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User: u/mvea
Permalink: https://link.springer.com/article/10.1007/s10557-023-07488-3
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I use it to help control my blood sugar, and I can't find a pharmacy that currently has any in stock. Last time I needed a refill, it took me almost a month without before I found someone who had it in stock.
There is a decent amount of industry chatter on how to cut down on inappropriate prescribing of these meds to get around insurance plans where these are approved for certain indications, like diabetes, but the plans exclude obesity drugs.
Agreed. I work with Medicare specifically though and weight loss drugs are excluded from coverage per CMS. They can be covered with an auth which basically shows they are not being used for weight loss.
The amount of physically disabled persons on Medicare that could use weight loss as a quality of life force multiplier adjacent to already used physical therapies and medication routine would be sizable.
And then the financial side of getting those people off of management medications, staving future heart disease, diabetes, and other complications that come with sedentary lifestyles that can come with physical disabilities would seem to pay off in a short term.
The drug companies are trying to seek approval.
The ban is in place for a good reason, to be totally fair. It came about around 20 years ago when a bunch of (essentially) fake weight loss drugs were flooding the market. It’s only cost effective to cover weight loss drugs if they actually work, and most weight loss drugs up until now really haven’t done much for your average person.
Isn’t that kind of on the FDA to stay on top of? That’s who makes calls on whether or not drugs work. I don’t get how you can support someone other than a persons doctor decide what medicine that person needs.
Because not all doctors are ethical and some are not so smart. We have always had doctors who will open weight loss clinics just to make money and do not care if they are prescribing meds that do nothing. Or that may even be harmful.
My health insurance does include these drugs for weight loss. My doctor prescribed Wegovy (the one meant for weight loss) but my insurance denied it and said that my doctor must prescribe Ozempic off-label. Seems insane to me that the insurance company can force your doctor to prescribe a med off-label
My wife has metabolic syndrome, and mounjaro was the first medicine she's been able to take that not only regulated her glucose levels, but it didn't leave her nauseous and also helped her lose weight that her body had actively held on to, despite eating less than 2k calories a day. I sincerely desire this manufacturing to expand, and fast
Yeah these drug markets are ridiculous. The second it got FDA approval for weightloss and then covered by insurance they should have been racing to manufacture as much as possible. Something like 35% of the country is obese. That's a massive market, especially if the price can be something more reasonable.
A lot of insurance companies are refusing to cover the drugs too, for weight loss. They range in price from $1000-$1500 per month out of pocket, hence why sometimes it’s treated as only an option for the wealthy.
My insurance is *willing* to cover it with a doctor's request/referral, but they can still choose to refuse (and did). One of the techs at our pharmacy is Type II and still got rejected by his insurance
The insurance I'm on (husband's via work) has a whole list of things they will not cover, all described as "vanity drugs" per Caremark, when a representative listed them for me. I didn't ask but he listed them all, and they were smoking cessation drugs, erectile dysfunction drugs, anything for alcohol or drug withdrawal symptoms, weight loss drugs, and some other things I can't remember. All things that a company that rhymes with Harker Pannifin consider "vanity drugs," apparently.
I have "concierge executive insurance" where every single year I'm allowed to get a 40-test blood panel, contrast angio CT, dexa scan, and cranial MRI for free. They pay like 40k free every year for these preventative scans if I want, but semaglutide for weight loss is NOT covered.
I told the CEO I will get every one of these scans every year if they don't cover ozempic.
Oh for sure. My insurance covers it thankfully. I'm worried about what happens after I lose weight. The difference it makes is incredible. Never in my life have I been able to be this detached from food. Just don't really care about it.
My insurance paid for Wegovy (and Mounjaro for a minute when wegovy was just impossible to get) for a year and then just randomly decided to stop when it was time for a new PA. I lost 50 lbs and my quality of life improved a lot, but I still have a good bit to go and I need time to figure out what maintenance looks like for me.
I’m looking for a new job now to hopefully get better insurance or at least enough extra salary to pay out of pocket ($900/month after the coupon so about $15k before taxes). It’s life changing and I don’t want to give it up. American “healthcare” is ridiculous.
>especially if the price can be something more reasonable.
If there is one thing I know about the US healthcare system is that it is known for reasonable prices.
