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Obesity as a Disease - Medication

13

Comments

  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    Semaglutide is license or obesity treatment. You are mistaken. This has been explained multiple times.
    I'm aware that has been reported in the paper. But that's simple a lazy reporter not knowing as much as say a medical professional.

    Sure, if they have very little supply, and a queue of diabetics waiting, then it could be valid. And for completeness that would also apply withhold from a single diabetic on maintenance in order to dispense to 4 others who need a starting dose.

    But supply was not the context we were discussing was it?

    You claimed it Doctors should not be prescribing the drug because it's not licensed. But that's was incorrect, as was explained, Semaglutide is license for both.

    Then you claim that the dose was different. But as pointed out, that wasn't true either.
    There further claims from other about being unsafe, untested etc. Nonsense.
    Supply issues in the past do not justify peddling lies now.

    If there was another shortage in future, a pharmacist could and should dispense wegovy pens to diabetics. I wonder would people cry about licensing then?
    It would be far better off is prescriptions were generic. Branded drugs are simply another way pharma rips people off.



  • Registered Users, Registered Users 2 Posts: 40,585 ✭✭✭✭ohnonotgmail


     And for completeness that would also apply withhold from a single diabetic on maintenance in order to dispense to 4 others who need a starting dose.

    How, exactly, is that supposed to work? do the 4 who need the starting dose share the single 1mg pen?



  • Registered Users, Registered Users 2 Posts: 3,729 ✭✭✭Ezeoul


    If this has changed in the last three months, please provide a link. Thanks.



  • Registered Users, Registered Users 2 Posts: 14,535 ✭✭✭✭Goldengirl


    Ah look .I am not going to argue this further having basically been told I don't know my own business ! Wow !

    As @Ezeoul linked above it is not CURRENTLY licensed for treatment of Obesity , only for Diabetics in this country .

    Doesn't mean it can't be used for obesity sure , but off label .

    Hopefully changing in September.



  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    Starting doses are .25ml-.5mg pens. I'm not sure what was confusing.
    A person needing 1mg could use multiple starting dose pens or they could be allocated to people needing the lower dose. I think withholding in that case is fine too, as the starter pens are the ones really limited in supply.

    Ozempic is marketed for diabetes. Wegovy is marketed for weightloss. Same manufacturer, same dose, and same doses (currently, the 2mg ozempic is not licensed afaik).
    Semaglutide is the actual drug in both cases. Semaglutide is currently licensed for weight loss in Ireland, and has been since the start of 2022.

    This has been explained multiple times, in the thread. But if you want a link, see HSE: https://www2.hse.ie/conditions/obesity/medicines-and-surgery-for-obesity/ Or the links to the actual license below.
    It's like getting a prescription for a particular brand, and the pharmacist giving you the generic form. Really common.
    Or Neurofen vrs Ibuprofen, etc

    How is weight loss medicine "your business"? I understand you are diabetic, but didn't you also say you were not on ozempic.
    I'm really sorry, but I fail to see how anything I have said is a comment on your business.

    As was repeatedly explained, Ozempic is a brand name not an actual drug. The active drug, is Semaglutide, and also as explained above, Semaglutide IS licensed for both diabetes and weight loss. Links to misinformed articles are not helpful. Nor where the false claim about testing from others. See links below to the actual licenses.

    http://www.hpra.ie/homepage/medicines/medicines-information/find-a-medicine/results/item?pano=EU/1/17/1251/005-006&t=Ozempic

    http://www.hpra.ie/homepage/medicines/medicines-information/find-a-medicine/results/item?pano=EU/1/21/1608/002&t=Wegovy

    Key point is the active ingredient is each list. Based on above licensing doctors can prescribe semaglutide for weight loss, pharmacists can dispense semaglutide for weight loss. They should do that subject to their own supply issues, obviously



  • Registered Users, Registered Users 2 Posts: 40,585 ✭✭✭✭ohnonotgmail


    I know what the starting doses are, thanks. Ive been on it 2 years. Why would someone on a 1mg even be considering getting 4 .25mg pens of a single 1mg pens? You're making no sense at all.



  • Registered Users, Registered Users 2 Posts: 3,729 ✭✭✭Ezeoul


    My last post on this, as you are literally trolling the thread at this point and I'm not indulging your nonsense beyond this.

    Semaglutide / Ozempic is licensed in Ireland, but that licence extends to the treatment of diabetes ONLY.

