Bodyodyody.

This is a fascinating conversation about GLP-1 drugs. It seems obvious to me that, no matter how you feel about these drugs, they are changing the human species in huge ways, many of which are yet to come.

Before my episode or bout, or whatever you call it, with coronary disease started last fall, I had asked my PCP if I could get a prescription for a GLP-1. I had gained and lost 20 to 40 pounds every few years since my mid-thirties. Losing it, which I accomplished by starving myself for a few months, got harder every time until eventually it felt impossible. Starvation didn’t work anymore. I couldn’t eat as little as I needed to eat to lose weight. Not only did it feel like physical torture, I would be so at odds temperamentally, philosophically, esthetically. I believe pleasure is necessary. Not that I think I should pig out every day and indulge every craving, but it goes against my most deeply-held ideas of what a good life is made of to be shouting “NO!” in my head to myself all day long, metaphorically slapping my hand just because I want to use those overripe pears to bake a pie.

My PCP said I wasn’t technically obese, so my insurance might not cover it, but he’d put in a prescription for Zepbound and see what happened. But that was the same visit when I told him I was having chest pain on my walk to the subway. He referred me to a cardiologist. By the time I got an appointment, I was having chest pain when I walked up stairs, and then when I walked across the apartment. Over the next couple weeks and with a series of tests, the clogged artery was discovered, and then I had the stent put in, which stole focus, so I didn’t go on the drug—it seemed like it was the only drug I didn’t go on—but then, as the urgency started to wane and I was recovering well, my cardiologist suggested starting Zepbound would be a good idea, not primarily for weight loss, but to help lower my cholesterol. And it did, dramatically, in concert with the other drugs. And I’ve lost 35 pounds since January. My weight now is what I weighed in college.

The transformation has been a little slippery to try to describe or make sense of. It’s a tangle of physical and mental and emotional changes. The improvement of my heart and arteries has been considerable, but not really felt so much as seen in the lab results. (My LDL cholesterol went from 120 to 48.) But the most dramatic change came with the weight loss, which caused a huge opening up of my emotional and mental life, a sense of having more free time, energy, space that had been full of thoughts about food, constantly mentally scolding myself, eating and being angry with myself, hating the way I looked, always measuring my body against an idea of what I thought my body should be like—or I think more precisely, what I felt my body did look like, that my body when it was heavier was wrong, inaccurate, and I was opposed to it—and hating my clothes, all the pants and shirts and coats that used to look good on me but that no longer fit, and also the ones that did fit, hating how big they were. All of that mental garbage is gone. Poof. I look in the mirror and see me. That open space is filled now with gratitude to be alive, which is a much lighter load than the other stuff. I came very close to a different outcome.

I think if you dig down deep enough this desire to look good, to believe my body looks good, is connected to wanting to be or feel sexually attractive, or not just wanting to be attractive but wanting to attract someone, and now. But I don’t experience that desire so acutely or urgently, or vividly, now as I did most of my life. I don’t need to take the “why not?” of that all apart here, except to say that I feel loved and safe, and I am old. I’m 65. My new skinny body that I feel so comfortable in is the body of a 65-year-old man: wrinkly, crepey, ropey, sagging, ass-less (the ass-loss happened before the drug, I just woke up one day and it was gone—nobody tells you that your ass and your lips disappear when you get old), but I’m not much worried about what I look like naked. (I was, non-stop, when I was younger.) What a relief.

I’m eating a lot less. That’s a big adjustment. We find ourselves with leftovers from most meals. I’m good at repurposing leftovers, but I can only find uses for so much. I’ve always prided myself on running a kitchen with very little food wasted and that’s harder to manage now but I’m slowly getting the hang of it. Restaurants are harder. Most of the time when an entree arrives I can see immediately that it’s enough food for three people. Even in the past it would have been much more than I needed, but I would have finished it anyway. I never used to be able to leave food on my plate. Now I physically can’t eat more when I’m full.

Speaking of my heart, Friday morning will be my last session of “cardio rehab.” The program was 36 sessions all told, 3 per week. Next week I’ll be back at my old gym doing essentially the same things but without the monitors, and the crazy assortment of New Yorkers, mostly men, some women, all my age or older, several of whom have much scarier crises to recover from, and without the phalanx of fit young women in athletic wear with serious smiles and good posture taking my blood pressure, giving me encouragement that may be slightly rote but not infrequently made me tear up, and showing me what to do with all those machines that somehow evoke for me the inside of a space ship. I have, oddly, enjoyed the whole thing, and I’ll miss it, and them, and the bad 80s rock.