Transcript of Marriage and Sex in the Age of Ozempic

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From the New York Times, I'm Rachel Abrams, and this is The Daily. In the last few years, G DLP1 drugs like Ozempic and Zepound have been radically reshaping the lives of millions of Americans. They have the power to change everything, from our appetites and our health to the clothes that we buy. But they also We have the power to affect other parts of our lives, how we date, how we see ourselves, even our closest relationships. Today, my colleague Lisa Miller tells the story of how these drugs upended one couple's marriage and how they dealt with the fallout. It's It's Tuesday, October seventh. Lisa, I don't think it's an understatement to say that we, in 2025, are in the middle of this, what feels like a weight loss revolution in the United States. Of course, we're talking about these drugs that everybody's probably heard of, Ozempic, Wegovi, Monjaro. I think most people know somebody who's been transformed by them. Maybe We, a lot of people themselves have actually had some experience with them. But I would just like to hear a little bit about what interested you initially.

Yeah, it's a revolution in how we look. It's a revolution in our health. It's got a gigantic potential to help people who have not been able to be helped before. The data show that one in eight Americans has tried one of these drugs. That's a lot of millions of people, right? It's creating all kinds of conversations, not just about how we feel and our health, but also how we look and how that matters in the world. I have a friend who takes the medicine and he says, If you are able to eat just five French fries, and you used to not be able to eat just five French fries and had to eat the whole plate of French fries, it gives It gives you grounding in the idea that you can control things in your life that you didn't think you could control. If you're a person who was completely helpless in the face of a plate of French fries and suddenly you get control of that, what else can you control? Can you control your gym-going habits? Can you control the way you relate to your children, the way you talk to your boss.

So my question was, if your body has changed so much, just the shell you walk around in, and your mindset has changed so much about what's possible for you, wouldn't that affect the way you relate to everything and everyone in your life, including your most intimate relationships? What really interested me was this question of how the GLP-1 drugs affected a marriage, especially when one partner is on the drugs and the other partner is How did you go about trying to find the right people to talk to to satisfy that question? We, at the times, have a thing called a call-out, where you ask the public a question, and that question is posted on social media and in the paper and all over the place. Then we get responses to that question. The question was this, has a GLP-1 drug, like Ozempic, and subsequent weight loss changed your relationship. It was the week last year between Christmas and New Year's, and it was like presents. I was getting all of these responses to the call out, and a lot of them were really interesting, I just want to say. One jumped out at me. Should I just tell you what he said?

Yes, do you have it? Yeah, I have it. He wrote, I believe it has changed a few things. Less alcohol consumption, smaller meal portions, improved health outcomes, increased awareness of food and drink consumption. But I believe GLP-1 has affected my wife's libido, no interest in sex, perhaps due in part to image issues, also increased mood swings on her part. I thought, there's a lot between the lines here. First of all, a lot of people wrote in about sex, but he was very pointed about it. He's ruminating on why struggling with it. I called them up. Can you hear me? I talked to both of them. Let's talk about middle names. They agreed to participate in the story as long as I used their middle names.

Javier.

Javier. So he is Javier and she is Jean. Jean.

J-e-a-n-n-e.

Okay. That works. They live in New England in a nice suburb.

We celebrated our anniversary a few days ago.

They had been married for 15 years. And would you be open to a visit from me? Yeah. Okay. And it became a long relationship.

The invitation is open.

In which I was probing and probing and probing about how these medications were changing the dynamics in their marriage.

Tell me more about that. How were the drugs affecting their marriage?

Well, I think maybe it's helpful to talk first about what their relationship was like before the drugs. It goes back to high school.

Junior year is when I met her, so it takes us to 1987.

They both grew up in Sacramento. What did you notice about her? What made you like her?

Her personality. Very outgoing, great smile.

Well, I thought he was cute.

He was a football player and also in the band.

So he's an offensive lineman. He's a fit, but a big guy, which as a woman is very comforting when you hug someone like that. You just feel safe.

And so at that time in high school, how would you have described your own body?

I was overweight back then. I mean, 17 years old fat.

She was in a bigger body and excruciatingly self-conscious about that? Yeah.

So always felt awful, never felt attractive.