    You've already been provided with multiple links, including an Oireachtas report that confirm this, yet continue to insist they are "misinformed" and what matters is the active ingredient, and not the purpose it is licensed for.

    So ask yourself this, if that were the case why do doctors have to prescribe it "off-label" for weight loss patients? Maybe you don't understand what prescribing off label means. It means prescribing a drug for a purpose other than it's approved for.

    Note, the link you provided from the HSE website is a copy and paste job provided to the HSE by the NHS in the UK where Ozempic is also not licensed for for weight loss.

    OP, good luck with the rest of your weight loss journey.

    I do wish you the best and hope you achieve your goals, however you may get there.

    Post edited by Ezeoul on


  • Registered Users, Registered Users 2 Posts: 40,585 ✭✭✭✭ohnonotgmail


    i think their problem is that they see Ozempic being licenced in Ireland and assumed that semiglutides in general are licenced. It is specific formulation of drugs that are licenced, not their ingredients or active substance.



  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    If there was no availability of 1mg pen, and you need to make it up. That’s really not hard to understand.

    I wasn’t aware you were on it, but I explained the sides are you previously were mistaken about them in this thread.

    Semaglutide is licensed is multiple forms. I literally linked to the license above. You’ve gone from confidently incorrect to head in the sand ignorance.



  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    The fact you can’t grasp really simple informat does not mean I’m trolling. It’s a reflection you alone.
    Although the fact to ignore my last link suggest you do grasp it - but are salty you were proven wrong.

    Semaglutide / Ozempic is licensed in Ireland, but that licence extends to the treatment of diabetes only.

    Semaglutide not licensed other than ozempic/diabetes?
    This HRPA license proves you are wrong. /thread



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  • Registered Users, Registered Users 2 Posts: 40,585 ✭✭✭✭ohnonotgmail


    no pharmacist is giving out 4 .25mg pens in place of a 1mg pen. you're talking nonsense.



  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    Did I say they were giving it out? The entire point was that they’d be entitled to withhold it from a diabetic in favour of somebody needing. LMFAO. You’ve just agreed with that.



  • Registered Users, Registered Users 2 Posts: 40,585 ✭✭✭✭ohnonotgmail


    Me:

    I know what the starting doses are, thanks. Ive been on it 2 years. Why would someone on a 1mg even be considering getting 4 .25mg pens of a single 1mg pens? You're making no sense at all.

    You:

    If there was no availability of 1mg pen, and you need to make it up. That’s really not hard to understand.

    you suggested they might. which is complete nonsense. no pharmacist would even consider that.

    and this

    they’d be entitled to withhold it from a diabetic in favour of somebody needing

    Diabetics are the ones needing it. that is who it is for. you are very dismissive of the people like me that actually need it. i can only describe it as trolling. on the ignore list you go.



  • Registered Users, Registered Users 2 Posts: 3,729 ✭✭✭Ezeoul


    Just stop this now. I draw the line at you throwing personal insults around.

    This is what you linked to and claims proves Ozempic is licensed for the treatment of weight loss in Ireland:

    It is a licence, but the licence does not say what you claim. I also searched the EMA website. Nothing there that says it either.

    We all know Ozempic is licenced in Ireland….FOR THE TREATMENT OF DIABETES.

    I noticed you completely ignored what it means for a drug to be prescribed "off label".

    So I'll leave readers of the thread to make their own conclusions, seeing as you're the sole poster on the thread who claims Ozempic is licensed for weight loss in Ireland, despite multiple sources that prove otherwise.

    Have a nice day.



  • Registered Users, Registered Users 2 Posts: 14,535 ✭✭✭✭Goldengirl


    They have been advised to do so by the HPRA . As said before .

    No I am not on the drug .

    I am a health professional . Semi retired but know my semaglutides from my dulaglutides , thank you .

    I have no issue with you or anyone else using this medication as I have stated before , but trying to diss others as posting misinformation while you yourself are clearly posting incorrect information is a bit bizarre tbh.

    Good luck to you if your doctor is prescribing it off label and you can get a pharmacy to supply it

    I don't see anyone saying anything else .

    The fact remains it is not licensed as yet here for use as a weightloss only drug because of specific supply issues for the target population , diabetics

    Not that it doesn't work , not that it is unsafe , down to lack of supply for a vulnerable population only .

