Obesity as a Disease - Medication

LastApacheInjun

TL;DR - Anyone on Ozempic/Wegovy or Mounjaro? Is it worth it?

Hi everyone

I'm going anonymous for this one as I have not totally made up my mind about what I am going to do here.

I am 47, and have been putting on weight since I was 25. I am now in the obese category on BMI.

Like many women of my age, I have also dieted on and off for the entirety of those 22 years. I have lost a stone, sometimes two, though healthy eating and exercise, but it never lasts for more than three months (mostly less). I find that - in comparison to my teenage years and my twenties, I am hungry all day long. I'm just exhausted of not only feeling like less of a person, I am exhausted by how much space food takes up in my mind, and how I have such low self esteem and self worth every time I think about my failed attempts to lose weight. I think I am a very capable person - I have a well paid career, H have raised three kids, I have done a lot of hard things. Why can't I control the amount of food I'm eating?

I had this conversation with a family member a while back, just when I was at the start of another healthy eating campaign that I was convinced was going to work this time. Her husband is an obesity and diabetes specialist, and she mentioned that - more than likely - I had an imbalance of the hunger/full hormones, would probably really benefit from medication, and it was unlikely any healthy eating program was going to work for me long term. At Sthe time I was pretty offended, like she didn't believe I had the focus or willpower to lose the weight, and I thought that would spur me on to prove her wrong. It did, for a while, until it didn't. I remember her saying "when you're ready, come and talk to me".

So I'm ready, and I have an appointment next week with another doctor in her husband's clinic. I've done loads of research on the medication available here, including reading about the trials. I have tried to listen to podcasts both advocating for, and against, these medications. I have followed threads on UK forums of the experiences of those taking the medication, but I can't see anything online here that sets out the Irish experience. So I have a number of questions:

1. Are you currently being prescribed Wegovy (i.e. Ozempic but for weight loss)? What has been your experience? Any side effects? Any shortages?
2. I'm particularly nervous of needles. I don't know how I'll get over the idea of injecting myself. How painful is it?
3. Does anyone know if Mounjaro is available to be prescribed in Ireland for weight loss, rather than just for diabetes? I know it was recently approved in the UK, and it seems to have less side effects and be more effective then Wegovy. I can see that it's approved on the Irishmedicines.ie website, but not what it has been approved for.
4. Can anyone confirm the cost of Wegovy (and Mounjaro if available) here? What is the cost when it moves up to the theraputic dose? Presumably that's a good bit more since it's 10 times the starting dose (Wegovy) or four times the starting dose (Mounjaro).
5. I understand that it is likely I will have to take this medicine for the rest of my life. I listened to a UK podcast, and they mentioned that semaglutide is coming off patent in two years. I know that Novo Nordisk are - unsurprisingly - trying to extend the patents in various jurisdictions, but I doubt they'll be successful. Can anyone shed more light on the patent situation? If there's generic manufacturers lining up then the price surely will come way down?

I'm going to ask all these questions of my doctor next week. I just really want to be fully informed before I make a final decision.

Kalimah

Hi, Just a couple of observations from my point of view. My husband was prescribed Trulicity ( Dulaglutide) for type 2 diabetes. It's similar in to Ozempic in that weight loss is a side affect of controlling the diabetes. He was on it for a month - the side affects were horrendous, constant nausea, diarrhea, fatigue, apathy. The diarrhea could come on with literally a ten second warning. I looked up a couple of websites to see if others had similar experiences - Diabetes UK was the main one. Virtually everyone reported awful side affects. Many people couldn't cope with them so gave up on the drug. Pancreatitis has been reported as a risk while on the drug and that's something you definitely don't want to get.

Injecting wasn't an issue - it's a tiny needle and it doesn't go in that far. The cost for us was nothing as it's on the Long Term Illness scheme - I think I have heard €300 quoted as a monthly price - though I stand to be corrected.

I feel for you with the weight - since menopause I have put on about two stones which has proved impossible to shift without a daily calorie intake of 1200 and an hour walking every day. I did that for a couple of months and lost a stone. Put it back on again. I'm concerned now about my heart health and cholesterol so I'm trying to get into more healthy habits. The weather doesn't help and nor does a sedentary 9 to 5 job!

