My Body is a Traitor, So I Was Prescribed the Weight-Loss Drug Zepbound

…Slightly maniacal meditations on being a middle-aged South Asian woman, body image, cultural expectations, and loss of control

Writer Sandhya Jain-Patel during her first pregnancy. She was recently prescribed the weight loss drug Zepbound to manage high cholesterol.

Nearly fourteen years ago, I stood frozen in the bra aisle at Target, my body working overtime to build, cell by cell, one of the most perfect human beings ever created (only rivaled by their younger sibling). Those microscopic machinations were reflected in the mounds of breast, belly, and backside that defined my corporeal topography, announcing to the world, “Baby on Board!”

My partner and I had been looking at diapers, bibs, and other items we didn’t feel like paying a premium for at Buy Buy Baby. As I dithered about whether Babar the Elephant matched our existing theme (spoiler alert: baby themes don’t matter when there’s spit-up on the clothes), he had wandered to the electronics section, no doubt shopping for a video game to keep him occupied when baby and I would be napping. After waiting a few minutes—the max of my BC, or “before child,” patience—I decided to head over to the nursing bras.

I walked through the non-pregnant bra section, my eye catching on the various specimens as if I was sifting through my family’s Kodak slides. Each style projected a moment of my life: the nondescript plain white ones that were the only choice available to my mother’s generation in India, the racerback styles that always chafed my deltoids, and the practical front-close ones that I preferred. I giggled at the selection of lacy and racy numbers that no doubt led to more than one wearer finding themselves in my current state. Collectively they exuded a halo of furtive come-hithers, a silky feeling of trespass, a purplish sense of magical anticipation. Whether for a new workout or a new date, new bras always meant titillating new possibilities.

Not seeing the maternity bras, I rounded the corner and stopped short. The swooning mood of the previous aisle poof-ed away under the fluorescent lights that hummed overhead like the not-so-subtle whispered gossip of South Asian aunties. I stared at the small plastic hangers of plain white, black, and Band-Aid-“skin”-toned cotton bras that hung in neat rows, lined up like soldiers ready to perform their mammary duty. The hair on my arms rose, perhaps in response to the sudden chill.

I picked up the hanger and turned it around, studying it from all angles. It looked… utilitarian…not exciting in any way. “Well,” I thought, “at least it will feel soft against us.” I reached inside to look at the size on the tag. 34B…perfect! That’s the size I usually wore—

Suddenly a slight sweat broke out on my neck and my heart began thumping wildly as my brain tried to work out what my body already knew. Then it hit me.

I wasn’t currently that size and I didn’t know if I would ever be that size again.

I braced my arm against the display and leaned forward, trying to catch my breath. The fluorescent lights trained on me like spotlights in an interrogation room. Snatches of What to Expect When You’re Expecting swam before my eyes:

“They may get engorged when your milk comes in… get bigger to match your growing baby…

“Bras that are too tight can cause mastitis, a painful condition…”

“Your nipples may get raw and bloody. Wearing a bra could be especially painful…”

The tag blurred. Hot tears pricked my eyelids as the folly of my intent hit me. There was no way to predict how much my breasts would swell postpartum. The illusion of preparation created by baby shower registries was just smoke and mirrors; I couldn’t buy control any more than I could register for guaranteed peaceful nights of sleep. The naked fact was that I was utterly unprepared for motherhood.

It’s strange to feel this thing, this corporeal vessel you’ve known your whole life, suddenly act with its own agenda. It’s a sense of betrayal that, to be honest, I’m not sure I’ve fully overcome. Now, as I pass my mid-century mark, it’s not much different—I simultaneously have a sense of control and feel a complete lack of it.

Like most mature South Asian women, I’ve learned what I need to maintain my flawless skin (retinol and sunscreen), a full head of hair (oral Minoxidil), and physical strength to ward off osteoporosis (weight-bearing exercise). But there are changes I can’t see or measure which are life-threatening. As I enter menopause, my cholesterol and blood sugar levels are skyrocketing dangerously high. Despite continuing to make healthy choices, I feel entrenched by cultural shame that I’m not “controlling” myself—as if my pancreas should respond to stern talking-tos and my liver could be shamed into better behavior. And I’m not alone in experiencing this biochemical betrayal.