    Both drugs you list from HPRA website ..those links do not refer to its uses . Which is the point we are discussing here .

    The HPRA have been quite clear about this . This from last November .

    https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.hpra.ie/docs/default-source/Shortages-Docs/ema-mandated-victoza-amp-ozempic-direct-healthcare-professional-communication-(dhpc).pdf%3Fsfvrsn%3D2&ved=2ahUKEwiDrJev5uyGAxUFQkEAHQa_BvMQFnoECDEQAQ&usg=AOvVaw3KfDZDzRhxXbMh6ZvJR2w5



  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    If a diabetic needed 1mg. And there were no 1mg pens available, it’s would be very reasonable to use two starter pens (contain 2mg total and up to .5mg doses), if they were were suitably available. It's not uncommon in medicine. (eg pharmacy fulfilling a 10mg script with 5mg tablets and instruction to take two).

    How is that being dismissive if anybody? I'm sorry you feel like that. and I'm sorry you think i'm trolling. But the forum is based on factually and correct information being posted. And unfortunately many of the claims, although well intentioned, were incorrect. I've highlight were they were wrong. Labelling that “trolling”, is good counter argument. I think you've posts on the site to know I'm not trolling.

    Post edited by Mellor on


  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    Are you really stooping to misrepresting/falsifying my posts. wow.

    The above is NOT the link I provided in my last post (post #111). The fact you are screenshoting a different link is kinda sad. That's from post #106 - where I proved both licenses. Not you only screenshot one🙄
    Here is the link from the last post https://www.hpra.ie/homepage/medicines/medicines-information/find-a-medicine/results/item?pano=EU/1/21/1608/002&t=Wegovy . And before you say wegovy is not available, nobody said it was. We are talking about licensing.

    A reminder what you said (as the above posts shows you're willing to twist things and lie).

    It was explained that ozempic/wegovy are two brand names for the same drug (semaglutide) and are licensed separately. I literally linked to the license. And you still claimed semaglutide was not licensed for weightloss (in post #108). You used the word semaglutide. I posted the license three times now, that should be enough But as you've lied above, here is a screenshot

    It is a licence, but the licence does not say what you claim. I also searched the EMA website. Nothing there that says it either.

    Did you really search the EMA website? I couldn't find anything to confirm my claims about semaglutide? I find that hard to believe, it's a very simple website. So really have to assume you are simply lying/misrepsenting my posts again. Which is weird. Anyway, here you go https://www.ema.europa.eu/en/search?search_api_fulltext=wegovy&f%5B0%5D=ema_search_categories%3A83&f%5B1%5D=ema_medicine_bundle%3Aema_medicine&f%5B2%5D=ema_med_status%3A100108&landing_from=73303 and a screenshot confirming what I've been saying.

    Semaglutide, licensed for obesty treatment (under the brand name Wegovy), since jan 2002.

    Your claim that semaglutide is not licensed for weight loss treatment is simply 100% false.


    The distinction between ozempic/wegovy and the drug semaglutide has been explained multiple times. Please don't waste time with the strawman "but ozempic is not….yada yada". Nobody said it was. I've been very clear in my wording. Most peopel got that.



  • Registered Users, Registered Users 2 Posts: 3,729 ✭✭✭Ezeoul


    How dare you, I falsified nothing. I screenshotted directly from YOUR link.

    I'm not that pathetically desperate to win an argument when the facts speak for themselves.

    Enough said. I refuse to engage with you any further.

    When you have to resort to gaslighting, personal abuse and false accusations. you lose.

    (OP, I apologise for my part in the ongoing derailment of your thread. It stops here.)



  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    I think you may be mixing me up with OP or another poster. I'm not sure what my doctor "my doctor" refers to. As I haven't mentioned my doctor, nor am I on or need any medication. I'm simply providing information for others. Which is the point of the forum.

    They have been advised to do so by the HPRA . As said before 

    And as I have said, I've no issues with prescriptions being limited when supplies are limited. I've repeated that a few times.

    The HRPA advise against starting diabetic patients on new treatments during shortages. Shortages of starter doses are and intentional supply action from NovoNordisk to avoid down chain pressure o namitenance doses.

    The HRPA also recommend when supplies are limited to switch to another GLP-1 RA injectable. Which is what I referenced above - and was told was "nonsense".