She would say that she became a super competent pleaser on all the clubs, doing all the things in order to compensate for the way she felt about her body. He had a crush on her. They both told me this story about how in high school there was this band performance in town, and he offered to walk her to her car.

That was my first attempt was, Let me walk you out to your car and then test the waters there.

I said, No, I'm a powerful woman. I don't need any man to walk me to my car. But I thought it was very galant.

It was as though she couldn't believe that he liked her in that way because she was insecure? She was so insecure about her body?

There have been times in my life where someone was actually flirting with me or trying to come on to me, and I just don't register the signs because I feel so uncomfortable in my own body that I feel like they must be bullying me or teasing me or just being mean.

So even though she had a crush on him, too, she wouldn't believe it.

So it sounds like basically, even though they might have liked each other or he certainly liked her, they did not get together in high school. They did not. But they were close.

Yes. They were unrequited high school sweethearts. They each married other people.

What happened was that my first marriage was coming to an end.

My first marriage had just ended.

Then all of our friends were reconnecting on Facebook. Jean looked up Javier on Facebook.

Our 20-year reunion was coming up that fall.

I told her that it'd be great to connect and have a cup of coffee.

They told me about their first date, and it just felt when they both described it like, finally. They both had this feeling of like- They knew. They knew.

The cup of coffee ended up being a dinner and some beers and a ride up to the skyline where you could see down under the bay. That's when the kiss happened.

I think things went pretty fast from there.

I remember the first night that we got together, that we connected sexually intimately.

They both told me about the first time that they had sex.

I mean, knowing... How should I say this? Assuming that she may have self-image issues, I was really impressed and delighted that she had no problem disrobing before me.

The way he talked about it was just as this unbelievably magical, uninhibited interaction.

She didn't say, Don't look at me, or I'm ashamed of this or the other, or my boots are too big, or my butt's too big, or I don't like this roll, whatever it might be. There was never any talk of that. I thought that she was happy in her body.

His point was that she was so uninhibited about her body, and that that was so pleasing to him. I'm running story by the both of them, and she was like, I don't exactly remember it that way. It wasn't that I felt great about my body. I never felt good about my body. What was amazing about that night was that I'd had this crush on him for 20 years, and here we finally were.

Now, we know that they eventually get together, right? They get married.

Yeah, they move to the East Coast where she gets big jobs in corporations. She's the earner. You get the sense that they fit each other's romantic fantasies, and they're extremely sexually attracted to each other. It's a big part of their identity as a couple. They have a child. They settle into a life where they both love food, they love restaurants, they love wine, and they get a big wine fridge in their dining room.

Living the dream.

They have friends down the street, and they have these game nights where they last all night. They have this happy suburban- Fun.

They seem like fun people. They enjoy living life with gusto.

Totally. They're doers. They like to imbibe in life. But throughout this, Jean struggled with her weight.

I was obese from a BMI perspective.

After she had her baby, she was heavy. She hated it. She had postpartum depression. She could not lose the weight. She did not feel good about that. Her self-image, her sense of her body was not happy. She would say she's gained and lost 70 pounds multiple times in her life, and it just felt like an endless struggle to her.

Did she tell you why she was having so much trouble keeping the weight off?

She talked about food noise.

Yeah, food noise to me, It feels like a constant need to eat. I don't feel hungry. I don't feel full. I don't have those physiological triggers to know when to eat.

The feeling of self-loathing that she describes of not being able to control that, like it's a failure of will.

Then being embarrassed about the food that I was eating. So, sneaking food. When I was home by myself, having a pint of ice cream because I could and I could hide it.

Eventually, this leads to health issues.

I do I have other chronic conditions that have developed over time. I had non-alcoholic fatty liver disease.

She says to her doctor, How about one of these GLP-1 drugs?

He wrote the script.

Can you just remind us, Lisa, how do these drugs actually work?

Well, they work by reducing your feeling of being hungry. Because of that, people lose a ton of weight really fast. People who have been dieting their lives and struggling with their weight are able to keep their weight off as long as they're on the drugs. She starts losing a lot of weight really fast.

Their clothing. Her clothing was starting to fit a lot looser.

You know, 10 pounds, 20 pounds.

