7 ms·

Goodbye, Ozempic

32 points by Plasmoid 3y ago

acumenical 3y ago
There's always fasting, calisthenics, and avoiding PUFAs.
mindcrime 3y ago
An alternative / replacement without the side-effects would be huge. Since I started 1mg / week of Ozempic, the phrase "power vomiting" has become part of my vernacular where it never was before. Just last night I was overcome by a round of puking that rivals stuff you'd see in a horror movie. :-( It doesn't happen often (2 times this year so far) but when it's bad, it's BAD.
- deleted 3y ago
  [deleted]
- jdorfman 3y ago
  I’ve been debating whether to ask my doctor about trying it. My whole adult life I’ve been struggling with my weight and tried nutritionist, apps, you name it and can’t keep the weight off for more than a year. I hate vomiting so this is making me rethink. Thanks for sharing very helpful.
  - mindcrime 3y ago
    I don't want to overstate the case. Again, the cases of intense vomiting have been very infrequent and - perhaps more to the point - it's possible that I could avoid those with corresponding changes to my diet, whether it's content, timing, etc. That said, even on days when there's no outright vomiting, I do experience moderately frequent nausea, which is rather annoying. Since I am diabetic, I've chosen to simply accept the side effects as being acceptable in service of the "greater good". But yeah, consider talking to you doctor and just see what he/she has to say. Maybe a smaller dose could help you with your weight, while not leading to the nausea / vomiting / etc. I'll note that I didn't start getting that stuff until my doc upped my dose from .25mg / week to 1mg / week. YMMV.
  - mainedotpy 3y ago
    I personally take ozempic and have also prescribed it to ~150+ patients for diabetes. I've maybe had to stop it in ~8 patients for tolerability issues. We unfortunately usually dont get to hear many chiming in to say that they tolerated it just fine. I do (2mg/week), down 45lbs. Being heavy is really bad for you. Don't be so quick to write it off d/t the possibility of vomiting.
    - JediWing 3y ago
      I will step in to be the "it's not so bad" coming forward. I get stomach upset and a bit of reflux when I overeat, but that makes total sense given the goal of the medicine. Honestly the metformin I was prescribed at the same time as semaglutide makes me feel worse more consistently, and even that is tolerable. I say go for it OOP. It shouldn't cause any permanent damage trying it out.
      - mindcrime 3y ago
        I get stomach upset and a bit of reflux when I overeat, I suspect that the couple of cases of severe vomiting I had, may relate to either eating too much, or eating at the wrong time, or both. So I think that if I'm more careful in the future, I can avoid those occurrences. Overeating is definitely bad, since Ozempic - as I heard it described - "slows down the movement of food through your digestive system, which leads to a feeling of fullness". That effect apparently being part of how/why Ozempic leads to weight loss. But that also suggests that you have to be really careful about not eating too much or you might overload your system in a way that exacerbates the side effects. My subject feeling is also that timing is an issue: I think that eating late makes it more likely that the bad side effects will occur. I'm trying to shift to making lunch my largest meal of the day, and then eating a very light dinner, and preferably earlier than in past years. Time will tell if this theory is right or not, but it's where I'm leaning at the moment.
    - bilsbie 3y ago
      How long does the vomiting last if you have a bad reaction? More than a day?
  - TaylorAlexander 3y ago