    I am a health professional . Semi retired but know my semaglutides from my dulaglutides , thank you .

    I have no issue with you or anyone else using this medication as I have stated before , but trying to diss others as posting misinformation while you yourself are clearly posting incorrect information is a bit bizarre tbh.

    If you are a health professional, and understand what semaglutide is (and dulaglutide, liraglutide, retratrutide, etc), then you understand its the active drug, available under multiple brand names. But I'm still unclear how I said "you don't know your own business".
    I said you were mistaken about semaglutide licensing, and I provided the licence. I think that's reasonable. If you are retiring it's understandable if are not up to date on all brands of a drug.

    I stand by my claim that the posts were misinformation (not necessarily intentional). And I believe I clearly proved that. For example.

    A poster claimed Semaglutide was not designed and tested for weightloss. That is false. I said it was false, and I provided a link the the phase 3 study in 2021.

    And above, a poster claimed Semaglutide was not licensed for weight loss. So I provided the license. Even though @LastApacheInjun clarified the licensing pages ago, poster where still repeating mistaken claims.

    I'm not sure how providing that information, along with links to the study, licence approval etc is "dissing" posters. I think taking it as a diss is overly sensitive.

    Good luck to you if your doctor is prescribing it off label and you can get a pharmacy to supply it

    I don't see anyone saying anything else .

    The fact remains it is not licensed as yet here for use as a weightloss only drug because of specific supply issues for the target population , diabetics

    As I said, I think you've confused me with somebody else.

    And many posters have made claims outside the supply issue. You literally just made one regarding licensing, as above that is incorrect.

    Not that it doesn't work , not that it is unsafe , down to lack of supply for a vulnerable population only .

    That's not quite correct. This whole conversation started when a posters claimed that semaglutide was safe or tested for weightloss, and it was simply a test dummy side effect. That is demonstrably false and has nothing to do with supply issues.

    Both drugs you list from HPRA website ..those links do not refer to its uses . Which is the point we are discussing here .

    Well sure, the HRPA link does not refer to it uses. Because that's not what the HRPA website lists directly, for that the HRPA links to the EMA (European medicines agency) website. I felt the HRPA website link was enough in that case as the intended use for other semaglutide labels was established in the thread.
    I'm surprised the HRPA link confirming the license was not sufficient for you given your statements above. But for completeness, here's the EMA information. Confirming the authorised usage, and that it's been licensed for almost 2.5 years. Screenshot is in my previous post.

    https://www.ema.europa.eu/en/search?search_api_fulltext=wegovy&f%5B0%5D=ema_search_categories%3A83&f%5B1%5D=ema_medicine_bundle%3Aema_medicine&f%5B2%5D=ema_med_status%3A100108&landing_from=73303  



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  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    The license I provided in post #111 was for the wegovy (weightloss) license. You replied with a screenshot to the ozempic diabetes license, not the one I linked to in my post. Everyone can click the link in my post and see that you are lying.

    The facts do speak for themselves. I proved the correct screenshot that proved you were wrong (and suddenly you're no longer engaging, lol).

    The one thing we are agree on is the intentionally screenshotting a different webpage is pathetically desperate.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    I think we can summarise discussions thus. Semaglutide is licensed in Ireland for both diabetes and weight loss. Doctors should not be hesitant about prescribing ozempic off label for weight loss on the basis of any health risks, or on the basis that the brand name ozempic was not submitted for approval as a weight loss drug.

    However they should warn their patients that there are shortages of some doses in some places, and pharmacists may need to keep their supply for those already on their books. At worst, pharmacists may restrict dispensing starter doses, even where they have supply, if there are ongoing or flagged shortages of the higher doses, and in those cases, they may dispense in accordance with need. In the majority of cases - the large majority probably - this will be diabetics. Though I would argue that perhaps a morbidly obese person should take precedence over a diabetic who may not have exhausted other options. But that would likely be unusual.

    In the meantime, if you have a pharmacy that can get regular supply then there should really be no issue in presenting a weight loss prescription. Yes, I understand that I am contributing to a countrywide or worldwide supply issue, but honestly my physical health, my mental health and being around for my kids is always going to trump that.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Hello everyone. So, weekly update. I'm due to take my injection today so this is the start of Week 10. Another 1.5lbs off today so that's 17lbs off in nine weeks. I've gone from 205.4lbs to 188.4lbs.