Best of luck😉

LastApacheInjun

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.

Ezeoul

I am on Ozempic for diabetes T2. I've been on it for about two years now but I honestly think the massive weight loss is over exaggerated.

I've maybe lost 20 pounds in that time.

Another factor is the availability of it.

It's now extremely hard to get in this country with even type 2 diabetics not being able to source it regularly every month. I haven't had it now for six weeks because my pharmacist cannot get it.

Any supplies he does get he keeps prioritised strictly for his diabetic customers.

HeidiHeidi

Sent you a DM

LastApacheInjun

Hi Ezeoul

i certainly don’t want to take away supply from someone who’s already on it and relies on it to control their health- whether that be diabetes or obesity. My family friend had assured me that supply had stabilised since Christmas but clearly that’s not the case?

im a little confused by the pharmacy comment though. I had thought that the pharma company would package up the semaglutide into ozempic pens for diabetics, and Wegovy pens for obese patients. Can the pharmacist give you either one interchangeably?

As to your weight loss I suppose 20lb might be a lot or a little depending on how much you had to lose? I assume you are on the diabetic therapeutic dose of 1mg? Most people have limited weight loss at that level. The therapeutic dose for weight loss is 2.4mg.

Ezeoul

https://www.boards.ie/discussion/comment/121898799#Comment_121898799

I am on the 1mg dosage for diabetics, as far as I knew, 2.4mg was not licensed here yet but maybe that has changed. The main objective for me is blood glucose control, not weight or weight loss. I didn't need to lose weight.

I can't speak for your friend, but twice since Christmas I have actually missed doses due to supply issues. There have been supply issues before, but I've never actually missed doses before, so from my perspective supply has worsened.

My pharmacist has only ever supplied me with Ozempic.

ohnonotgmail

Just to chime in with my own experience with Ozempic. On it since July 2022 for T2. The first few months were horrendous. Properly miserable. really bad nausea every day. no throwing up though. Not sure if that was better or worse. I started off at 110Kg and I am now just under 80Kg. 6'2" male. the weight loss has levelled off in the last few months. I did have some availability issues last year but this year has been better. I think I have missed 2 weekly doses in total. I did have to switch pharmacy last year as they were just useless. No communication at all. my current pharmacy are much better. I wouldn't be terribly keen on injections either but the needles are only 5mm and less than an half an inch long so they haven't been an issue.

FrStone

You will be prescribed Ozempic. Wegovy and Mounjaro are not available in the Republic.

It works a dream to be honest. It costs circa 165 a month for the Ozempic.

Also, ignore anyone on about taking a drug away from diabetics. Similar to obesity, type 2 diabetes can be reversed by good diet. There are also plenty of other drugs available to type 2 diabetics. Obesity and diabetes are both chronic diseases. Neither deserves to be treated over the other.

Alexus25

One question OP, how many calories do you go on when you go on a diet?

LastApacheInjun

https://www.boards.ie/discussion/comment/121910555#Comment_121910555

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.

Photobox

https://www.boards.ie/discussion/comment/121896703#Comment_121896703

Same here with menopause, issues with weight gain. Up a stone since last year, despite eating the same as I always do and brisk walking for 40 minutes every day. It has completely thrown me tbh.. starting cutting down my portions a few weeks ago and has made no difference.

Ezeoul

https://www.boards.ie/discussion/comment/121910500#Comment_121910500

It's not diabetics who are prioritising Ozempic supplies for themselves. They have no say or control over who gets it.

For now, my pharmacist will only dispense it to diabetic patients. I can give you his email address if you wish to complain on behalf of anyone else.

And while there may be other drugs available for diabetes, many diabetics need to take a combination of medications to manage the condition, and are not just taking a single drug. It's a progressive condition that is a lot more complex than just pop a daily pill, or take a single injection, with blood tests every six months and review of medications to ensure the condition is under control / staying under control.

Alexus25

https://www.boards.ie/discussion/comment/121914172#Comment_121914172

It's just it took me 20 years to finally learn beyond a cognitive level that low calorie diets just set you up to fail. Its just far too low for your body and brain to sustain and you end up piling back on the pounds, and with extreme low calorie diets, you lose sufficient muscle too, sadly I know from experience.