She used to not wear jeans, for example, because she wouldn't be able to fit in them comfortably. She was always wearing the leggings type of clothing.

They both noticed it.

She slowly transitioned from the yoga pants to the jeans.

Not eating that much.

I feel for the first time in my life, this may be it. I may be able to keep this weight off because I've addressed the food noise.

The food noise that had been tormenting her is gone. She feels like it's a miracle, really.

Wow. So this is just a really dramatic, very quick shift.

Yes. I mean, she lost 60 pounds inside of eight months. Then she notices that people start treating her differently.

Yeah. So flying home on a work trip, and I was in the window seat.

She told me this story about she travels a lot for work, and she was on a flight home from Chicago, and she was sitting in the window seat.

A guy sat in the middle seat and said, Oh, I'm so glad I'm sitting next to a small person. He said, Sometimes you're in the middle seat, and you're crowded between two big people, and it's really uncomfortable. On the one hand, I'm like, Hey, I'm a small person. But on the other hand, it really pissed off because when people looked at me before or sat next to me on the plane before, were they thinking these things the whole where I'm trying to have a nice conversation and all that's in their head is I'm stuck next to this fat person.

She was so furious on behalf of her bigger self.

It's like in this moment, she's almost caught between her old self and her new self.

She's defending her old self as she's happy for her new self. It's really an unbelievable moment of transformation.

Well, and even at work.

At work, she felt this way. She's a successful professional She's always been a successful professional.

But I feel like the marketing team is putting me out there more.

Now, suddenly at work, she's getting these outward-facing opportunities where she's being put forward as a talking head to talk to the media, for example, or she's being put forward to talk to the board in a way that she hadn't been before.

But I feel like there's this different perception of me. I'm the same person. I'm just pounds lighter.

Now, this is a thing that others have said, too, about these drugs, that once the world starts approving of you, and I've got air quotes up here, the door is open. A lot of the people I talk to for this story talk about the opportunities that get presented to them, promotions and dates. You have access to partners that you didn't you have access to before. You can do things physically with your body that you couldn't do before. I talked to one guy who started running marathons all of a sudden. If you're married, it presents a whole world of things that you have to suddenly start figuring out that may have been latent or unspoken, or the agreement that you made when you got together has be renegotiated in some way that you didn't anticipate at all. And that was definitely true for Jean and Javier.

We'll be right back.

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Lisa, I'm so curious how these huge changes the Jean is going through, both physically and emotionally are affecting her relationship with Javier.

I mean, one of the first things that happened was that she totally lost her appetite for alcohol. That's not unusual. People on these medications frequently lose their appetite for alcohol, so much so that researchers are investigating whether GLP-1s are a good treatment for alcohol abuse, addiction, other kinds of compulsive behaviors. For Jean, the loss of appetite just changed her whole approach to having fun with her husband. I mean, no longer could they sit on the couch and uncork a bottle of wine at the end of the day or go to the local brew pub and try out the new beer. None of it felt good to her anymore.

We go over to a friend's house and we'll have a game night or something like that. We'll still go. I just won't drink. That's fine.

But it was also just that her appetite for that life where you're going out and you're hanging with friends and you're staying up late and everybody's drinking, those appetites, they had limits as well.

I would have liked to get home earlier before anyway. Now I can say, I'm not drinking. I would like to be home.

In fact, She had an introverted side that hadn't been able to express herself because she was so busy being a pleaser extrovert because she was in a bigger body and she wanted people to like her.

I am not as much of a night owl as my husband is, and I like to read my Kindle a little bit before I go to sleep at night, and I just don't do well the next day if I'm out really late.

Once she was in a smaller body, she could assert herself and say, Actually, I like being at home.

But she's also telling Javier she doesn't want to do the things that he thought that she loved.

And that they loved together. They loved together, right. That was like the fabric of the fun that they had always had together.

How does he respond to all this?

He does not like it.

No, I like going with the flow. I mean, living in a moment and enjoying whatever's going on in social aspects, social events. Yeah.

He was like, No, this is not how we are. We are the people who do these things.

I think he misses his drinking buddy, the person who is going to stay out late.

It sounds like the lifestyle stuff led to a lot of tension.

More than tension. I mean, I think they had a really, really, really hard time. When I met them, they were fighting a lot.