    I can't see or feel much of a difference yet. I had been hovering around the 180s for most of 2021-2023, so most of my clothes were bought to fit the size I am now. I did feel like I was bursting out of some things a couple of months ago, and now they are a little more comfortable.

    Not so many side effects this week, but I did eat a lot healthier over the weekend, prioritising protein and fibre.

    My cousin's husband popped over to drop some things off during the week. He is the one who is a diabetes and obesity consultant. I just managed to squeeze into conversation that the Ozempic was going well with some side effects but nothing I couldn't handle. He said that actually, there's really no need to suffer any side effects at all, as long as you stay on the lower doses for as long as they work for you, and only go up a dose if you feel you need to. So that might be comforting advice for anyone starting out. He was really pleased that it was working out - I suppose if you are quite a vocal advocate of these drugs its good to hear the success stories (not that I am quite that yet).



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Week 11 Day 1

    2lbs off today bringing me to 186.4lbs and 19lbs lost in total over 10 weeks.

    I was hoping for a nice round 20lbs lost in 10 weeks but it was not to be and I’m sure I’ll get there next week. 20.5lbs would be 10% of my starting weight.

    My weight has fluctuated wildly this week. I came down with a bad cold last Thursday and that put me off food even more than usual. On Saturday morning I was 186lbs. Then the food noise came back with vengeance on Sunday and I bought treats in the afternoon, had a full dinner and more treats in the evening. I definitely didn’t drink enough water. I had lots of gas, heartburn and cramping on Sunday night and Monday morning I weighed 189!! Wtf?? Well, my body cleared itself out alright on Monday - not ideal as I was in the office - but I seem to be back to normal today.

    I don’t understand why I can’t just do the simple things to prevent this from happening. I know overeating will bring on pain and gas and a “clear out” yet I seem to keep doing it. I still turn to sugar and caffeine when bored or stressed and it seems my body hasn’t reprogrammed itself yet to remind me that this stuff has immediate negative consequences.

    I have my first follow up appointment with my doctor tomorrow- via zoom. He’s a GP though, not a psychologist, so I’m not sure he’ll be able to shed any light. If he does, I’ll post back here.



  • Registered Users Posts: 529 ✭✭✭snor


    well done. You are doing great.
    I started around the same time as you and after doing well initially I have plateaued after 3 weeks - only lost 10lb in total. Need to drink more water and take in more fibre. Feeling nauseous a lot which is alleviated by eating and this is certainly not helping!



  • Registered Users, Registered Users 2 Posts: 826 ✭✭✭taxAHcruel


    Seems there is another two. Diary of a CEO podcast again. Both are however more woman orientated. Which is interesting in itself because all too often new drugs and treatments and modalities are not specifically studied in women.

    Latest episode. This time with a Dr Tyna Moore.

    Her take on it is a little more (but not totally) geared towards women - and heavily geared towards relatively "microdosing" Ozempic and the effects this appears to have. So a bit of a different take than the previous two podcasts I mentioned on the thread. But overall quite an interesting take.

    About a week ago. This time with a Dr Mindy Pelz.

    She is slightly more against it but not in any big way. She is more geared towards self control, discipline, fasting regimes like intermittent fasting and so forth. But a lot of what she says might cover the concerns you were expressing in post #124 @LastApacheInjun if I remember correctly. Though it was a week ago I listened to it.



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  • Registered Users, Registered Users 2 Posts: 7,697 ✭✭✭SuperBowserWorld


    ...



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Thanks @taxAHcruel. I listened to the Huberman Lab episode. I liked it and I didn’t like it. Dr Knight was excellent but as Huberman is also a neuroscientist he fell into the trap of discussing the topic with an equally qualified colleague forgetting that his audience is not similarly qualified. I felt I needed to take notes and google terms simultaneously in order to completely follow what they were discussing. And Jesus, I realise I am not Huberman’s target audience but I found him to be a royal p**n to listen to. Constantly interrupting, only to go on some rambling musings about theories that were clearly entirely unproven. Dr Knight had the patience of a saint while he gently debunked Huberman’s theories. Needless to say I won’t be subscribing.


    I’ll give those two DOAC episodes a try. I’m sceptical of the naturopathic “doctor” recommending microdosing ozempic 🙄 But I’m all on for anything that might help alongside ozempic. Obesity is such a complex disease - it appears treatment is both physical and mental.