Our South Asian culture is so judgmental when it comes to other people’s weight and health issues. We assume the subject of our gossip is eating “too much of sweets” (because apparently no one can resist ladoos), or is “too lazy to exercise” (ignoring the fact that South Asian women especially are juggling more roles than a Bollywood movie star). The whispered commentary follows women like me like insidious shadows: “She’s let herself go,” they say, as if her health is fully in her control.

In fact, it’s a well-established medical fact that menopause makes sugar and cholesterol levels go haywire, but somehow this isn’t common knowledge. How could it be? Most doctors get just one day to learn about menopausal health in med school, so not only are they struggling to keep this crucial information front of mind when treating patients, but the general public is completely unaware of these significant changes happening to uterus-bearing bodies. Combine this lack of widespread awareness with the fact that South Asians develop diabetes and heart disease at a lower BMI than other racial/ethnic groups, and we have a recipe for disastrous health outcomes for my identity group...and no one is talking about it.

Enter tirzepatide, most commonly known by the brand names Mounjaro or Zepbound. After a year of monitoring my health and implementing her suggested lifestyle changes, my doctor prescribed Zepbound six months ago, and I have a lot of feelings about this:

“What is wrong with me that I can’t train for a marathon/eat more broccoli/do the work?”

“I can’t tell anyone in my family, they will think I’m a helpless, hapless, vain woman.”

“What will my new Substack bestie,

Jameela Jamil

, and her iWeigh campaign, think of me?”

Now, those who know me also know I spend very little time on what other people think. (To wit: I reserve jeans for “special occasions” and my Minoxidil-luxurious tresses are rarely seen out of a messy chignon). However, it’s hard to erase decades of culturally entrenched conversations, ambushing my self-confidence when I least expect it. For a while, these thoughts made me miserable:

“I’m writing, I should be exercising.”

“I’m eating, I should be fasting.”

“I’m spending time with my kids, I should be doing something—anything—more active.”

Notice that pattern? The constant “should-ing on myself” is just the surface symptom. Beneath it lies a lifetime of internalized messages about control, discipline, and self-worth. And to punish myself even further, I’ve gone down a rabbit hole on all the possible changes that could happen to me. Of course, there’s the weight loss, but will my skin get saggy so I resemble the elephants we saw last summer at The Sheldrick in Kenya? Will my hair fall out despite my devotion to Minoxidil? And most importantly, will any of this actually achieve our real goal—lowering my cholesterol and blood sugar levels?

Unlike pregnancy, there’s no What to Expect When You’re Menopause-ing guide for South Asian women—though someone should write one, complete with footnotes on how to handle the comments from those loudly whispering elders. We’re writing it in real time, and there’s woefully little information on how this drug specifically affects women of color.

Fortunately, I’m not experiencing any déjà vu of that gut-wrenching panicky feeling that I had so long ago in Target. Maybe it’s having been through two pregnancies, maybe it’s being emaciated from a life-threatening illness, maybe it’s the wisdom from age and experience that has taught me that nothing is forever—not body shapes and sizes, not personal and professional struggles, and not what others say or think about me.

Instead, I’m prioritizing what I’m saying to myself. In this uncharted journey, I’m discovering that the most profound changes aren’t happening to my body—it’s how I’m finally learning to replace the inherited chorus of “should-ing on myself” with my own authentic voice. A truthful voice with which I’m saying the quiet parts out loud.

Sandhya Jain-Patel is a writer and multicultural storytelling specialist whose diverse background as a “third-culture kid” informs her unique storytelling perspective. She is currently working on a sci-fi fantasy series based on Indian mythology, and publishes occasional musings at Jain of All Trades. Sandhya is co-author of the Wall Street Journal bestseller Beyond Diversity, and her TV pilot, Sarah/Swati, placed in the Second Round in the Drama Pilot category at the 2021 Austin Film Festival. A Fulbright scholar fluent in three languages, Sandhya holds multiple master’s degrees in sciences and arts.