Obesity as a Disease - Medication

Thanks for the reply Kalimah. i am not so worried about pancreatitis, as I believe the risk is mostly for people who are also taking the drugs for diabetes. It makes sense that where a drug is stimulating your pancreas to produce more insulin, and you have a pancreas that's already flat out trying to produce insulin, pancreatitis would be a concern. I believe in the trials that Novo Nordisk carried out, people who are taking the drugs for weight loss had no higher incidence of pancreatitis then the people who were on the placebo.

Not to go all tinfoil hat on it, but I'm aware that most of the trials are funded by the company that stands to make massive profits on this medication, so even the trial data I am taking with a pinch of salt. The trials only lasted just over a year. Perhaps that risk of pancreatitis might significantly rise after five years, I dunno. That said, I know that it is a fact that obesity is linked to all sorts of illnesses - 18 different cancers, heart disease, stroke - so I'm weighing the pros and cons of being on the medication, and staying how I am, and right now the medication route seems to be far less risky.

I am very wary of the side effects. I know that 10% of people who take Ozempic/Wegovy can't continue with it as the side effects are so debilitating. That seems to be the category your husband fell into, which is such a pity. I get that it is very likely I will get some side effects, I'm just hoping I fall into the 50% where the side effects are mild. I hate hate hate being nauseous or even less, throwing up. I was quite depressed on my pregnancies when I had morning sickness and have basically given up alcohol because I can't do the hangovers. At least now I'll be able to take motillium if I feel sick, which you can't do when you're pregnant. But I know if I get nausea for longer than a month or two, I won't be able to continue.

It depends on the diet. I did ones where I didn’t calorie count - WW, SW, Atkins. I tried a calorie deficit of 500 cals in combo with couch to 5k and kettlebells and did well on that until I got pregnant. I lost the most weight on a diet where I ate 1200-1400 cals a day along with a 1hour daily walk. But eventually the cravings kicked in which spiralled into food binges. I just have always craved sweet food and find it impossible to switch that craving off permanently.

I'd imagine he meant 1mg a week. 1mg a day would be far too high.

I wonder are the diabetic patients more likely to suffer from the side effects given they are already on other medications? I know from the threads I have read that virtually nobody gets away with no side effects - constipation and low level nausea are practically a given - but it does seem rare that people come off it because the side effects are too harsh. For the people in the UK taking it for weight loss (and honestly it seems like the wild west over there) the people who come off it are those who only intended to take it for three months and who got no results after the first six weeks or so. Honestly it looks like half of them do virtually no research before ordering the stuff through an online pharmacy - some of which don't even look for proof of your BMI!

I thought I'd have an appointment this week with the clinic I'm intending on going to but they don't have any appointments until mid-April. Which is fine. I'm quite an impulsive person at the best of times and I didn't want to lash into this program just because it was new and shiny. I'm going into this for the long haul and I'd like some more time to prep myself mentally for it.

Lots of posters have DM'd me regarding their views - for and against - some of whom have had experience taking the injections, some of whom are about to start like me. I might come back around to this in a couple of weeks and start a support thread, and hopefully a few more will be willing to share their experiences openly on the thread.

I do hope I won't have to hunt around different pharmacies for one that is willing to dispense ozempic for weight loss. There's a low level drip drip of humiliation when you are obese as it is, without a pharmacist basically saying you don't have a disease, you just have a moral failing.

@longtimelistener thanks so much for your post. It is indeed comforting to know of an experience that isn’t riddled with side effects!

I don’t really understand why Wegovy isn’t available here yet. It’s been available in the UK since last September, it’s been approved by the EMA and it’s listed as approved on the irishmedicines.ie website 🤷🏻‍♀️

Hi All

I went to a specialist GP last Monday week and got a prescription for Ozempic. I was away last weekend and go into the office at the start of the week so I didn’t want to start until I would be at home, just in case I was one of the small number that get side effects straight away.

I went to small pharmacy close to work but they had no supply. They were very nice and apologetic so I didn’t feel like they were being snippy about it or anything. They advised me to try an All Care and Hickeys pharmacy nearby as they are supplied by Uniphar, and I found stock at the Hickeys. The pharmacist there said that it was becoming easier to get stock in. It was €143 for the pen. The doctor tells me there are eight doses in the 0.25 pen, so I can either take a double dose in weeks five and six, or I can decide to titrate up a bit slower.

I was quite nervous taking it last night. I hate needles. So nervous that I decided to count clicks and only took half a dose. The GP said that it was ok to titrate up slower then the recommended doses if I was worried about side effects.

I don’t know what I was worried about. I injected into my tummy and I felt nothing! I would have thought it hadn’t worked if it wasn’t for the telltale pinprick hole.

This morning I woke up to my normal hunger, which isn’t surprising as I only took half the starting dose and for most people the change doesn’t kick in for weeks. But I found one slice of toast with peanut butter was enough for breakfast and I am here at 12 o’clock still not hungry. Maybe it’s just psychological but normally my stomach would be growling by now. So we’ll see.

I’m drinking loads of water, and am going to focus on fibre and protein in meals so hopefully I can ward off any nausea/gastro effects.

I’ll check in again next week.

I've listened to that podcast now - god it's brilliant. Johann Hari is a brilliant speaker and you can tell the depth of the research he's done for his book. It's a very interesting listen, and quite a fair one I think. It'd be a great suggestion to anyone who is thinking of starting taking semaglutide, in whatever form.

week 3 Day 3

2lbs off this week - so down from 205.4lbs to 197.8lbs. I’m ok with that.

The appetite suppression didn’t kick in until Sunday this week. I ate a McDonald’s chicken wrap on Saturday and then ate badly for the rest of the day, which resulted in a day long dose of the runs on Sunday. I knew it would be a possibility so I can’t really blame the medication.

