presenting science and personal experience, the book is fast-paced and generally quite hilarious. This all while packing an impressive amount of information into a rather short length.

The Book's Weaknesses

The book's weaknesses are rather minor, and really, the only thing that comes to mind is that some of the stories seem like they may be somewhat embellished. For example, Johann relates a "vision" of the destruction of McDonald's outlets all over the world as he self-administered his first Ozempic injection.  Indeed, the most famous McDonald's features are the most prominent in his vision. This, however, makes it all the more hilarious because how many even knew there are famous McDonald's restaurants throughout the world?

Along similar lines, from Johann's description of his eating habits, you would think that he must have weighed closer to 300 lbs than the 200 he actually weighed.

Conclusion

Magic Pill is truly a masterful piece of writing: hilarious, serious, informative, objective, deeply personal, and thought-provoking all at once. Indeed, even for those uninterested in the subject (unlikely, given all the controversy), it may be worth reading solely to study how to write well.

Although Johann avoids getting preachy, some fascinating philosophical questions are left for the reader to ponder. If processed foods truly permanently alter our brains, is the notion of free will and willpower in weight loss misunderstood?  What does society getting to the point of processed foods causing so many problems for such a significant portion of the population say about the nature of capitalism cranking them out anyway? Is regulation necessary?

Although Johann only hints at it, the relationship of Christian beliefs to the subject stuck out in my mind. In Christian theology, Satan is constantly tempting you, and you must exercise your free will to resist. Nevertheless, being human, you will fail, and only Jesus can redeem you from this. If there is a "magic pill" that just makes these "temptations" go away, then what are they? "Virtue pills"?

I can't entirely agree with all of Johann's conclusions. For example, I am skeptical that once you have consumed too much processed food, you are condemned to GLP-1's for the rest of your life (in general). However, his empirical data regarding the real-world situation has to be taken seriously. Similarly, although I ultimately disagree that processed food is a failure story for unregulated capitalism, and, indeed, I see the rise of GLP-1's likely to be a great success story, Johann presents both sides of the story so well that the book is definitely worth 4.75 out of 5 stars.