Obesity as a Disease - Medication

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.

fits

absolutely. We are losing muscle at a frightening rate unless we do something about it. Bone density is another consideration especially with early menopause. Resistance training is so helpful for health.

LastApacheInjun

https://www.boards.ie/discussion/comment/122227936#Comment_122227936

My doctor showed me the pen and needle and spoke fairly briefly about the injection. I was apprehensive before doing my own injection two or three weeks later, but to be honest it was so straightforward I couldn't really mess it up (as long as you follow the instructions of course). The instructions say that you have to prime the pen before the first injection from it, and that was also easy to do. By the third injection I could have done it in my sleep. There's also loads of you tube videos with people demonstrating what to do, and that also helped.

LastApacheInjun

https://www.boards.ie/discussion/comment/122228871#Comment_122228871

I'm on 0.5 now. I titrated slowly upwards, doing 3 x 0.25, 2 x 0.3, and 1 x 0.4. That left 0.25 in my first pen, which I used along with 0.25 from my new 0.5 pen.

Mellor

https://www.boards.ie/discussion/comment/122227936#Comment_122227936

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

It’s subcutaneous injection so pretty simple.

LastApacheInjun

Week 8, Day 1.

189.8lbs this morning, so 1.6lbs lost this week, for an overall total of 15.6lbs lost in seven weeks. I'm delighted to be under the 190 mark. I'm still losing an average of 1.5lb a week which I think is very sustainable and should avoid any of the other problems with quick weight loss e.g. hair loss, gallstones, light headedness.

I went up to 0.5ml last week and have found an increase in side effects, even when eating relatively clean, and even though I titrated up slowly and took 0.4ml the week before. Again, the side effects aren't too bad - mild headache, fatigue, some gastro issues, but they were definitely across nearly the whole week. I think I'll go back down to 0.4ml today and stick with that until the side effects wane.