    Of course everyone's struggle is personal. For me, I have been listening to the Maintenance Phase podcast, reading Aubrey Gordon's new book, and learning that a lot of what we hold as fact or "common sense" about weight loss is untrue, that individual bodies respond very differently to the same diet and exercise schedule, and that a lot of the ideas around fatness are rooted in a cultural anti-fatness that views fatness as a personal failing, rather than another parameter of the body like height or hair color. This has helped me learn to simply be happy with my size. Our bodies are not all meant to be skinny like the people we see on TV or instagram. There is a natural variance even for people with healthy diets and good exercise routines. I can't enumerate everything that Aubrey Gordon shares in her excellent book, but I can say that learning to accept myself has been far more rewarding than constantly trying to chase weight loss schemes that only leave me back where I started. I feel confident and sexy now without any weight loss, and this is leading more people to be very obviously more attracted to me (because confidence is sexy!). I realized I never needed to lose weight to be attractive, I needed to accept myself for who I am. I would urge anyone considering these treatments, whose lifelong effects we still do not understand, to learn about anti-fatness and how we have all been misled in to believing that everyone is supposed to be skinny. Here's a great article from Aubrey to get started: https://www.npr.org/2023/01/12/1148169767/anti-fatness-keeps-fat-people-on-the-margins-says-aubrey-gordon https://www.npr.org/2023/01/12/1148169767/anti-fatness-keeps... Finally I want to say that if anyone is just going to come in here and say being fat is unhealthy, or repeat any of the common tropes about weight loss, you're not going to get anywhere with me. The whole point of Aubrey's work is that these so-called common sense ideas are so deeply held in our society that few have really questioned them, and it takes more than a cursory examination to try to make sense of how we got here. Repeating the basic ideas does nothing to advance this conversation. If you must respond, read the article above before criticizing the basics of what I am saying. Aubrey can explain it far better than I can.
    - Georgelemental 3y ago
      > that these so-called common sense ideas are so deeply held in our society that few have really questioned them Yes, these issues have been studied and questioned. In traditional hunter-gatherer societies (people whose diet and lifestyle matches what humans evolved for), obesity is almost unheard of, as are diabetes and other metabolic diseases. But when these same hunter-gatherers adopt a modern lifestyle and diet, their rates of these diseases go way up. From this evidence, we can conclude that obesity is not a purely natural phenomenon, but caused in part by modern lifestyles.
  - mgarfias 3y ago
    I take 2mg ozempic, worst thing was starting (lower dose) and with any stomach upset, I get nasty sulphur smelling burps. It’s gross, but didn’t last.
- ed_elliott_asc 3y ago
  I’ve got a hiatus hernia (the oesophagus doesn’t shut so acid flows up) - I’ve been sick every night for years, since taking semaglutide I’ve stopped being sick every night so for me it is better and the opposite.
  - klipklop 3y ago
    Wow I have the same problem. Did it get better you think due to weight loss?
    - ed_elliott_asc 3y ago
      I don’t think so, it was almost immediate, probably to do with eating less
- kingofheroes 3y ago
  I, personally, have actually been having pretty good results with berberine (yes, yes, I know its a TikTok trend right now). Its really helped control my hunger and I haven't noticed any side effects.
  - Volundr 3y ago
    I've considered trying berberine just for the heck of it, but it seems like it reduces the diversity of the gut bacteria which makes me concerned that if it didn't work out well for me it wouldn't be a simple as stopping taking it.
rwmj 3y ago
This is a good, related opinion article: https://davidaaronovitch.substack.com/p/in-defence-of-ozempic https://davidaaronovitch.substack.com/p/in-defence-of-ozempi... In defence of Ozempic - Why the weight-sadists hate the new drug
- jdorfman 3y ago
  That was a great read thank you for sharing.
eggy 3y ago
We need to push lifestyle change to treat obesity - diet, exercise, sleep - vs. pharmaceuticals. Big pharma just keeps rolling out v2.0, 3.0, etc. for the customers they've built through advertising and having doctor's marketed to push them on their patients along with government lobbying. He'll, how many COVID boosters did Big Pharma try to push at $30bn a round going into their purses?