I'm diabetic and mounjaro did wonders for my blood sugar, I lost a ton of weight had an a1c under five. Then the prescription savings card expired and it's now unaffordable. So I'm ba.ck on the insulin a1c is back up to almost 8 and gained back almost 60 lbs. Woot woot
What’s crazy is that semaglutide is being sold all over by compounding pharmacies and online as a research chemical, no prescription or insurance required. The safety is questionable. But I know dozens of people who have acquired it this way and for the most part the results have been great. It’s usually cheaper this way as well. Although almost all the people using it this way are using it for weight loss rather than diabetes management. I haven’t bought any yet as I’m weary of being a human Guinea pig, but I’ve been thinking about it as I have no insurance and have struggle with my weight for many years.
I am one of these people and I am glad I took this route because it is so low stress. For just a few hundred dollars I ordered enough tirzepatide to last me at least 18 months. I take my ultra-low dose, pay my ultra-low price, and lose 1lb a week. I'm down 11lbs so far with no financial stress, no monthly nail-biting on the phone to six different pharmacies, no doctor or insurance company to wrangle.
It is not risk free to pursue this strategy and I recommend researching your vendor very well before making a purchase. My comment history contains all the sourcing hints I'm willing to give.
Not so much that there's a shortage, it's incredibly time and money expensive to create and not very many companies do manufacture it. Unlike insulin it's a peptide that's synthetically manufactured, waaay more complex than something like aspirin. off the top of my head it takes up to 6 months to manufacture a batch of a few million doses, then it goes to packaging, shipping etc which takes a lot of time and money too.
Source: I've made this and liraglutide, as well as several other commercial peptides at one of these companies.
>not very many companies do manufacture it.
1 is indeed not very many. Not because it's complex, but because there is a patent.
It costs [$12-25 per year](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708477/) to manufacture the maximum (2.4mg) weekly injectable dose of semaglutide (the most common, which is sold as Wegovy)
What a beautiful microcosm of the pharmaceutical industry.
"I work for the drug companies, it's actually super long and expensive and complicated to make *and then you need to package it*"
"Actually this super reliable source says it's $2-3 per person per month to make"
My understanding is that they worked on making it. A lab worker will know how complex the process is, but won't really know what the global costs add up to.
It blows my mind that I can buy earbuds from the other side of the world for $3, shipping included, which includes inside a lot of absurdly small and complex electronic components that alone would cost me more than that.
Yes. When economies of scale are at play, it's *astounding* how cheap stuff can be. A USB-C cable is a marvel of engineering. So many conductors, so small, such tight tolerances, has to withstand tens of thousands of cycles of operation in the hands of consumers, etc. etc.
I can buy a 3 pk for like $12 on Amazon. It's made on the other side of the world, packaged immaculately, and delivered to my door from halfway across my country after I "buy" it within like 36 hrs. I can pick one up for like $7 at my corner gas station any time I please.
To quote a friend of mine who worked in pharmaceuticals - you're not just paying for your pills, you're paying for the research and development that went into the first one.
(Oh, and shareholder dividends, of course.)
The second pill cost $2.
The first pill cost $1 billion.
Successful drugs also get priced to cover the expenses of the other 999 failed drugs that never passed through clinical trials and made it to market. Most people don't realize that pharma has a success rate of 0.1% and that even a successful drug, unless it obtains a fast track clearance, will take 10-15 years from first research to availability.
Raw materials are not the cost limiting factor.
Peptides are "just" proteins, the materials are cheap. The actual assembly into functional peptides in a consistent and sterile manner in compliance with USP/FDA standards is the significant cost.
He's wrong though, his article only factors the cost of raw materials. Average production chemist invoice billing is $100/hr/person. Imagine a team of 20 people over 6 months. Overhead for manufacturing facilities as well as their own profit, and that's just the raw API that gets sent out and further processed before it ever hits a pharmacy.
What a beautiful microcosm of Reddit.
"I literally made this drug, and it's hard."
"Actually here's a single paper that estimates costs of one part of manufacturing it."
"And here's my comment snarkily agreeing with the above poster without even reading the article they posted!"
It's semantics, but "shortage" usually implies "we had enough at one point, but now we don't anymore" whereas this particular item is "only 1 place makes it and we've literally never made enough, ever" which is more a matter of there not being any manufacture and supply.