Highly recommend you read this study too, it's fascinating and so true

https://maze.wp.st-andrews.ac.uk/2021/05/04/the-minnesota-starvation-experiment-how-it-happened-and-what-it-taught-us/

I'm now on 1700kcals a day and doing the coach to 5k atm, and have lost almost half a stone in 2 weeks, I'm now 'normal' weight but if I lost just over a stone in less than a year I'd be delighted, but well see, 1700 calories is much more manageable than 1200 and you don't feel starving or as preoccupied with food. As Einstein allegedly say - Insanity is doing the same thing over and over again and expecting different results.

I crave sweet food too, and still have it, I just try where I can to switch to the fibre one and skinny bars as they have fibre in them which compared to a standard chocolate bar, makes you feel fuller for longer and is lower in calories

Anyway,the very best of luck on your journey

farmerval

I'm a T2 diabetic, I was on Ozempic, I couldn't continue, the side effects were too much, a combination of constipation and diarrhoea.

I am going for scopes next week to be sure that nothing more serious is in the cause. I am off all diabetic medication for 6 weeks, trying to sort my gastric issues out. Currently my Blood Sugar is up 50% from when I was on meds. Obviously I cannot continue without meds but also could not continue as I was.

The bottom line here is that many people cannot take the side effects of Ozempic at 1 mg per day, most likely at 2.4mg's for obesity even less people will be able to take it.

OP if you go ahead, do so with your eyes open, you can only try and see how you react. Google Anton Savage with Donal O Shea (HSE Obesity Expert) on Newstalk on this subject. It was well discussed there.

Ezeoul

https://www.boards.ie/discussion/comment/121915198#Comment_121915198

Were you taking 1mg per day ?!?

I am on 1mg per week !

LastApacheInjun

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.

farmerval

https://www.boards.ie/discussion/comment/121915211#Comment_121915211

1mg per week. I was also on Metfornin. I would be constipated for a couple of days with lots of burping, reflux, etc. followed by extremely sudden diarrhea.

The above was difficult, the overall worst piece was tiredness and complete lack of energy.

Overall, everyone reacts differently to medication. A friend of mine has been extremely successful on a very low carb diet, while I have had no success on it. Different folks and strokes, and ultimately, you'll only know if you go.

I think this is the link to the Newstalk segment which is well worth listening to regarding Ozempic. Very interesting that they were stating that Ozempic is a very safe medication and also recognising that diet and exercise are not always enough. https://www.newstalk.com/podcasts/the-anton-savage-show/what-is-behind-the-growing-popularity-of-ozempic

Ezeoul

Got call from my pharmacist today that he got some Ozempic in stock and I could come and collect.

He told me he got enough for six patients, though he has 25 more diabetics on his waiting list.

He said all pharmacys are prioritising this way, but he could mean all in the chain he works for.

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.

I think that is kind of unfair and I really don't think they are making any moral judgements.

Ozempic is still primarily licensed as a diabetes drug in Ireland, thought it can be prescribed "off-label" for weight loss.

longtimelistener

Hi @LastApacheInjun, I spotted this thread and said I'd offer my 2 cents. I'm a woman in her late 30s, and my weight crept up since I hit my 30s. I was always a little plump, but by the end of 2022, I was about 84 kg (a bit over 13 stone) at 5'5/165cm. My BMI hit 30/31. Like you, I had had success with diets but never kept the weight off.

I heard about Ozempic around Christmas 2022 and I went to my doctor in early January to discuss whether it might suit me. She was happy to prescribe, and I commenced in late January 2023. I lost a couple of kilos under my own steam prior to starting, so my starting weight was 81kg.

Like you, I read a lot online about side effects, and freaked the hell out of myself! I took a few tips from the internet: People advised that nausea was less likely when you inject your thigh, rather than your belly, so I did that. They advised injecting at night so you could sleep through the post-injection phase, so I did that. They recommended an isotonic drink in the mornings, like a soluble multivitamin thing, so I did that too. I think they recommended it have magnesium in it for nausea, but I can't remember now. I know I got them in Holland & Barrett. I kept peppermint tea and ginger tea on hand in case I needed it.