- eggy 3y ago
  Remember that obesity and its attendant maladies were the leading co-morbidity in COVID deaths, but that was conveniently memory-holed for fear of fat shaming. I read a post about the 14-year-old or close girl who died from COVID. The parents said she was healthy, and yet the photo portrayed an obviously obese teen. Nature and reality do not practice tolerance in these cases. Maybe some shame is not an absolutely bad thing.
  - pseudalopex 3y ago
    > Remember that obesity and its attendant maladies were the leading co-morbidity in COVID deaths, but that was conveniently memory-holed for fear of fat shaming. Obesity is not the most common or most severe risk factor for COVID death. And it was discussed much.
- kiba 3y ago
  If it works, it works. Don't be afraid of pharmaceuticals, but at the same time take advantage of lifestyle changes. If you're going to lose weight through appetite surpassing medicine, you will lose muscle mass along side with fat. If you're not careful, you might become fatter as you become more skinny, hence 'skinny fat'. Drugs are just tools like any other.
- jmbwell 3y ago
  I think any trustworthy physician is going to include diet, exercise, and other lifestyle changes as part of a comprehensive obesity treatment plan. Pharmaceuticals can be a valuable tool as well. A patient and their doctor are going to know more about the approaches that are right for them than anyone on some thread here.
gumby 3y ago
I’m delighted that there are all these new alternatives. Not only because I believe they will help people. But selfishly because I take .75 mg a week to help manage my glucose level and the weight loss users have made the drug hard to get (even though a dose as small as mine doesn’t help weight loss — in fact I’ve been gaining weight, something I have struggled to do). A couple of months go the drug stopped being back ordered and the pharmacy said they were prioritizing diabetics. Not sure how they can tell — perhaps my other prescriptions?
- ribosometronome 3y ago
  Presumably switching to de-prioritizing off-label prescriptions?
- mainedotpy 3y ago
  You sure thats Ozempic? Sounds like Trulicity based on the dose.
  - halostatue 3y ago
    I’m on a .25mg/week dose, so I wouldn’t discount the dosage report.
  - gumby 3y ago
    It is indeed a blue ozempic cylinder. There is one with selectable dosages for ramping up and acclimitizing and a 1.0 mg only for prolonged use, but I got good results before I got to 1.0, so went back down because why not take less. I believe the weight loss dosage of semaglutide is well over 2 mg.
876978095789789 3y ago
[flagged]
- ntonozzi 3y ago
  Insulin resistance causes weight gain, and insulin can cause insulin resistance right? It's complicated but not implausible.
notamy 3y ago
https://archive.is/oS7Su https://archive.is/oS7Su
solomonb 3y ago
From what I understand, Ozempic works by slowing down digestion and thus reducing appetite. If that is the case then wouldn't this be precisely evidence that caloric restriction is all you need to reduce obesity?
- notyourwork 3y ago
  I thought we already have had that evidence for a long time. Humans, including myself, have trouble self limiting when everything is accessible.
- jayroh 3y ago
  Yes, and … “Calories in” is half. “Calories out” (the amount you burn) is the other half. Having been on the “nothing but diet” train for long windows of my life I can confidently say that if you don’t pair the former and latter, you’ll end up in the yo-yo cycle. Over and over again. Took a long time for me to understand that and I STILL struggle.
  - solomonb 3y ago
    I don't understand. If one is gaining weight then that implies they consumed more calories then they 'burned' and aren't restricting calories enough. Exercise and training would increase your burn rate and allow you to do less caloric restriction but at the end of the day it comes down to eating less calories.