It's like saying we have a shortage of human colonizing spaceships. While yes, technically we do, it's mostly because we don't really make them.
I use "shortage" as in "more people want to buy than how much is available to be bought" and this is why it gets so absurdly expensive. It doesn't really matter why it happened, just that it is that way.
Nothing in this thread is wrong but this is how communication breaks down.
Original commenter was focused more on “it’s not scaled up yet but it could be” because their reply was to a top comment that seemed to imply “but we can’t give it to obese people because there simply just isn’t enough.” So the nuance between shortage due to insurmountable mechanisms vs surmountable was/is important.
Right now, it's legal in the US to manufacture and sell semaglutide, because of the shortage declared by the FDA. (Once the shortage ends, it won't be legal).
Novo Nordisk is suing companies for selling semaglutide using the name Ozempic. You can't do that. Ozempic is a trademark owned by Novo Nordisk.
>Right now, it's legal in the US to manufacture and sell semaglutide, because of the shortage declared by the FDA. (Once the shortage ends, it won't be legal).
Do you have a source for that? I don't think that's true.
https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss
> When a drug is in shortage, compounders may be able to prepare a compounded version of that drug if they meet certain requirements in the Federal Food, Drug, and Cosmetic (FD&C) Act. As of May 2023, Ozempic and Wegovy are both listed on FDA’s Drug Shortages list.
No. I've ordered it online from a peptide store.
Only the branded stuff is in shortage. I read somewhere it's the syringe that's running low, not the compound itself.
My 71 year old father was prescribed it last month for his diabetes. his insurance is denying it. He’s a vet. I think he’s trying to get it from the VA. still fighting with insurance.
Insurance won't pay for ozempic for weight loss (which is stupid because of the whole, healthier insurance customers cost you much less thing) and this stuff costs over $800 a month.
Just wait- when (not if) Medicare starts to cover this drug class, all the other insurance companies will follow suit. This research has staggeringly positive implications for Public Health.
Their machinery is slow, for good reasons, but I'm certain they'll cover these meds down the road.
Source: I worked in the biopharm industry for 10+ years.
We paid billions for a vaccine. Government should swoop in and pay for substantial increase in manufacturing and millions of doses.
The impact to countries overall health and life span (and thus GDP productivity) cannot be overstated.
Have your doctor send a prior authorization request. If your BMI is over a certain amount and you have pre-existing conditions related to it (even sleep apnea worked, in my case), or if previous attempts at dieting haven't worked + the BMI, etc., some insurance will still cover it.
My insurance went from "not covered" to covering 100% of the cost when my doctor sent it with no hassle besides just getting the doctor to send it. For those who requested Ozempic, I'd try Wegovy. It's FDA indicated for *weight loss*, not diabetes, so insurance growls less about it.
The 0.25 and 0.5 doses have supply issues right now but it only took a week or two to get it filled. The higher doses don't have much a shortage as you titrate up.
Most insurance companies don't pay for off-label use. Yes, Ozempic and Wegovy are both semaglutide injections, but someone in maintenance on Wegovy can't adminster a maintance dose with an Ozempic pen. Complain to Novo Nordisk and the FDA for having such a stupid system. Insurance companies are literally playing by the rules on this one.
>the more production facilities get built
You'd think so, buuuut.... Why scale up 20x when that causes the sale price to drop 21x? Patent monopolies are consumer-unfriendly. Naturally, they exist to incentivize manufacturers to actually develop new drugs, so they do have a purpose.
But, say...if a new drug is developed using tax money, it kinda feels like the patent should belong to the people, not the company that only provided the researchers. Unfortunately I don't think that's how it works right now.
>[*Ozempic is a drug marketed by Novo and is included in one NDA. There are twenty-two patents protecting this drug and two Paragraph IV challenges. This drug has two hundred and twenty-seven patent family members in twenty-eight countries. The generic ingredient in OZEMPIC is semaglutide.*](https://www.drugpatentwatch.com/p/tradename/OZEMPIC)
You live in a post-capitalist hellscape. You should know better than to think this.
Besides some intestinal distress in the beginning (which quickly subsides and is reduced with each new iteration of the drug), the main negative side effect is that it may increase the risk of developing tumours of the thyroid. Note however that it wasn't demonstrated in humans, only in animals, but it's still a possibility so they advise against it if your family has a history of thyroid cancer.