I had basically zero side effects! No nausea, no stomach pains, no diarrhoea. I did get constipated, but that's because my food intake went down massively. I eat a yoghurt for breakfast with 10-15g of chia seeds in it and that typically does the job. If I need to, I take psyllium husk tablets too. I just try to be mindful of getting enough fibre and everything is fine.

I stayed on Ozempic until July 2023, when supply became too big of an issue and all pharmacies started gatekeeping dispensing. I felt like a criminal trying to get it! So my GP switched me to Saxenda. It's way more expensive (€250 vs €150 per month) and a daily injection, so while it's fine, I'm desperately awaiting the day Wegovy becomes available here.

For your reference, by the time I switched to Saxenda, I'd gone from 81kg to about 68kg (~10 stone 9 lbs). I never did anything that felt like I'd changed my lifestyle unsustainably - I didn't start exercising madly or give up alcohol. I lived just as I previously had, but I naturally ate much less and basically never wanted to snack, which had always been my downfall.

When I switched to Saxenda, I titrated my dose up very slowly due to cost. I eventually settled on a 1.8mg dose for maintenance, rather than the full 3mg. I still lost another 5 kgs between July 2023 and Feb 2024. I've stayed put at about 63kg (~9 stone 13 lbs) since then, which was my goal weight. I might fluctuate up or down 1kg but nothing major. I want to say Saxenda is less effective, but I feel that's an unfair statement as I don't take the full dose. I do snack more on it and feel more hunger than on Ozempic, but again, that's my choice due to the cost savings of staying on a lower dose. Also, I moved to injecting in the morning, into my belly, with Saxenda and have no side effects at all, even though my doctor warned the risk of side effects was higher with Saxenda than Ozempic.

These drugs honestly were life changing for me and I wouldn't change them for the world. The piece of mind of maintaining a healthy weight outweighs the financial cost, massively. I'm lucky that I can afford it, and I'm aware that's not true for everyone though.

I'm commenting because the natural tendency is for people to complain/report online when something didn't agree with them, but if everything was fine, you don't tend to share it, so I wanted to provide a bit of balance on this thread, both for you and everyone else who might read it.

Ozempic is a nightmare to get, still, but I'm told it shouldn't be too long until Wegovy is available, and that's specifically for weight so it'll solve the issue of the drug only being available for type 2 diabetes.

LastApacheInjun

@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 🤷🏻‍♀️

farmerval

https://www.boards.ie/discussion/comment/121936535#Comment_121936535

Well done Injun, you approached it really well and are succeeding. Congratulations. Everyone that this approach works for is another success. I've lurked around this forum for years and the one thing I can say for certain is that there are many ways to control/manage weight, but finding the one that works for you is the key.

LastApacheInjun

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.

LastApacheInjun

Day four here.

I ended up taking the second half of my injection on Thursday night. Thursday and Friday I didn’t feel much change in my appetite. I forgoed my usual pizza on Friday and opted for chicken strips which I ate with salad. More out of force of habit than hunger i decided I’d have a small bowl of ice cream thinking “well maybe it won’t kick in for me for a week or two”. About five minutes later a wave of nausea came over me. Not pleasant but I thought “okay, if I feel sick then definitely my digestion is slowing down”. I paced the room for a bit, drank some water and the nausea mostly disappeared.

The last two days have been, honestly, a revelation. I’m eating smaller portions of healthier meals, and don’t feel the raging hunger in between. I look at crisps and chocolate and am sort of… agnostic about them? I have never ever experienced this. If this is what slim people feel all the time then no wonder they just say “cut down on the snacks and eat smaller portions”. It’s easy if you feel like this. It sort of makes me feel sad, and angry that all these years I thought it was just a moral failing on my part that I couldn’t stop eating between meals.

Some thing I am doing to minimise side effects are:

• drinking an electrolyte drink first thing
• Loads of water during the day
• Checking my protein and fibre through MyFitnessPal
• taking a teaspoon of psyllium husks with water
• Drinking peppermint tea

I also intend to titrate up slowly - 0.25 next week, then two weeks of 0.3 and two weeks of 0.4. That way I hope to avoid the increase in side effects that seems to happen when you move up from one pen to another.

