(2023-06-17) Opinion Im On Ozempic Now I Weigh Much Less But Have More Questions

Opinion | I’m on Ozempic. Now, I weigh much less but have more questions. “Well, if I gave it to you, you’d be the thinnest person I’ve ever prescribed it for.”

Over the years, I tried a little hypnosis and a lot of grapefruit. I attempted Scarsdale and SlimFast, counted calories and cut carbs.

So, at 63, I was stuck, and unhappy. This time, I just couldn’t seem to get my appetite under control, I told my doctor

I jabbed it into my abdomen. (Calling this an injection overstates things — it’s a teeny, painless pinprick

As I write this, I have lost 40 pounds, an astonishing quarter of my body weight

I have more energy

Ozempic is just part of a new arsenal of medications being used to treat obesity. In June 2021, the Food and Drug Administration gave the go-ahead to an identical formulation, at higher doses and a higher price, under the brand name Wegovy. Another diabetes medication, tirzepatide (marketed under the brand name Mounjaro), has demonstrated even more dramatic weight-loss results — 22.5 percent on average versus 15 percent with Wegovy — and the FDA is expected to formally approve its use to treat obesity.

these medications are hugely expensive; they can cost more than $15,000 annually

What are the consequences of long-term use, especially because evidence suggests that patients quickly regain weight once they using stop the medication?

The new class of anti-obesity medications didn’t come from the search for a weight-loss drug. Instead, it was the accidental byproduct of medication designed to help diabetics control their high blood sugar. In the 1980s, researchers discovered an appetite suppressing hormone, which they named GLP-1, short for glucagon-like peptide-1.

A different diabetes medication, tirzepatide, manufactured by Eli Lilly under the brand name Mounjaro, has produced even more impressive results, up to 22.5 percent of body weight at the highest doses

The risk of more serious complications — pancreatitis, gallstones, thyroid cancer — appears remote

some experts cautioned me, we don’t know what we don’t know: these new drugs last in the body and act on the brain in far higher concentrations than we have ever experienced.

other gastrointestinal consequences remained (with apologies if this is too much information, constipation, sometimes followed by diarrhea.

What I also experienced, and what remains, is an unfamiliar feeling: satiety.

My sleep apnea had been so severe that tests showed I was waking up an alarming 54 times every hour; new testing put it in the mild range and my sleep apnea machine has been stashed in the closet. In November 2020, my LDL cholesterol — the “bad” kind, which raises your risk of heart disease and stroke — was at 146; it was down to 133 by March 2022 and, a year later, to 120

Most insurers do not currently cover medications for obesity alone. But my doctor was able to point to my risk of developing diabetes and my insurer, thankfully, did not question the need for coverage.

other countries have chosen to limit the availability of these medications. Canada’s Drug and Health Technology Agency recommended against public reimbursement of semaglutide for weight management, while the United Kingdom’s National Institute for Health and Care Excellence said semaglutide use should be reimbursed, but only for a maximum of two years. But tellingly, as the New England Journal of Medicine piece observes, “In both countries, the prices of these medications are roughly one third the prices in the United States.