32 points by Plasmoid 3y ago

There's always fasting, calisthenics, and avoiding PUFAs.

An alternative / replacement without the side-effects would be huge. Since I started 1mg / week of Ozempic, the phrase "power vomiting" has become part of my vernacular where it never was before. Just last night I was overcome by a round of puking that rivals stuff you'd see in a horror movie. :-( It doesn't happen often (2 times this year so far) but when it's bad, it's BAD.

deleted 3y ago
[deleted]
jdorfman 3y ago
I’ve been debating whether to ask my doctor about trying it. My whole adult life I’ve been struggling with my weight and tried nutritionist, apps, you name it and can’t keep the weight off for more than a year. I hate vomiting so this is making me rethink. Thanks for sharing very helpful.
- mindcrime 3y ago
  I don't want to overstate the case. Again, the cases of intense vomiting have been very infrequent and - perhaps more to the point - it's possible that I could avoid those with corresponding changes to my diet, whether it's content, timing, etc. That said, even on days when there's no outright vomiting, I do experience moderately frequent nausea, which is rather annoying. Since I am diabetic, I've chosen to simply accept the side effects as being acceptable in service of the "greater good". But yeah, consider talking to you doctor and just see what he/she has to say. Maybe a smaller dose could help you with your weight, while not leading to the nausea / vomiting / etc. I'll note that I didn't start getting that stuff until my doc upped my dose from .25mg / week to 1mg / week. YMMV.
- mainedotpy 3y ago
  I personally take ozempic and have also prescribed it to ~150+ patients for diabetes. I've maybe had to stop it in ~8 patients for tolerability issues. We unfortunately usually dont get to hear many chiming in to say that they tolerated it just fine. I do (2mg/week), down 45lbs. Being heavy is really bad for you. Don't be so quick to write it off d/t the possibility of vomiting.
  - JediWing 3y ago
    I will step in to be the "it's not so bad" coming forward. I get stomach upset and a bit of reflux when I overeat, but that makes total sense given the goal of the medicine. Honestly the metformin I was prescribed at the same time as semaglutide makes me feel worse more consistently, and even that is tolerable. I say go for it OOP. It shouldn't cause any permanent damage trying it out.
    - mindcrime 3y ago
      I get stomach upset and a bit of reflux when I overeat, I suspect that the couple of cases of severe vomiting I had, may relate to either eating too much, or eating at the wrong time, or both. So I think that if I'm more careful in the future, I can avoid those occurrences. Overeating is definitely bad, since Ozempic - as I heard it described - "slows down the movement of food through your digestive system, which leads to a feeling of fullness". That effect apparently being part of how/why Ozempic leads to weight loss. But that also suggests that you have to be really careful about not eating too much or you might overload your system in a way that exacerbates the side effects. My subject feeling is also that timing is an issue: I think that eating late makes it more likely that the bad side effects will occur. I'm trying to shift to making lunch my largest meal of the day, and then eating a very light dinner, and preferably earlier than in past years. Time will tell if this theory is right or not, but it's where I'm leaning at the moment.
  - bilsbie 3y ago
    How long does the vomiting last if you have a bad reaction? More than a day?
- TaylorAlexander 3y ago
  Of course everyone's struggle is personal. For me, I have been listening to the Maintenance Phase podcast, reading Aubrey Gordon's new book, and learning that a lot of what we hold as fact or "common sense" about weight loss is untrue, that individual bodies respond very differently to the same diet and exercise schedule, and that a lot of the ideas around fatness are rooted in a cultural anti-fatness that views fatness as a personal failing, rather than another parameter of the body like height or hair color. This has helped me learn to simply be happy with my size. Our bodies are not all meant to be skinny like the people we see on TV or instagram. There is a natural variance even for people with healthy diets and good exercise routines. I can't enumerate everything that Aubrey Gordon shares in her excellent book, but I can say that learning to accept myself has been far more rewarding than constantly trying to chase weight loss schemes that only leave me back where I started. I feel confident and sexy now without any weight loss, and this is leading more people to be very obviously more attracted to me (because confidence is sexy!). I realized I never needed to lose weight to be attractive, I needed to accept myself for who I am. I would urge anyone considering these treatments, whose lifelong effects we still do not understand, to learn about anti-fatness and how we have all been misled in to believing that everyone is supposed to be skinny. Here's a great article from Aubrey to get started: https://www.npr.org/2023/01/12/1148169767/anti-fatness-keeps-fat-people-on-the-margins-says-aubrey-gordon https://www.npr.org/2023/01/12/1148169767/anti-fatness-keeps... Finally I want to say that if anyone is just going to come in here and say being fat is unhealthy, or repeat any of the common tropes about weight loss, you're not going to get anywhere with me. The whole point of Aubrey's work is that these so-called common sense ideas are so deeply held in our society that few have really questioned them, and it takes more than a cursory examination to try to make sense of how we got here. Repeating the basic ideas does nothing to advance this conversation. If you must respond, read the article above before criticizing the basics of what I am saying. Aubrey can explain it far better than I can.
  - Georgelemental 3y ago
    > that these so-called common sense ideas are so deeply held in our society that few have really questioned them Yes, these issues have been studied and questioned. In traditional hunter-gatherer societies (people whose diet and lifestyle matches what humans evolved for), obesity is almost unheard of, as are diabetes and other metabolic diseases. But when these same hunter-gatherers adopt a modern lifestyle and diet, their rates of these diseases go way up. From this evidence, we can conclude that obesity is not a purely natural phenomenon, but caused in part by modern lifestyles.
- mgarfias 3y ago
  I take 2mg ozempic, worst thing was starting (lower dose) and with any stomach upset, I get nasty sulphur smelling burps. It’s gross, but didn’t last.
ed_elliott_asc 3y ago
I’ve got a hiatus hernia (the oesophagus doesn’t shut so acid flows up) - I’ve been sick every night for years, since taking semaglutide I’ve stopped being sick every night so for me it is better and the opposite.
- klipklop 3y ago
  Wow I have the same problem. Did it get better you think due to weight loss?
  - ed_elliott_asc 3y ago
    I don’t think so, it was almost immediate, probably to do with eating less
kingofheroes 3y ago
I, personally, have actually been having pretty good results with berberine (yes, yes, I know its a TikTok trend right now). Its really helped control my hunger and I haven't noticed any side effects.
- Volundr 3y ago
  I've considered trying berberine just for the heck of it, but it seems like it reduces the diversity of the gut bacteria which makes me concerned that if it didn't work out well for me it wouldn't be a simple as stopping taking it.