I had a sneaky weigh in this morning- 4lb down! Now, this doesn’t count as it’s mostly water but it is still encouraging.

taxAHcruel

I have not listened to it yet but I see the latest episode of Diary of a CEO podcast is a 2.5 hour discussion about Ozempic. So thought I would mention it for anyone here following that kind of thing.

Think it is looking at the negative and cautious sides of it. So it might be at least somewhat interesting to listen to. It's not a drug I know about or care about so I have no opinions on it myself but it will be interesting to listen to the podcast on my next run all the same.

The only thing going around my martial arts gyms and other mats about it - is that you should really focus on resistance training and muscle training in general while on Ozempic to stem the issue of losing muscle mass as you lose body weight. But that is what we would also say about any attempts to lose weight quickly. Some people think Ozempic is causing that while others thing it's just that you are seeing normal diet effects but just a bit accelerated. So Ozempic is not causing it so much as just making normal things happen faster.

I assume a focus on building muscle mass will be mentioned in the podcast too. I can report back again after I listen to it, if anyone is interested and has not got 2.5 hours to invest themselves.

LastApacheInjun

That’s a really good point TaxAHcreul. I’ve signed up to a weights class at work, which doesn’t start until the end of May. If I am going to titrate downwards at some point I’ll need to have a good bit more muscle mass than I do now, so that my metabolism can cope with the increased calorie intake. That and I know it so important for women to do weight training as they head into menopause.

LastApacheInjun

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.

LastApacheInjun

Week 2 Day 4

I haven’t found the injection to be as effective this week. The food noise was back on Monday, Tuesday and Wednesday weren’t too bad, but it had definitely all worn off by Thursday and I’ve found myself snacking a lot over the past two days. No nausea, no side effects (apart from feeling a bit cold and sleepy yesterday).

5.5lbs off in the first week, which is decent considering I really only had three days where I felt a real difference in my appetite.

I’m off on holidays on Monday - just in Ireland so no worries about flying with the pen - and I am considering taking 0.3 or 0.35 on Wednesday. We’ll see - maybe I don’t want to risk side effects when I’m away.

LastApacheInjun

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.

ohnonotgmail

Out of curiosity where did you get the progression from 0.25 to 0.30 to 0.4 to 0.5 from?

LastApacheInjun

https://www.boards.ie/discussion/comment/122124996#Comment_122124996

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).

LastApacheInjun

Well, here we are. Week 4, Day 1.

1.8lbs off this week, so down from 205.4lbs to 196.0lbs in three weeks. Again, the appetite suppression didn't kick in until Sunday this week. On Monday I got a bento box in town for lunch. The items were far too deep fried and the portion enormous, so while I only ate half of it I still felt really uncomfortably full. When I got home, my husband had made dinner. While I only had a teeny portion, I ended up feeling very nauseous for the rest of the night. I think I have to accept that breaded chicken, even a small portion, is no longer my friend. Especially if it's from a takeaway.

In other side effect news, I find that I am very sleepy the two days after injecting. Like that exhaustion you get with a hangover, but without the headache or feeling sick. The tiredness does pass and I do hope my body gets used to the medication this side effect will wear off.

Other than the bento box, I find that my food choices have become so much healthier. Certainly I am eating far less highly processed foods and far far less sugar. It also helps that, when you're not starving, something like a chicken salad or a jacket potato with tuna is so much more appealing. I do wonder whether the fatigue is related to my body adjusting from using sugar for energy all the time, but I suppose that doesn't explain why it only happens the day or two after injecting.

I decided to inject this morning rather then before bed. The house was quiet and I was using a new pen needle (which I got a box of from Amazon). I forgot to hold the injection in for six seconds after pressing the plunger, and there was a drop or two coming out of the needle when I pulled it out, so I suspect I didn't get the full 0.25ml dose from that first injection. I had decided to go up to 0.3 this week anyway, so I counted three more clicks on the pen and injected that too. That's probably only brought me up to my normal dose. In light of this I'll probably only go 0.35ml next week.

ohnonotgmail

For me fatty foods and spicy foods are just unpalatable now. Anything heavy or stodgy is also completely out.

snor

https://www.boards.ie/discussion/comment/122123326#Comment_122123326

Can I ask where you got the additional needles please

LastApacheInjun

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.

