Last week, the <em>Guardian’s</em> curiously-titled Health and Inequalities correspondent <a href="https://www.theguardian.com/society/2025/jun/05/contraception-warning-over-weight-loss-drugs-after-dozens-of-pregnancies"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">reported</mark></a> that the Medicines and Healthcare products Regulatory Agency (MHRA) had issued an alert over the effects of weight-loss drugs on contraception.
The warning came in the light of 40 reports of pregnancies occurring while women were using drugs such as Ozempic, Wegovy and Mounjaro.
The MHRA noted that Mounjaro – a drug which, unlike Ozempic and Wegovy, does not include semaglutide – may similarly reduce the effectiveness of oral contraception such as the Pill. It continued: “Therefore, those taking Mounjaro who are overweight and are using an oral form of contraception are advised to also use a non-oral form of contraception.”
The different weight-loss drugs work by mimicking hormones which either trigger an increase in insulin production and slow the rate at which food is digested, reducing appetite, or else act “on a second hormone involved in appetite and sugar control".
The headline on the Government Press Release sternly announced: “Women on 'skinny jabs' must use effective contraception, MHRA urges in latest guidance”. Use of the modal verb “must” takes on an imperative emphasis when pronounced by a government agency.
The dire result warned of by the Government is, then, unscheduled pregnancies and babies. Yet pregnancy, however unscheduled, is not a disease, while the same cannot be said of Pill-caused infertility, however temporary.
Decades of unremitting promotion of oral contraception makes us forget that the pathological state of infertility is precisely what the Pill is meant to cause so as to enable conception-free sex. In this it differs from “natural family planning” whose many virtues build on the fact that it works around, rather than sterilising, the woman’s fertile days.
It is interesting that weight-loss drugs – often used for medical reasons and certainly less black and white morally than contraception – are now held to account not as superfluous technology but as restoring fertility, albeit as an unwanted side-effect.
The story is instructive about the state of our culture. The term “medical” in the Hippocratic tradition applies to healing, not to lifestyle choices aimed at instrumental control. (Indeed, the term “medical” is now also routinely used for death-dealing “lifestyle” choices such as abortion and assisted suicide.)
Characteristically developments in technology are breathlessly welcomed as indicating a further mastery over “nature” and ourselves. Our society’s morbid focus on technology and on autonomy has, over hundreds of years, transformed our understanding of morality, politics, health and even the nature of reason itself.
When man is seen primarily as a creature of desires it is only natural that these desires create policies aimed at the ends on which they focus. For a society which begins with generic man as a desiring creature is very different from one which sees people as partaking in a divine order in which they have distinctive roles to play and privileges and obligations linked to those roles.
Once we think in exclusively desire-based terms we simply seek for “means” to the achievement of our ends. Reason becomes focused not on ends and what we “ought” to do but rather on the efficiency of means to ends set by our desires.
Means come to be treated as neutral and compared in terms of scientifically discernible “efficiency” as we focus on the use of technology to get us what we want. In such an atmosphere we lose sight of the truth that means are, in a crucial sense, the end in the process of becoming – a truth more likely to be grasped when ends are not seen solely in terms of what we happen to desire.
The Catholic Church long ago warned in<em> Humanae Vitae</em>, in the context of contraception, against the dangers of replacing self-mastery in favour of manipulative technique.
In 1990 Pope John Paul II noted, commenting on <em>Humanae Vitae</em>:
“… a people's development does not derive primarily from money, material assistance or technological means, but from the formation of consciences and the gradual maturing of ways of thinking and patterns of behaviour. <em>Man is the principal agent of development</em>, not money or technology. The Church forms consciences by revealing to peoples the God whom they seek and do not yet know, the grandeur of man created in God's image and loved by him, the equality of all men and women as God's sons and daughters, the mastery of man over nature created by God and placed at man's service, and the obligation to work for the development of the whole person and of all mankind.”
When applied to the generation of life, we can all see how contraception transformed the very meaning of the procreative act which makes sense of marriage, despite its being advertised simply as a “means” of spacing births. This “means”, which paid no heed to the nuptial meanings of male and female bodies, transformed sex and marriage and the ends they had hitherto been understood as serving. The misuse of technology brings with it conceptual transformation.
Can anything similar be said about weight-loss jabs? Clearly we are not dealing here with such weighty issues as the transmission of new life and the appropriate interpersonal environment for its nurture and the parents’ mutual support. Our sexual desires concern matters of far greater weight than our appetite for food. Regulating through technical means our appetite for food does not deform us in way contraception does. And achieving weight-loss is often a good end to aim at, at least if we are unhealthily obese.
Yet, the wish to manipulate our body to reduce appetite should be approached with a little caution, and not only because it may have unfortunate health side-effects. Self-denial is valuable and if we get used to thinking it can always be bypassed or assisted by technical means there is a danger that we start to view the body itself instrumentally – or, as John C. Berry puts it, as “a set of biological mechanisms to be manipulated. In this way the human body becomes a resource to be utilised".
That has, of course, been realised already in some areas of medicine, including the harvesting of organs from those who may still be alive but are judged dead by highly contestable criteria.
There is nothing wrong with weight-loss jabs which seek the good end of reducing dangerous obesity. But general caution about “work-arounds” which seek to manipulate our appetites may be called for.
There is also the fact that a personal and social pleasure – enjoying a good meal – may become less appealing: as one drug pioneer <a href="https://www.wired.com/story/obesity-drugs-researcher-interview-ozempic-wegovy/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">puts it</mark></a>,<em>“</em>you lose your appetite and also the pleasure of eating, and so I think there's a price to be paid when you do that. If you like food, then that pleasure is gone.” Some <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10669484/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">users</mark></a> report improvements in their preoccupation with food and their mental health generally, while others report ill-effects such as being “afraid of solid food” and “feeling too awful … to exercise or enjoy life”. Also troubling is the fact that those who stop taking weight loss drugs often regain the weight they had lost – and more quickly than with behavioural interventions.
That said, at least while they are being taken, weight-loss drugs may help avoid over-concentration on food for those who think too much about it. In one user’s <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10669484/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">words</mark></a>, “it quiets the food noise in my brain. By which I mean that Ozempic frees up the mental and emotional energy I used to spend on either thinking about food or thinking about not eating food.”
Two bioethicists <a href="https://philpapers.org/archive/RYATEO-17.pdf"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">comment</mark></a> on semaglutide users in a recent issue of the <em>Journal of Medical Ethics</em>: “They no longer want to eat at unhealthily high quantities. This frees up their mental space to pursue their goals and to have a better life. In a way, semaglutide enables a person to choose their own desires.”
We end on a note of agreement with two caveats: not all ways of “choosing desires” are created equal, while our stress should always be on what is “choiceworthy” – not merely “chosen” – in the way we act and feel.
<a href="https://thecatholicherald.com/castration-and-human-dignity-doctors-are-not-agents-of-social-control/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color"><strong><em>RELATED: Castration and human dignity: ‘Doctors are not agents of social control’</em></strong></mark></a>
<em>Photo: A box of the drug Ozempic rests on a pharmacy counter in Los Angeles, California, USA, 17 April 2023. Ozempic was originally approved by the FDA to treat people with Type 2 diabetes. Since then, there has been a spike in demand for Ozempic, or semaglutide, due to its weight-loss benefits, which has led to shortages at times. Some doctors prescribe Ozempic 'off-label' to treat obesity. (Photo illustration by Mario Tama/Getty Images.)</em>
<em>Anthony McCarthy is director of the Bios Centre (<a href="http://www.bioscentre.org/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">www.bioscentre.org</mark></a>)</em>.
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