“Do you want pasta or fish?”

I was at lunch with a friend I hadn’t seen in a few months, and she was looking me up and down. “Can you have pasta given, you know, the carbs?” she asked delicately.

“Oh, I’m not on any special diet,” I replied, already irritated.

“I mean …,” she continued, even more gingerly, “can you have carbs on the shot?”

The shot? Oh, the shot.

I suddenly understood why so many public figures—Mindy Kaling, Adele, Khloé Kardashian, Kyle Richards—have either denied using it or refused to comment. The assumption that I was taking Ozempic embarrassed me, even though there shouldn’t be anything shameful about it. (Besides, I’ve never tried it. My weight has only marginally fluctuated since my daughter was born, and she’s eight now.)

I didn’t bother to explain that Ozempic doesn’t work like that, even though I know almost everything knowable about it: as an editor, wellness is one of my beats, and as a human, a member of my family endured it for eight months. I changed the subject as quickly as possible and ordered the carbonara.

Who knows how the rumor got started, but it didn’t entirely surprise me. I’m always yammering away about intermittent fasting, ProLon, and glucose levels. For heaven’s sake, I suffered through a weekend at Buchinger.

I’m the kind of American woman who has been trying to shrink, even just a little bit, since puberty. I grew up in the 90s on a diet of reduced-calorie everything (remember Olean?) and the “Cathy” comic strip. (Learn to read while discovering the perils of the fridge!) My eating was so disordered that when, for two years in high school, my best friend managed to subsist exclusively on sweet potatoes topped with I Can’t Believe It’s Not Butter! spray, I was jealous. I once adopted a diet whose main components were Wint-O-Green Lifesavers and Nescafé. I’m much healthier now, but in my 20s, on the nights when I wasn’t subsisting on rare cheeseburgers (hold the bun) and dry martinis from Diner, in Williamsburg, I ate popcorn for dinner. Air-popped.

Despite all that nonsense, no one has ever called me thin. And I love my body. In fact, I suspect I see it more positively than others do. For this, I would like to thank every wonderful man who has ever witnessed me naked and felt compelled to react approvingly. Your words—and actions—mattered, maybe even more than they should have.

This relentless desire to lose weight doesn’t originate from a desire to be someone I’m not. It’s simpler than that. Or maybe it’s more complicated. I guzzled the social conditioning of my time—that thinness signifies self-control, virtue, and beauty—as if it were a pitcher of Crystal Light Lemonade (only five calories per serving).

In the last week of February, more than 373,000 Ozempic prescriptions were filled.

We’re a lot better off than we were 30 years ago, thanks in no small part to the body-positivity movement. But fat phobia remains alive and well. The Ozempic craze among those who use it as an aesthetic choice versus a medical intervention reveals an unfortunate truth: The thin-is-in mentality is as pervasive and enduring as ever.

Ozempic and its peers promise to not only recalibrate body composition but to make eating, and all of its associated issues and concerns, not such a loaded proposition. Semaglutides work on the brain in more ways than one, chemically curbing hunger so that, yes, you eat less and start shrinking. And then, having lost fat, you stop yearning to lose it.

Ozempic is being used by all sorts of people—overweight, underweight, diabetic, rich, famous, infamous, and those who are just plain tired of worrying about their weight. I recently heard a rumor that one of New York’s most prominent Social X-Rays (both in public profile and profile photo) is taking it so she doesn’t have to work so hard at staying so thin. Maybe semaglutides should come with a side of cognitive behavior therapy, since issues with weight are rarely just about the numbers on the scale.

I once adopted a diet whose main components were Wint-O-Green Lifesavers and Nescafé.

Given the tremendous popularity of these drugs, losing weight could become something that a large percentage of the population no longer really worries about. I don’t even dare to imagine it. How would we fill the headspace? With an idea that would put Bezos out of business? With a new path forward for the Electoral College? With a running loop of the new Lil Uzi Vert album?

The more I think about Ozempic as a path to freedom—from what I’m eating, what I’m wearing, how I’m feeling about what I’m wearing, how I’d rather be wearing something with a looser waistband—the more I want it. But now, idiotically, I have adopted the impression that taking it would make me morally inferior to those who do things the old-fashioned way.

Diet culture tells us to believe that weight loss is supposed to be hard. And it is, often impossibly so. That’s why there’s a battery of experts and shamans and influencers who are more than happy to assist for the cost of a book or a healing session or $19.99 per month (but you can cancel your subscription at any time).

Some do eventually arrive at what is called a “goal weight,” and those who have a public profile are fetishized with before-and-after spreads in supermarket magazines. But now, thanks to Ozempic, losing weight, too, is loaded. The magazine stories don’t mention it and instead extol the virtues of “diet and exercise,” even though now the science tells us that for many people, and for complex reasons, that old formula might actually be a myth.

Administering the shot requires all of 30 seconds once a week, but it’s not an easy way out. My Ozempic-afflicted family member once left the table in the middle of a dinner party to vomit up his gazpacho. He spent most of Christmas in the bathroom. He used to relish nothing more than a split of Bordeaux and a delicately sauced roast chicken, until he started skipping dinner entirely because the aftermath was too unpleasant. After eight months and 30 pounds of weight loss, he’d had enough. Six weeks later, he’s having his suits let out. Again.

It’s a miserable price to pay, and I’m not even talking about the $900-a-month cost. And yet I could stomach Ozempic if it bought freedom from the nagging awareness of my weight that has plagued me since adolescence. But still. Wouldn’t it be wonderful to find that freedom without crippling nausea and a risk of thyroid cancer?

This kind of reconditioning is a long way off. But it’s not unprecedented. All kinds of interventions were originally fraught with judgment and shame. In my grandmother’s day, nobody dared admit to coloring their hair. Getting a face-lift used to involve hiding out in a recovery center, not documenting it step-by-step on Instagram. Maybe one day, semaglutides can be used without the stigma.

The next time someone asks, I’m going to say, “Yeah, sure, whatever, I’m on it.” I’ll still take the pasta.

Ashley Baker is a Deputy Editor for Air Mail and a co-host of the Morning Meeting podcast