Before it was a conversation, and now it's a fight, and one of us is going to walk away angry because we're not seeing eye to eye on something.

Their fights could be loud and ugly.

I started really wondering who I was with. I mean, this person that I had been with for a better part of 15 years really started to take a change.

Maybe- Javier said to me, We go from zero to 60 in seconds.

Bottom line is it became very confusing to me as far as how to manage our relationship. I would even comment to her and say, I don't recognize you. I need a roadmap. I need a roadmap to figure out what's within bounds and what's out of bounds. I don't feel like I can be myself with you the way I used to be because I don't want to offend you or I don't want to make you feel badly because things have changed a lot.

One of the biggest things that changed is that they completely stopped having sex. When I met them, they hadn't had sex since she started taking the drugs, which was almost a year. Javier told me that he really missed it, and he missed her, and he missed her body.

I used to love feeling her body, her big body, next to me in bed. The softness of her body, the extra tummy and the extra booty.

They both talk about the loss of her butt. Are there things you miss about your previous body?

My butt.

They both loved her butt.

I missed that voluptuousness. That was an attraction early on in our relationship, to me anyways, being able to lean up next to her and feel her, for lack of a better word, draping over me or onto me. That's no longer an option. Now it's cuddling, and it's cuddling as tight and closely as we can or as I can. And that's the extent of the intimacy. I'm at a loss for why there's no physical intimacy or hasn't been any.

This physical connection that they had has completely changed into something else. And neither one of them knows exactly how how to find it again. But for you, the voluptuousness was erotic.

It was erotic. It was comforting. It was nice. It was sensual. And that's no longer the case. And this new body, I haven't really been able to touch or explore or anything like that.

It's not as accessible.

It's not. No.

Why haven't they had sex? Was that just another appetite that the drugs reduced?

I mean, that's what Javier's theory was, is maybe. There's some evidence that these medications decrease sex drive, but there's more that they increase it. Jean has different theories of the case. She's gone through menopause. She's been on antidepressants for a really long time, and both of those things are known to suppress sex drive. But I think there's actually something bigger at work here.

I haven't said this to him. I just didn't say no before.

She started to be able to draw boundaries between doing things for other people because they want them and being able to articulate what she wants. She doesn't want to have sex, and she's saying so in her marriage to her husband.

I'm setting the boundaries. I don't want to have sex, but before I would because I felt like it was my responsibility.

That is empowering for her in some way.

God, I can totally see why making an intense physical and emotional change could lead somebody like Jean to need to, if nothing else, take a break from having sex. But I can imagine if you are the person's partner, that's suddenly finding out that the person that you shared a really active, pleasing sex life with doesn't want it or doesn't like it. I can imagine that that's totally devastating. Did she tell him that that's how she felt?

I mean, he could tell, but he very much wants to be her loving partner.

What does that mean in the context of not having sex when you want sex?

Well, they were both working on this in therapy, individually and together.

For example, we discussed with my therapist, and she provided a link that has to do with intimate touch.

Javier's therapist gave him an exercise that was meant to help couples who aren't having sex or who want to get over some hurdle in order to have sex.

There's this three steps or three phases.

The first stage is one partner lies down fully clothed, and the other partner touches him/her every everywhere except the erogenous zones. The partner who's clothed and lying down says what they do and don't like.

Now that's out of bounds or that makes me ticklish or don't touch me there. Or they can say, I like that.

They did it one time, and Javier said he enjoyed it very much. But when he asked her, did she want to do it again? She said no.

They didn't even get past the first phase of the exercise.

I want to solve this problem because it's It's difficult for a married couple not to have that physical intimacy.

But also, you have to share this new body with him when you haven't totally gotten comfortable in it yourself.

Yeah.

Does that resonate with you?

Yes, it does. I have never felt comfortable when he has made a positive comment about my physical appearance. I feel more entitled to that praise now, but still trying to come to terms with being in a smaller body. And what does that mean for us? Other than not being embarrassed on his behalf. He's not married to a fat woman anymore.

It sounds like the drugs unearthed something. They unearthed some dynamic in their sex life that Jean had only been may be vaguely aware of, but certainly had not been in a position to act on before she felt differently about herself.

