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June 2024 Issue
Explore
The new propaganda war, Ozempic and obesity, Suleika Jaouad's art of survival,
and a Mississippi family driven north by tragedy. Plus Daniel Radcliffe, Albert
Brooks, sunscreen absolutism, a female-midlife-crisis novel, airport lounges,
hypochondria, and more. View Magazine
 * The New Propaganda War
   Anne Applebaum
 * The Art of Survival
   Jennifer Senior
 * Ozempic or Bust
   Daniel Engber
 * The Lynching That Sent My Family North
   Ko Bragg
 * The Godfather of American Comedy
   Adrienne LaFrance
 * How Daniel Radcliffe Outran Harry Potter
   Chris Heath




Illustration by Vartika Sharma for The Atlantic
Health


OZEMPIC OR BUST

America has been trying to address the obesity epidemic for four decades now. So
far, each new “solution” has failed to live up to its early promise.

By Daniel Engber
May 8, 2024
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1

In the early spring of 2020, Barb Herrera taped a signed note to a wall of her
bedroom in Orlando, Florida, just above her pillow. NOTICE TO EMS! it said. No
Vent! No Intubation! She’d heard that hospitals were overflowing, and that
doctors were being forced to choose which COVID patients they would try to save
and which to abandon. She wanted to spare them the trouble.


EXPLORE THE JUNE 2024 ISSUE

Check out more from this issue and find your next story to read.

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Barb was nearly 60 years old, and weighed about 400 pounds. She has type 2
diabetes, chronic kidney disease, and a host of other health concerns. At the
start of the pandemic, she figured she was doomed. When she sent her list of
passwords to her kids, who all live far away, they couldn’t help but think the
same. “I was in an incredibly dark place,” she told me. “I would have died.”

Until recently, Barb could barely walk—at least not without putting herself at
risk of getting yet another fracture in her feet. Moving around the house
exhausted her; she showered only every other week. She couldn’t make it to the
mailbox on her own. Barb had spent a lifetime dealing with the inconveniences of
being, as she puts it, “huge.” But what really scared her—and what embarrassed
her, because dread and shame have a way of getting tangled up—were the moments
when her little room, about 10 feet wide and not much longer, was less a hideout
than a trap. At one point in 2021, she says, she tripped and fell on the way to
the toilet. Her housemate and landlord—a high-school friend—was not at home to
help, so Barb had to call the paramedics. “It took four guys to get me up,” she
said.



Later that year, when Barb finally did get COVID, her case was fairly mild. But
she didn’t feel quite right after she recovered: She was having trouble
breathing, and there was something off about her heart. Finally, in April 2022,
she went to the hospital and her vital signs were taken.

The average body mass index for American adults is 30. Barb’s BMI was around 75.
A blood-sugar test showed that her diabetes was not under control—her blood
sugar was in the range where she might be at risk of blindness or stroke. And an
EKG confirmed that her heart was skipping beats. A cardiac electrophysiologist,
Shravan Ambati, came in for a consultation. He said the missed beats could be
treated with medication, but he made a mental note of her severe obesity—he’d
seen only one or two patients of Barb’s size in his 14-year career. Before he
left, he paused to give her some advice. If she didn’t lose weight, he said,
“the Barb of five years from now is not going to like you very much at all.” As
she remembers it, he crossed his arms and added: “You will either change your
life, or you’ll end up in a nursing home.”

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Daniel Engber is a senior editor at The Atlantic.