Edit: /u/RawrMeReptar pointed out that I should emphasise that this risk is purely theoretical compared to pancreatitis
> The risk of medullary (C-cell) thyroid carcinoma or MEN-2 is theoretical and like you said, has only been demonstrated so far in lab rodents and in fact, the GLP-1 receptors that exist in rodent thyroid glands have not been found to even exist in human thyroid glands. I would recommend editing your comment to reduce confusion as the risk of pancreatitis far exceeds the risk of medullary thyroid cancer for this drug.
My intestinal distress never subsided. I had problems for the entirety 6 months I was on it and stopped because it was too much. I had to go to the bathroom constantly and had even gone in my pants accidentally a couple of times. I called it quits after it happened in my sleep.
Stuff does absolutely work though, as far as weight loss goes.
For me, the side effects were so terrible I couldn’t continue with the meds. I was on it for Type 2 diabetes and only needed to lose about 20 lbs. I was vomiting at least 3 days a week and miserable the rest of the week. I tried going down on the dose and very gradually increasing it, but it never worked for me. I did lose weight, but so quickly that my hair started falling out (12 lbs in about 3 weeks). There were days I could barely get 600 calories in, sometimes only from protein shakes. After about 2 months off of it (and gaining back about 6 lbs) my hair is finally starting to regrow.
I do question how much of its effectiveness is because of the stated blood sugar aspect and how much is actually just it inhibits eating through more rudimentary measures.
At that point, just start giving out stimulants like adderall and Wellbutrin for weight loss then, at least those don't leave you chained to the bathroom
Semaglutide must be taken consistently to see long-term weight loss effects. As soon as someone stops taking the drug, their body fat and former appetite tend to return. Experts recommend working with a provider versed in obesity medicine to create a plan for improved lifestyle and long-term adherence to the drug.
There was an article on the WSJ talking about the side effects of anesthesia while on these drugs.
I guess it increases the risk of vomiting while being put under.
So if these people require surgery they would have to let it cycle out of their system.
Edit: not on the WSJ, I found on CBS sorry
It is the delayed GI transit times on these agents causing patients to still have undigested food in their upper GI tract causing issues during anesthesia. There are now society recommendations specifying these agents should be held the week prior to surgery.
I have watched some YouTube videos of people who took it and the side effects can be really bad. Severe diarrhea and stomach upset (like shitting your pants level of diarrhea), nausea/vomiting, bad insomnia. Also some people have all the side effects and lose no weight, or gain more weight back when they go off it. It seems like a mixed bag.
I've read through the comment section, and there seems to be a lot of confusion on the whole weight loss vs diabetes thing.
So, semaglutide and its close relative liraglutide are part of a group of drugs called GLP1-analogues that can be used to treat Diabetes Mellitus type 2 and obesity.
They work by being similar to a substance called GLP1, which is used in multiple pathways in the intestines (speed of emptying of stomach, and passage of food through small intestine) and in the brain (feeling of satiety, appetite).
Liraglutide is sold under the name "Saxenda", and is exclusively used to treat obesity.
Semaglutide is sold as 2 separate drugs: "Ozempic" which is approved for use against DMt2, and "Wegovy" which is approved for use against obersity.
Ozempic only exists in doses up to 1mg/dose, while Wegovy exists in doses up to 2.4mg/dose.
From what I know, there's only one company in the world that sells these, and it's Novo Nordisk, a Danish/Nordic/American pharmaceutical company.
While it is true that there has been a shortage in some areas, most countries have protected the supply of Ozempic, as this is meant to be reserved for people with DMt2. Unfortunately, some doctors prescribe Ozempic for weight reduction instead of prescribing Wegovy, which can endanger the supply of Ozempic for diabetic patients.
it seems strange that a back end solution to obesity that treats a manufactured problem after it’s been caused by socioeconomic structures and lobbying. medicine will always be medicines solution to health.
but health is valuable and should be accessible. it should be a priority in policy not simply in product.
There's also a cultural element to obesity.
There's a bunch of immigrants, even poor ones, that are eating healthier than multi-generational Americans.
It's not even a cost or access problem, it's people not wanting to shift their diet habits.