Yes, I think that's true. I think they're both completely blindsided by that.

I didn't see, for being ignorant or naive, that there were many fundamental differences. We seemed to enjoy everything, the food, the drinking, the socializing, the active lifestyle, being parents. I felt that we were always on the same page and we're on the same... We weren't two ships in the night crossing paths. We were one ship.

We all get into our relationships with these unstated contracts that are not totally happy compromises sometimes. Then something like this happens, and you have to ventilate that contract and say, Okay, this is not what I want. They're doing that. You're empowered in a way to take up space to say what you want, and that forces you to have to figure out what you want.

Yeah.

Beyond just like, I want to leave the party at 10. In a way, that's easy. Do I want to have a sexual relationship with my husband? Do I want to leave my corporate job? Do I want to... These are much bigger questions. Yeah. Yeah.

And sad that at 53, that I'm starting to have those thoughts. Aren't those the kinds of things that most people think about when they've graduated from school, right? I'm the good girl, and I do what's expected.

In a certain body, and now you have a different- In a certain body, yeah.

I know this is just one couple and one anecdote, but I am really curious if you had any big takeaways for how these drugs could affect relationships.

I mean, one psychotherapist said to me, Romantic partnerships, marriages, are invested in stability and everything staying the same. We have books about what happens when you're going through the death of a parent or when you move or when you have a baby. These are gigantic life changes. But we haven't spoken about what happens when one partner's body completely changes and their feelings about their body completely change. But I talk to a lot of couples, and what I concluded after speaking to them was that the couples that seemed to manage it best were couples who weren't rigid in their expectations of one another.

What do you mean?

What I mean is You can't get too committed to, We are the people who have dinner.

I wasn't sure what you were going to say.

You can't be too committed to, I make this lasagna and he loves to eat it. We have two margaritas on Fridays with the so-and-so's. Those kinds of rituals, which are very reliable and very defining for couples, especially if you've been together for a really long time, all of that gets renovated with one person on a weight loss drug. If a couple can say, It's okay. Still the same person. We'll do something else. We'll eat less lasagna.

I believe, Lisa, what you are describing is flexibility in relationships.

Flexibility in relationships, which is really hard. All right. How have you been? I will say that I spoke to Javier and Jean again recently, and I noticed a softness between them, a level of empathy and understanding that I hadn't seen before.

It's not bad. It's not toxic. It's not horrific. It's harmonious, but there's still times of tension, but then that's normal. What's the relationship? How would you describe it? Kind of like a dance?

I think not as anxious and angry as we had been.

When I met them, they said that they had agreed to be together. It this way. But I felt that that was at stake. This most recent time when I met them, I felt that they were bought into that agreement. What about the Physical stuff, I have to ask.

Still the same.

But they're still not having sex.

My reaction to that has been to be patient and to not be pushing it. There's not much I can do. Other than to say it sucks, and I miss that. I wonder if it'll ever come back.

Is there anything you want to say more?

I still feel very strongly that this is one of the best things that I've done for myself. This is it. I have lost the weight, and I will maintain this for life.

I'm just so grateful. Lisa, thank you so much. It's such a pleasure to talk to you.

I really enjoyed it, too. Thank you, Rachel.

We'll be right back. Here's what else you need to know today. The Supreme Court declined to hear an appeal for Ghislaine Maxwell, the longtime Jeffrey Epstein associate, who was convicted of charges relating to enabling his crimes. The decision was Maxwell's last chance to get clemency from the courts, and now her only option for an early release from prison is likely a pardon from President Trump. And on Monday, a federal judge declined to block federal troops from heading to Chicago, setting up a fight between Illinois and the federal government. The state has sued the Trump administration, claiming that it's creating chaotic and unsafe conditions for residents and violating the US Constitution. We'll be covering the efforts by President Trump to send troops to Chicago and other cities on our show tomorrow. Today's episode was produced by Nina Feldman with help from Anna Foley. It was edited by Ben Calhoun and Lindsay Garrison, with help from Patricia Willens. Contains music by Marion Lozano, Dan Powell, Pat McCusker, Diane Wong, and Leah Shah Demeran, and was engineered by Chris Wood. It for The Daily. I'm Rachel Abrams. See you tomorrow.