Last summer, my skin began to itch. I did not have a rash, or an insect bite, which meant the cause remained a mystery and lotion didn’t help me for long. I scratched my legs, my ankles, my feet, my scalp, my neck. Sometimes I found blood on my sheets after I scratched myself while falling asleep. In fact, I slept most of the time. I went to bed when I finished work in the evenings and stayed there most weekends. If I did go out in the heat I wanted to vomit, and I could no longer keep up with my friends or my husband on walks. Instead I sat indoors and watched a spider build a web in my bedroom. I mostly thought about eating, because I had never been so hungry in my life, but nothing I ate ever satisfied me. The hunger was so commanding, so pitiless, that I wondered if it could be supernatural.

I learned early that autumn that I needed medicine, not an exorcism. An endocrinologist diagnosed type 2 diabetes (and it was “serious,” he told me, gesticulating). High blood sugar had dried out my skin, making me itch; it had stolen my energy, sickened me in the heat, and caused my relentless hunger, or polyphagia. I started a high dose of metformin along with a GLP-1, Mounjaro, which I injected near my belly button once a week.

To me, Mounjaro is medicine. To others, it is more symbolic. I’ve read that GLP-1’s are a magic elixir — or a shortcut, even a symptom of cultural decline. Not long after my diagnosis, I saw photos of Ariana Grande and Cynthia Erivo on the red carpet, collarbones jutting; posters said they must be on GLP-1’s. Meghan Trainor took Mounjaro and Lizzo tried Ozempic and low-rise jeans were popular again. President Trump called it “the fat shot,” and critics thought J.D. Vance was on it. It is a strange moment to watch myself shrink and a stranger moment to be ill. Mounjaro, and drugs like it, have become another way to moralize.

The GLP-1 discourse is so frenzied and detached from reality that it complicates my life and, lately, infuriates me. When I first started taking the drug, I was reluctant to mention it to anyone; I didn’t want to be judged, or turned into an object lesson, while I was trying not to die. Diabetes is complicated enough by itself, and the American health-care system is one more obstacle to good health. In my case, Cigna refused to cover Mounjaro at the lowest dose, which forced me to increase........

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