Mellor

Some old posts, but a bit of a round up.

https://www.boards.ie/discussion/comment/121897666#Comment_121897666

I'd consider 20lbs loss, when not specifically trying to lose weight to be a pretty strong indicator of the affinity for weight loss.

Have you have some success losing weight in the past?

https://www.boards.ie/discussion/comment/121920245#Comment_121920245

I'm not sure if fairs to compare the effects on a diabetic, who is also other drugs target blood glucose levels, with a person is not diabetic. There variables are just too different to say the side effects are the same.

https://www.boards.ie/discussion/comment/122075739#Comment_122075739

A bit mad that ozempic is an open and common topic at a martials arts gym. Obviously PEDs are rife in competitive martial arts. But I wouldn't thought obesity drugs where the hot topic.

But people do cut silly amounts of weight. A good way to strip muscle mass if F% is not already very high.

LastApacheInjun

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.

ohnonotgmail

https://www.boards.ie/discussion/comment/122168209#Comment_122168209

Just a slight correction. If you were diabetic you would be paying 0. Diabetics get their medication on the long term illness scheme not through the drug payments scheme. Your pharmacist is right about moving off the starter dose.

LastApacheInjun

https://www.boards.ie/discussion/comment/122168255#Comment_122168255

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.

ohnonotgmail

https://www.boards.ie/discussion/comment/122168606#Comment_122168606

the starter dose for weight loss is the same as it is for diabetes. 0.25 → 0.5 → 1 → 1.7 → 2.4 , upping the dose every 4 weeks, is the titration schedule for weightloss with wegovy. obviously you cant get past 1 with ozempic (i think there is a 2mg ozempic but i've never seen it) but that is where you should be after 2 months.

LastApacheInjun

https://www.boards.ie/discussion/comment/122168796#Comment_122168796

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.

Mellor

https://www.boards.ie/discussion/comment/122128594#Comment_122128594

Generally its probably better to titrate up when the effects start to wane, rather that prescheduling a timeline. This will mean you get the most bang for your buck for the longest and get as long as possible out of each script. There's no rush to the max does.

https://www.boards.ie/discussion/comment/122140640#Comment_122140640

The tiredness is due to the levels in your body peaking post injection as it releases. Then you levels taper down over the rest of the week until your at about 50% right before the next injection.
Splitting the dose over two injections would mean more stable levels, not so high a peak, not so low a dip. Would likely help with side effects.

LastApacheInjun

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.

lenan

Thanks for sharing your progress. Can I ask you the cost?

LastApacheInjun

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.

lotstolose

Hi,

I started yesterday with an injection of 0.25ml. My starting weight is 106.8kg. I'm happy to answer any questions and log my progress here. Today I ate very little and wasn't hungry and I've no idea of it was psychological or physical. A small bit of nausea and was very tired but I had a busy weekend which could have explained the tiredness.

LastApacheInjun

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.

ohnonotgmail

for those using ozempic that are not diabetic, who showed you the correct way to inject? I'm T2 so I was shown by a diabetic nurse, including the pre-injection check.

fits

https://www.boards.ie/discussion/comment/122076097#Comment_122076097

if anyone is thinking about starting strength training I highly recommend Kate Rowe Ham and the owning your menopause app. She has a four week beginners course and live classes every weekday that can also be done on catch up. Great nutrition advice too and it’s all science based. She’s @katerh_fitness on Instagram.

snor

https://www.boards.ie/discussion/comment/122221514#Comment_122221514

U still on 0.25? Just finishing week 4 of 0.25 and 10lb down. Think I will finish my 0.25 pen before starting my 0.5.

eggy81

https://www.boards.ie/discussion/comment/121914202#Comment_121914202

just on this in regards to menopause. My wife got lymphoma in her late 30s and had to go through some quite severe chemo and targeted radiation therapy at the end of her treatment. This was in her early 40s and appeared to kick her into early menopause. Obviously after the treatment the medical advice was to exercise as much as the energy levels would allow and watch the diet. This happened for a while. Probably 2 years before falling away. I could see her trying her best but still her weight would stay the same or even increase. My question is that even if weight loss isn’t happening for some advised to lose weight are you still gaining benefits fitness wise/overall health wise from doing a bit of activity ? I assume yes and always try to emphasise that but I know she’s gets discouraged not seeing the results in herself.