rwmj 3y ago

This is a good, related opinion article: https://davidaaronovitch.substack.com/p/in-defence-of-ozempic https://davidaaronovitch.substack.com/p/in-defence-of-ozempi... In defence of Ozempic - Why the weight-sadists hate the new drug

jdorfman 3y ago
That was a great read thank you for sharing.

eggy 3y ago

We need to push lifestyle change to treat obesity - diet, exercise, sleep - vs. pharmaceuticals. Big pharma just keeps rolling out v2.0, 3.0, etc. for the customers they've built through advertising and having doctor's marketed to push them on their patients along with government lobbying. He'll, how many COVID boosters did Big Pharma try to push at $30bn a round going into their purses?

eggy 3y ago
Remember that obesity and its attendant maladies were the leading co-morbidity in COVID deaths, but that was conveniently memory-holed for fear of fat shaming. I read a post about the 14-year-old or close girl who died from COVID. The parents said she was healthy, and yet the photo portrayed an obviously obese teen. Nature and reality do not practice tolerance in these cases. Maybe some shame is not an absolutely bad thing.
- pseudalopex 3y ago
  > Remember that obesity and its attendant maladies were the leading co-morbidity in COVID deaths, but that was conveniently memory-holed for fear of fat shaming. Obesity is not the most common or most severe risk factor for COVID death. And it was discussed much.
kiba 3y ago
If it works, it works. Don't be afraid of pharmaceuticals, but at the same time take advantage of lifestyle changes. If you're going to lose weight through appetite surpassing medicine, you will lose muscle mass along side with fat. If you're not careful, you might become fatter as you become more skinny, hence 'skinny fat'. Drugs are just tools like any other.
jmbwell 3y ago
I think any trustworthy physician is going to include diet, exercise, and other lifestyle changes as part of a comprehensive obesity treatment plan. Pharmaceuticals can be a valuable tool as well. A patient and their doctor are going to know more about the approaches that are right for them than anyone on some thread here.

gumby 3y ago

I’m delighted that there are all these new alternatives. Not only because I believe they will help people. But selfishly because I take .75 mg a week to help manage my glucose level and the weight loss users have made the drug hard to get (even though a dose as small as mine doesn’t help weight loss — in fact I’ve been gaining weight, something I have struggled to do). A couple of months go the drug stopped being back ordered and the pharmacy said they were prioritizing diabetics. Not sure how they can tell — perhaps my other prescriptions?

ribosometronome 3y ago
Presumably switching to de-prioritizing off-label prescriptions?
mainedotpy 3y ago
You sure thats Ozempic? Sounds like Trulicity based on the dose.
- halostatue 3y ago
  I’m on a .25mg/week dose, so I wouldn’t discount the dosage report.
- gumby 3y ago
  It is indeed a blue ozempic cylinder. There is one with selectable dosages for ramping up and acclimitizing and a 1.0 mg only for prolonged use, but I got good results before I got to 1.0, so went back down because why not take less. I believe the weight loss dosage of semaglutide is well over 2 mg.

876978095789789 3y ago

[flagged]

ntonozzi 3y ago
Insulin resistance causes weight gain, and insulin can cause insulin resistance right? It's complicated but not implausible.

notamy 3y ago

https://archive.is/oS7Su https://archive.is/oS7Su

solomonb 3y ago

From what I understand, Ozempic works by slowing down digestion and thus reducing appetite. If that is the case then wouldn't this be precisely evidence that caloric restriction is all you need to reduce obesity?

notyourwork 3y ago
I thought we already have had that evidence for a long time. Humans, including myself, have trouble self limiting when everything is accessible.
jayroh 3y ago
Yes, and … “Calories in” is half. “Calories out” (the amount you burn) is the other half. Having been on the “nothing but diet” train for long windows of my life I can confidently say that if you don’t pair the former and latter, you’ll end up in the yo-yo cycle. Over and over again. Took a long time for me to understand that and I STILL struggle.
- solomonb 3y ago
  I don't understand. If one is gaining weight then that implies they consumed more calories then they 'burned' and aren't restricting calories enough. Exercise and training would increase your burn rate and allow you to do less caloric restriction but at the end of the day it comes down to eating less calories.