  • Registered Users, Registered Users 2 Posts: 2,544 ✭✭✭ECO_Mental


    Just started on Ozempic yesterday just for weight loss...I'm 50 and just touched 22 stone. Although I'm just over 6ft it was getting out of control. My BP was going up and I mentioned it to my doctor at my annual check up and he said its great for weight loss and prescribed it straight away. Problem getting a pen from a chemist as they were all sold out but got one after a week. Took 1st shot last night, nothing yet as far as I can see but I'm going to try and eat healthy as well and work with it.

    In my 50s and facing sniper alley its time to get my **** together health wise. I'll keep ye posted on progress

    6.1kWp south facing, South of Cork City



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Welcome ECO_Mental!



  • Registered Users, Registered Users 2 Posts: 30,268 ✭✭✭✭Wanderer78


    …great to hear and best of luck with it…..

    …i am concerned that not enough is being done in regards the psychological elements of weight issues, as this plays a major role with the issue….



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  • Registered Users, Registered Users 2 Posts: 93 ✭✭Slick666


    hi guys, I have type 1 diabetes and I’m 17 stone, my bmi is obese!!! I asked my diabetes consultant about ozempic and he told me to try lose weight the “old fashioned” way first! Ya I’ve been trying that with years doc! Anyways it’s so hard for me to lose weight. I’m also on medication and the insulin makes it hard for me to lose weight. My weight is affecting my social life, it’s non existent as I’m repulsed by my fat looks. I’ve never been fat before and I hate it. Where could I get ozempic? I want this weight off now. I’m 41 years old and my life is on hold with about 3 years now with this excess weight. It’s all well and good losing weight the old fashioned way but I’m 41, my life is not getting longer. Exasperated at this point!



  • Registered Users Posts: 4 lotstolose


    Hi,

    Just an update. I first posted June 3rd and was 106.8kg and today July 8th I'm 97kg. I'm thrilled. I'm just genuinely not hungry and probably only have one meal a day. This is a game changer for me. I did 4 x .25mg and 2 x .5mg and next week I move onto 1mg.

    I've had virtually nothing in terms of side effects. A little nauseous and some fatigue but nothing major at all.

    I'll keep updating here. If anyone has any questions, please fire ahead.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Slick666 - I went to My Best Weight in Dalkey. There are other weight-loss specialist GP services around I think. One in Blackrock and one on Baggot St if you google them.

    I seem to have plateaud a bit, after 10 weeks of losing. I have gone up a pound and I definitely feel actual hunger returning. I'm tracking calories on the Lose It app and trying to up my protein. It is probably because I only gave myself a 0.4ml shot last week, to try and avoid some of the side effects that I experienced the week before. I think I will need to up it to 0.6ml this week, and maybe up it again a week later to see if the appetite supression returns.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    30lbs down in a month is a massive amount - that's about 13% of your start weight. I don't want to burst your bubble at all- I'd say you're delighted. But be careful regarding losing that quickly on an ongoing basis. Rapid weight loss can be because you are losing both muscle and fat. Once you hit your goal weight, your metabolism will be very low if you've lost a lot of muscle. And then there's the hair loss, gallstones, saggy skin and hormonal imbalances that may come with rapid loss.

    I really don't want to be a Debbie Downer - the freedom that Ozempic gives you when it works is intoxicating, especially if you have struggled with food intake and hunger for years/forever. But this is a marathon, not a sprint. You may not feel like it, but in the long term it might be better to up the calories you are eating during the day and lose a little slower.



  • Registered Users, Registered Users 2 Posts: 93 ✭✭Slick666


    hi, thanks so much for your reply. I have googled the place in dalkey and will Contact them. My diabetes consultant told me that I may not heed his advise and go to a doctor to get ozempic and I think I will. It’s so easy to say “lose weight the old way” which I’ve actually lost a stone doing but it’s taking so long. I need a boost. What are the side effects? Do you feel nausea?



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    As far as I can tell, it's not the losing the weight the old way that's the problem, it's maintaining any kind of loss. The obesity specialists are now saying that if you go into a calorie deficit, your body drops your metabolism accordingly. So you might lose 10%-20% of your body weight but your body increase your hunger and reduce your fullness in order to make you regain the weight. That's where the problem lies, and that's where Ozempic really comes into its own. It appears that when you reach the amount of weight Ozempic allows you to lose (which is different for everyone), the hunger comes back but crucially you don't put weight back on - as long as you stay on the medication of course.

