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“I had been on the overweight, obese side, and then I had quickly seesawed to the very, very thin side—too thin. At this point in my life I was no better off, no more intelligent, and had no more knowledge than I did when I took that first diet pill in the sixth grade. Now it was time for me to try to find some balance, some middle ground, for the first time in my life.”

“We did every product that you could imagine — from cupcake endorsements to a diet pill at the same time, to sneakers or things that I didn’t know enough about for them to be super-authentic to me,” the reality television star told The Times in 2019.

What viewers couldn’t know, but what she catalogs cheerfully in the book, are the drugs she’d taken that day: “a diet pill, a small amount of coke, two joints, six halves of Valium, which makes three, and a glass-and-a-half of wine. So far.”

When a nurse practitioner prescribed Mounjaro to Marcela Romero to lower her blood sugar in November 2022, she bristled at the idea of taking a “diet pill,” she said.

Notably, that systematic review found that nonprescribed diet pill use was significantly higher than the use of nonprescribed laxatives and diuretics for weight management.