I had three good days of not feeling too hungry and no food noise on Sunday - Tuesday. That also helped as we were away and the food choices weren’t that healthy and the portions massive. I mostly opted for two starters and no dessert. We were also cycling a lot so I’m hoping for a little muscle gain! I did feel the noise coming back on Wednesday evening, and definitely yesterday.

The injection is so easy now. I can nip to the bathroom and have it done in two minutes. I’ve had to order more needle tips as there’s eight 0.25 doses in the Ozempic starter pen but only four needles with the pack. I’ve decided to do 0.3 next week, 0.4 the week after and then 0.5. There’ll be a tiny bit left over but that’s fine.

I asked my doctor whether I could titrate upwards more slowly than the manufacturers recommended steps in order to avoid the side effects that appear to be more prevalent the week someone goes up a dosage. He said that was no problem - it’ll take me longer to get to the therapeutic dose and therefore my weight loss will be slower but if I was okay with that there was no reason not to go up slower.

It has the added benefit of the first pen being more affordable too, as it will last me seven weeks rather than six. If I find that 0.4 works well for the whole week, I may stick with that dose until it starts not to work (which may not happen).

Hi Snor. I got the Pip brand needles on Amazon.co.uk. I see that they are sold out now though. You just need to find 32g 4mm needles. Careful about using UK websites - most don't deliver to Ireland and if they do, you run the risk of having the needles stuck in customs for weeks. If you can't get anything on Amazon.co.uk, try the french or german Amazon websites.

I tried my local pharmacy but they are small and didn't have them. A larger Boots might.

week 5 Day 1

194.4lbs this morning, so 1.6lbs lost for an overall total of 11lbs in four weeks. The losses are small but steady, and it’ll all build up as the weeks go on.

I got my 0.5 pen yesterday even though I have today and next week’s shot left in the 0.25 pen. I was worried that I’d have trouble finding it but I got it in the same pharmacy, no problems.

Incidentally, I mentioned to the pharmacist that I might stay on the 0.5 dose as long as it continues to work for me. He was quite dismissive of that, saying “no, no, you should go up to the therapeutic dose next month, the doses you are on are only to get you used to the medicine”. I couldn’t really understand that. Firstly the therapeutic dose for weight loss is 2.4mg, which isn’t yet available in Ireland, so 1mg is not the therapeutic dose for me. Maybe he thought I was diabetic? I don’t know how, as if I was, I’d only be paying €80 through the drug payment scheme, instead of €143. 🤷🏻‍♀️ And anyway, the desired outcome from this medication is weight loss. If I’m getting that from a lower dose why would I take a higher one?

side effects wise, very minimal this week. I wasn’t cold or tired this week. My only slip up was at a bbq last Saturday, where the fattiness of the food led me to feel rotten all day Sunday. That seems to be the case with this medication- it’ll very rarely let you get away with a bad meal. Which in general is a good motivator to eat healthy but does lead you to being quite unsociable- unless you want to tell all and sundry that you are on Ozempic.

Ah I see. I didn’t realise that it was fully covered for diabetics.

Is there any drawbacks from staying on the starter dose if you’re continuing to lose weight? I’d be really interested to know. The max I can be prescribed at the moment is 1mg, but technically that is also a starter dose for people looking to treat obesity.

It's true that the trials showed that participants lost approximately 15% of their body weight at the 2.4mg dose. Those that stayed on the 1mg dose lost an average of 10% of their body weight. But obviously there is huge variation amongst individuals in how they react to each dose. Some people don't lose anything until they get to 1.7 or 2.4, some lose lots at the 0.25mg dose.

I absolutely see that, if I was having very minimal weight loss on the lower doses, I should be at 1mg after two months (and ideally at 2.4mg after four months, if that option was available here). But if I'm steadily losing at the 0.5mg dose, what is the downside of that? Side effects appear to increase as you titrate up through the doses, especially in the week or two after increasing your dose. I don't see the point of doing that if I continue to steadily lose on a lower dose. Of course, my body might get used to the lower dose and stop losing weight, in which case it makes perfect sense to titrate upwards. I just don't understand why you "have to" titrate upwards on the schedule that Novo Nordisk have recommended.

week 6 Day 1

194.0lbs this morning, so only 0.4lbs lost this week. I had some hormonal fluctuations over the weekend so I'm hoping for a bigger loss next week. That and I went out for a big meal (couldn't eat all of it) and had four cocktails on Friday. Anyway, it's downwards, which is all I care about.

No side effects at all this week, but no strong appetite suppression either. I had kept my pen in the fridge for the first three weeks, and then took it out when I went on holidays, and haven't put it back in. Now, Novo Nordisk say it can be kept open and out of the fridge for 56 days. That said, I wonder if it is a little less effective. Either that, or my policy of titrating upwards more slowly means I'm getting too used to the lower doses. I'll stick to my plan, do a 0.4ml dose today and then move up to the 0.5ml dose next week.

Hi Lenan. It was €142 for the 0.25 pen (which is lasting me 6.5 weeks) and same again for the 0.5 pen, which is waiting for me in the fridge. I don’t know about the 1.0 pen, I expect that’ll be 20/30 euro more? I think it can depend on the pharmacy.

Well here we are, Week 7 Day 1. 2.8lbs down this morning, which I’m very happy about. However I had more moderate side effects this week. Again, it was as a result of eating high fat food and overeating- popcorn at a movie and another barbecue on Saturday. I had sulphur burps and a stomach ache all Sunday and then woke at 4.30am with the dreaded D. It was really quite painful and kept me in the bathroom until 6am. So that was not fun.

id like to say lesson learned but until I get better at being assertive in social situations it probably won’t be.

Still, 191.4 this morning, with a stone gone. Onwards and downwards and hopefully to better choices.