Actor Josh Peck, perhaps best known for his role in Nickelodeon’s early-2000s sitcom "Drake & Josh," embarked on his weight loss journey long before weight loss medications like Wegovy and Zepbound entered the market — as did millions of others.

But Peck’s recent joke about it in a viral TikTok has fanned the flames of a heated debate: Is it “natural” to lose weight with medications like Ozempic or are people who take them “cheating” their pounds away? 

The short video, which has been viewed more than 21 million times, shows the "How I Met Your Father" actor panning the camera around his face with a caption that reads, “When you lose 100 pounds naturally and then Ozempic.” The audio is a clip of the song “Rose’s Turn” from the musical "Gypsy" that says, “All that work and what did it get me? Why did I do it?” 

Many of the 11,000 people who commented on the TikTok reassured Peck that he lost weight “the right way” or the “healthy way,” which he “should be proud” of. Many others said that they’re frequently offended when people assume that Ozempic or other medications helped them lose weight. 

“No Ozempic just discipline and effort,” one person wrote. 

“It's honestly more motivating knowing you did it the cool way and not the fast way,” another said.

But there is no “right” way to lose weight, experts say. It’s not about natural versus fake, fast versus slow, or disciplined versus lazy. Weight loss is complex and depends on a plethora of factors that both can and cannot be controlled. Above all, a balanced diet and healthy relationship with exercise is critical, no matter how people try to lose weight. 

“People try to discount the idea that you lost weight just because you had bariatric surgery or used drugs,” said Dr. Sahar Takkouche, a bariatrician and associate professor of medicine with the Vanderbilt University Medical Center. “But there’s no such thing as fake weight loss. The bottom line is that every case is different and the things that work for some people might not work for others.”

'Nobody is cheating by using Ozempic'

Many people aren’t able to lose weight with changes to their diet and exercise habits alone, Takkouche said, often because of underlying issues such as insulin resistance (Type 2 diabetes) and fatty liver disease, many of which have strong genetic components. In fact, genetics may account for up to 70% of people’s predisposition to be overweight or develop obesity, Takkouche said. 

“Nobody is cheating by using Ozempic. They're using some of today's modern tools to help them achieve a healthier lifestyle, which doesn't mean quote unquote low weight,” Takkouche said. “It means less fat around your body that increases your risk of heart disease, diabetes and other problems. A lot of people today fixate on the number on the scale, but that doesn't always represent the truth.”

Injectable medications like Ozempic and Mounjaro (approved to treat diabetes), as well as Wegovy and Zepbound (approved for weight loss), work by sending signals to the appetite center of the brain to reduce hunger and increase fullness — simultaneously correcting some of the metabolic problems that people with various conditions face. 

Ozempic face:It's not a medical term and it's hurtful

Weight loss with these medications isn't possible, however, without a healthy diet and consistent exercise regime, Takkouche said. Failing to maintain these healthy habits can explain why many people regain some or most of the weight they lost within a year after stopping use of the drug. 

“You need to have a proper diet and exercise in addition to taking these medications. They do not replace one another,” she said. “Some people just require additional help with injectable medications.” 

More on Ozempic:Sharon Osbourne lost too much weight on Ozempic, but she doesn't regret it. Why her case is uncommon

Studies have also found that the longer people are overweight or have obesity, the harder it becomes for them to lose weight and the greater their need to pursue more extreme measures like surgery and medications, Takkouche added. While weight loss drugs are known to cause side effects like nausea, vomiting and diarrhea, they have also been found to reduce risks for heart attack and stroke among people who are overweight or have obesity.

“The truth is, there’s no easy way out of the disease of obesity,” she said. "It is something that patients will have to deal with for the rest of their life whether they had surgery, used injectables or changed their diet and exercise habits.” 

Ozempic and the body positivity movement 

The assumption that using weight loss drugs is the “easy” way to shed pounds has, according to fat liberation activists, fueled weight discrimination and reversed much of the progress made in the body positivity (or body neutrality) movement. 

Victoria Abraham, 23, has been on and off Ozempic for two years to regulate her blood sugar levels. She has been rationing a single box of medication she received three months ago because of a nationwide shortage as more people who don’t need the drug use it for weight loss — a reality she feels has normalized conversations about dieting again as we see more people undergo drastic body transformations.

More on body positivity:What happens when a ‘body positivity’ influencer loses weight? Fans revolt.

“We had exited that era of constantly monitoring others bodies and always consuming weight loss content” Abraham said. “As a fat person who talks about these issues, I've been noticing more and more hate comments, cruelty and just overall nasty behavior from others.”

As a self-proclaimed fat liberation activist, Abraham is trying to change attitudes around what it means to be fat: “My goal is for people to stop defining their worth with their size. There's always going to be someone thinner, prettier. But as long as you’re at a point where you like yourself, I think that's what matters.”