Obesity as a Disease - Medication

There’s a lot of info online. Various reasons for people to want to know how to do it.

It’s subcutaneous injection so pretty simple.

I'm on week two on 0.25. I found on the first week by day 6 after injection my appetite was fully back. I assume that will change as I go up through the doses.

I was out yesterday and had a few pints, nothing crazy. I ended up getting some chipper food afterwards. Even though I wasn't hungry, I knew I'd better eat something. By christ did I pay for it today. Spent the whole morning vomiting. Couldn't tolerate even a glass of water until the afternoon. Lesson learned. Will be knocking the booze and greasy food on the head for the foreseeable.

Well done on your progress.

You're obviously getting great results and the lifestyle adjustments are coming through as well. You seem to be very thoughtful in your approach and are getting the results.

The great thing is you are losing and finding ways to minimise the side effects. If 0.4 or 0.5 or whatever is the correct level for you then it is.

Again, well done and keep up the good work, and the progress reports!!

I'm glad you are doing good, I didn't realise it was prescribed by GPs to non diabetics, public or privately o

Why should it only be prescribed to diabetics? Silly attitude imo.

If OP has paid for the medication, it is there property and they are entitled to use it.

Who would be prescribing it if not their doctor.

Because it is only approved for the treatment of diabetes

I personally have no issue with non-diabetics being prescribed or using a drug licensed for diabetes off label, when supplies are plentiful. Have at it.

But when supply is very limited (as it has been), then I do think that pharmacies are correct to prioritise supplies for patients with a condition the drug is actually licensed for.

Just for info - since you enjoyed the previous podcast - another informative and relatively deep discussion about the drug came out today on the Andrew Hubermann podcast. The discussion is with one Dr. Zachary Knight under the title "The science of hunger".

Hilarious that you say I should educate myself, and then follow up with that ignorant nonsense.

Semaglutide was designed as a longer acting GLP-1 receptor agonist. That's exactly the pathway that aids weight loss, there were existing GLP-1 weight loss drugs at the time. This is not some shocking side effect, where people taking risks with unknown consequences. It's was literally be designed, tested and approved as both an anti-diabetic and an anti-obesity medication used.

Phase 3 testing for weight loss took place in 2021. https://www.nejm.org/doi/10.1056/NEJMoa2032183

Taking a medicine that is tested and licensed for weight loss, prescribed by a medical professional is not being a test dummy. It's literally taking tested and approved medicine, that due to the brand name is considered off label.

not just a brand name. a very different dose as well. Ozempic is only licenced for diabetes treatment in ireland.

According to my endocrinologist 1mg is not the optimum dose for diabetics, and has told me the max dosage they can prescribe will be increased, they're just waiting on whatever permissions are required.

So a supply issue does still exist.

A pharmacist is more than qualified to make that decision. that IS their qualification.

they are not obliged to fulfill any prescription. i'm sure there are some that wont fill a prescription for the pill. as for somebody coming in with a prescription for multiple ozempic pens, if they have to decide between filling that prescription or filling ozempic prescriptions for diabetic patients then I hope they would decide on the latter.

I think this is a really good thread and credit to you for it.

However I have to disagree with your characterisation of diabetics with type 2 as due to obesity .

Yes , a large proportion of diabetics are overweight hence the emphasis on weight loss to try to improve health and control blood sugar .

But it is not as simple as that .

It is a fact that many diabetics gain weight precisely because of their inability to metabolise sugars and carbs and not the other way round .

I am lucky enough to be one of the skinny type 2 Diabetics as are my siblings and our disease is 100% genetic . ( Father ,grandparent )

I had gestational diabetes on three pregnancies requiring insulin .

Before I was diagnosed I gained weight over the course of a year just a couple of stone but uncharacteristic for me , felt very unwell and tired and craved carbs .

I had always been slim , a healthy eater and physically active .Walking swimming cycling and worked in an active job .

The diagnosis coincided with an inflammatory illness which the doctors think triggered my diabetes . which caused the weight gain

That weight fell off quickly as soon as my blood sugars came under control but I felt unwell for a good few months after that until I got a handle on my diet and other complications .

I still do whenever I get an infection which diabetics are more susceptible to or if I have any strain which triggers inflammation and high sugars . But that is daily life for most diabetics .

I am on other meds , not on Ozempic but do agree that it should be widely available to those with high BMI over 30 if at all possible .

But I can totally understand why its use presently is restricted to those with Diabetes who don't respond to other medications .

Diabetics , even without high blood sugars can have a cascade of progressive illness (cardiac ,kidneys, nervous system, feet , eyes , high blood pressure and high cholesterol ) all of which are exacerbated by their diabetes which is a chronic inflammatory condition .

Every effort has to be made to prevent all the other co-morbidities from developing .

Obese people suffer some of these co- morbidities as well , but with all due respect it is incorrect to say it is the same as being a diabetic .It is not .

If you are obese AND diabetic your risk factor is multiples for all the co morbidities mentioned above over a person who is just obese .

On the Ozempic and it's side effects I have no issue with this discussion

But it's not suitable to discuss a serious chronic and progressive illness as if it was just a matter of t2 diabetics " eating healthily and reversing it ". Once a diabetic , always diabetic whether under control or not .

I am not sure if you meant to minimise Diabetes , but that is how it comes across ...

I hope that Wegovy which has been recommended for treatment of obesity will soon be available in Ireland for those who want it .

The more medication available so there is not such competition between those who would LIKE a medication to help them loose weight , impacting on the requirements of those who actually medically NEED it .

I'm aware. But as above, it's a brand name. Semaglutide is the drug and is available so doctors are perscribing.
The claims that is reckless, untested, test dummy stuff is simply not true.

Incorrect again. Semaglutide is approved in a range of doses for each. Each person is prescribed the appropriate dose for their treatment - which is the case for all medication.
Starting does for both are the same.

Semaglutide is licensed for both obesity and diabetes. The fact they are labelled separately is irrelevant medically. Besides, obesity treatment is the higher dose. So the claims that ozempic is unsafe to treat obesity is totally baseless.

The claims that is reckless, untested, test dummy stuff is simply not true.

So the claims that ozempic is unsafe to treat obesity is totally baseless.

Please quote the post where I made any of those claims. Please don't attribute another poster's words to me.

My only issue is about supplies, and it is my unchanged view that where there are limited supplies, the treatment of diabetes takes priority.

See the excellent post from @Goldengirl who put it better than I did. Also note the point made that Ozempic is often prescribed to diabetics who have stopped responding to other diabetes medications.

Contrary to what is posted above, there are still supply issues. If you would like to check out the living with diabetes threads, you will see recent posts from diabetics about difficulties in supplies as recently as this month.

If a patient has a prescription for say 1mg semaglutide, there are no valid grounds to refuse it.

If they have a diabetic patient that requires it then that is a valid ground to refuse.

they are got qualified to appraise a GP or other doctor's treatment that is medically approved

that is just plain incorrect.

You attributed it to me by specifically quoting one of my posts, and then responding to it in a way that made it look to anyone reading like it was I who made those claims.

Please do not do that again.