Obesity as a Disease - Medication
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15-03-2024 11:56am#1
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:
- Are you currently being prescribed Wegovy (i.e. Ozempic but for weight loss)? What has been your experience? Any side effects? Any shortages?
- I'm particularly nervous of needles. I don't know how I'll get over the idea of injecting myself. How painful is it?
- 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.
- 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).
- 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.
Post edited by LastApacheInjun on2
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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😉
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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.
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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.
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Sent you a DM
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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.
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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.
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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.
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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.
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One question OP, how many calories do you go on when you go on a diet?
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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.
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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.
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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.
Post edited by Ezeoul on1 -
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
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
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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.
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Were you taking 1mg per day ?!?
I am on 1mg per week !
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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.
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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
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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.
Post edited by Ezeoul on0 -
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.
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@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 🤷🏻♀️
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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.
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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.
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