    I haven't felt a huge amount of nausea - only when I overeat or eat very high fat/high processed food. It's actually more diarrhea I've suffered with. 90% of the time it has been very mild but I have had two or three days over the 10 weeks so far where I'd describe it as moderate, where I have had painful cramps and have lost a couple of night's sleep. I've also had sulpher burps, which are unpleasant but the least worst of the side effects in my opinion.



  • Registered Users Posts: 4 lotstolose


    I completely agree with everything you're saying. I've kept going to the gym and my meals are mainly protein based. I'm just surprised by how "not hungry" I am. I do recognise that the pace of the loss is unsustainable though. I'm sure it won't continue at this rate !



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Week 12, Day 1 and my first gain. I weighed in at 187 this morning, which is a gain of 0.6lbs, for a total loss of 18.4lbs.

    I took my Week 11 dose a day late last week. No reason except for a bit of laziness. I also only took 0.4mg. I don't really know why - maybe after the conversation with my relative I thought that I'd try to keep the doses low in order to avoid the side effects.

    Either the dose was too low or I'm getting too used to the medication, as I had very little side effects over the past week but also very little effect from the medication. I definitely felt hunger - proper stomach rumbling hunger and I could eat larger portions than I have been able to up until now. But the big downer was the food noise and cravings. Boy did the cravings come back. My two times during the day when I find it difficult to avoid cravings are on my way home from work when I'm in the office, and around 9pm at night. I definitely felt the inner voice coming back - debating whether I'd buy this or that, how much I would eat of this or that. It's hard to know whether Ozempic provides some sort of placebo effect - where you're told it gets rid of cravings so you kind of ignore them when they come, or whether it has a true effect on that part of the brain. Either way, it definitely wore off this week.

    Anyway, I've taken my Week 12 dose this morning instead of this evening, hoping it might kickstart things. I have also upped to 0.55mg. I know it's not a big jump from 0.4mg, but I don't want to fall into the trap of taking a larger jump in dose and getting harsh side effects, just because I'm impatient with my weight loss. If I don't find that 0.55 is an improvement, I'll go up to 0.65 or 0.7 next week.

    I do hope that Ozempic allows me to lose some more weight. I realise that the average weight loss in the trials was 6% after 12 weeks, and 10% after 24 weeks, so I'm exceeding that at this stage. It'll just be difficult to only lose just over a stone when I really have three more stone to go, and have to fork out €146 a month to merely maintain that smaller loss. If I was paying €146 a month to maintain a 3/4 stone loss it'd much easier to justify.

    I'm trying to stretch out the doses for as long as possible so that I don't get to a point where the 1mg dose "stops working" (I realise that's somewhat inaccurate to say, because if I am maintaining the loss then the Ozempic is working). It'll be a long old time to wait while maintaining before the Wegovy comes on the market and I'll be able to titrate upwards again.



  • Registered Users, Registered Users 2 Posts: 40,585 ✭✭✭✭ohnonotgmail


    dont take this personally but I have no idea why you are playing about with the dose as you are. there is a titration schedule and you have decided to completely ignore it and make it up for yourself. i don't know why a conversation with a relative would make you change your dose. unless they are a consultant endocrinologist.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    in fairness, he is actually a consultant endocrinologist (I mentioned him in the first post) but you weren’t to know that 🤩

    I should have also said that I discussed my titration with my GP at my appointment last week. He agreed that it was ok to take a lesser dose if the side effects were getting too much, though he said it would be better if I stayed a bit longer on the same dose.

    I do get what you are saying though. Before I went to my first appointment I was reading some of the threads on the UK websites and I thought - j*sus, this is the Wild West with people just making up titration schedules. However when I mentioned it at my first GP appointment he said going slower up the doses was not necessarily a bad thing and some people can and should stay on lower doses if the are getting decent weight loss results. He did say that it was probably better not to mention that to my pharmacist because “their heads tend to explode” (his words) if you don’t follow the manufacturer’s guided timelines.



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  • Registered Users Posts: 4 lotstolose


    So, we were away when I posted this and a different scales had me lighter. I'm home and this morning weighted 98.2kg so a loss of just over 8kg. Which is still fantastic.

    I took the 1mg dose on Sunday (am following the titration schedule) and I definitely feel an increase in nausea - so much so that I don't really want to eat at all - I'm only forcing myself to. Mind you, I only took it Sunday night and today is only Weds. It's not impacting me massively, just coming in a few little waves. I'm going to hold off the scales until next Monday morning and I'll see how things are then. On Monday morning I'll have been on it for 7 weeks.



  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    I would agree that increasing faster than the titration schedule is a bit silly. But the opposite is not nearly the same thing.
    Especially with dealing with hormones and/or drugs with potential side effects.

    The titration is more about weaning people on, then finding the minimum effect dose. And of course simplifying dosing. It makes no sense that .5mg is fine in week 8, but you need twice as much in week later. A more steady titration is more logical, but less practical.

    The 1mg dose doesn't start until week 9. If you're on the 1mg dose before week 7 you are not following the titration schedule.
    If your healthcare provider is advising dosing, then that's between the two of you. But just flagging on the case the was an error.



  • Registered Users, Registered Users 2 Posts: 40,585 ✭✭✭✭ohnonotgmail




  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    well that's different obviously. I assumed moving up to .55, .65, .75 was the initial increase. If they'd been on 1mg for a few weeks and adapted, then likely should be stay there - unless sides are a major issue and doc instructed to move down.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    Hi All - not much to update. I appear to have plateaued around 186/187 for the past two weeks. I was on holiday for the past week, so that didn't help. But I'm back on track now. Still on 0.6mg, which I will increase to 0.7mg on Wednesday. I'm hoping to stay on that for a couple of weeks. At least I'm not putting any weight on, and I'm hoping that I'll break the plateau in the next week or so.



  • Registered Users, Registered Users 2 Posts: 1,364 ✭✭✭cmyk


    Well done, I've been reading this thread with interest. I'm a PT and have a number of clients using these drugs. As I've always tended to say to my clients through the years, not regaining is still a massive win, even if psychologically that's a tough spot to be.

    Just out of interest you mentioned in the OP that you couldn't consistently exercise before hand. Have the drugs helped, either directly through the physical weight lost or otherwise in re-introducing exercise at all?



  • Registered Users, Registered Users 2 Posts: 911 ✭✭✭Bassfish


    My own two cents, one thing people who have never been obese often don't appreciate is how bloody hard it is to exercise when you're very overweight. Even leaving g aside being self-conscious, it can be physically really hard on the joints and you can do alot of damage easily.

    I've lost 24kg (lost 18kg before going on Ozempic) and it's like a new world, being able to move around and exercise and just go about my life so much easier. This has knock on effect to so many things in your life like your confidence and mental health and how productive you can be when you have more energy because you're not as tired as before.

    I'm now running 10km (very slowly) a few times a week. I couldn't have dreamed of that two years ago.



  • Registered Users, Registered Users 2 Posts: 120 ✭✭LastApacheInjun


    I very much agree with this. By far, the first thing you need to fix is the food intake, both quality and quantity. And while I understand that exercise is needed in order to maintain weight loss, it is - in my opinion - next to useless in helping you lose weight. Now, that's not that I don't understand the concept of calories in versus calories out. But in my experience starting exercise (whatever that may be, weights, running etc) while obese is nearly counterproductive. It's painful, because of the strain on the joints. It generally increases appetite, which is something you are trying to avoid while you are correcting a previously unhelpful diet. And it requires a nearly superhuman effort, because you are carrying around the extra weight all day anyway, and you are eating in calorie deficit, so you're starting from exhausted. Mentally, I find that you are much better off spending your efforts on meal planning, reminding yourself to eat healthy snacks, spending any extra time catching up on tasks so that you are not stressed, and getting more sleep. The time to take up exercise is better when your are say, a stone away from healthy weight.



  • Registered Users, Registered Users 2 Posts: 1,364 ✭✭✭cmyk


    Yep and that plays out exactly with the evidence - poor for weight loss (at lower volumes and intensities at least).



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  • Registered Users, Registered Users 2 Posts: 39,729 ✭✭✭✭Mellor


    If somebody is very obese, then simply a increasing incidental movement over the can add a lot. Walk to the shops increase of the car, stairs instead of the lift. Getting in 10k steps. As you said, they are carrying the weight everywhere.

    But the more weight you lose, the less energy you burn doing those things. Which means the benefit of exercise increases, while the strain decreases. May be something to think about adding to the balanced, controlled diet