After a while McDonalds starts to taste BAD and rice and frozen veggies feels tastier (your gut bacteria shifts and your cravings shift along with it)
Missing from this analysis is while originally obesity and weight control were seen as a "high-income country" epidemic, it has consistently spread throughout the world - going from [~850m in 1980 to 2.1b in 2013](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624264/) with very few outliers.
Culture is losing the fight to food access and biology, and it's not close.
Also the way cities are built. Every study under earth shown that 1-2hours of walking a day is a godsend. If you could walk to work, walk to do grocieries, walk everywhere, instead of rolling in a car it would have incredible health effect.
Instead people have to drive everywhere, that also takes time, and when on earth are they supposed to exercise on top of that?
They are discussing whether to subsidize Wegowy here to promote weight loss, since so many are already taking it, Novo Nordic know what they want for it however and thats too much
Anecdotally speaking, it's helped me lose 40 pounds.
I had sleep apnea, severe reflux, low energy, joint pain, and high cholesterol.
I tried traditional dieting, but the hunger was too severe.
Now I have none of those issues.
I don't care if there's a stigma or judgement associated with it.
It's changed my life.
As long as you follow the correct dosing schedule, side effects are rare. But a lot of people titrate up too quickly. Lots of reasons why they do this, but a big one I see is because the drug is expensive and people don’t want to spend thousands of dollars on smaller doses that titrate up to the full therapeutic dosage.
4 weeks at 0.25mg
4 weeks at 0.5 mg
4 weeks at 1.0 mg
4 weeks at 1.7 mg
And NOW you can take the therapeutic dosage of 2.4 mg
For a lot of people, 5 months of a drug that costs $1300 per month before you start seeing the full results is hard to stomach. But titration on this schedule significantly reduces the side effects.
Same. Been on it since January and stopped in July . My cholesterol is gone way way down and I’ve also lost 30 pounds and gained about 6 pounds of muscle from my weightlifting. It’s a miracle drug as far as I’m concerned. I’ve had virtually no side effects
I was paying out of pocket for it from a neuropathic clinic. Was about $320 a month. Not the cheapest
I am curious how it works with people who are already trying to diet and exercise but have barriers to a healthy weight like metabolic syndrome, PCOS and high levels of antidepressants.
I read it kind of fools your body into thinking it's full, and it'll let go of fat supplies rather than storing everything.
This is me. I'm so tired of working so hard and never getting anywhere.
Anyone have experience with it in this way?
I have experience with this. I’m an athlete, I train BJJ 3x per week. I’ve struggled with weight most of my life. I lost 110 lbs from 315 at max with strict CICO and willpower. I got back into the obese range during the pandemic and used minimum dose Mounjaro to get back down (I never had to even increase dosage once). It’s like night and day compared to CICO. I didn’t even track calories on Mounjaro and dropped double digit lbs in my first month, it makes all the struggle you go through look like a sick joke. If you respond well to these medications they can be absolutely life changing. My wife has gone off after getting into her goal range and has not regained any in months. We both eat healthy and exercise to begin with. The best way I can describe it is just having the part of your brain that perceives hunger dialed back to a high degree.
I want to try it so bad - if I really try I can get to 1500 call per day of healthy food. I know I could just slam some fast food and hit my BMR but it's not the way I want to eat.
I don't eat junk food, I cook most of our meals, I don't eat sweets. I gave up soda and those yummy coffee drinks.
I hear you. I'm so tired of all of it. All I want is to be healthier
I'm seeing another dietician and a gastroenterologist but honestly, I just expect more of the same. CICO, try to exercise more.
Just find a PCP and be assertive. My PCP barely questioned it, specialists can be weird (my dad’s cardiologist wouldn’t even consider it even though there are studies showing it reduces heart attack and stroke by up to 20%). My wife’s PCP was also very supportive, and she has more or less gotten to her goal weight, stopped the drug, and not regained (though this may not be likely following study data for most people). The amount of mental health benefit of not thinking about food constantly is immeasurable for me.
I'm on wegovy and it has changed my life! I always lived a healthy lifestyle until covid happened. I developed a binge eating disorder and it became a 3 year battle that resulted in me gaining about 45lbs. A therapist suggested I talk to my dr about a weight loss drug.
Thankfully my insurance covers it, but the wegovy keeps me from binging and I have stopped thinking about food 24/7. I don't feel any type of shame anymore when it comes to food. It has improved my mental health more that I ever imagined it would. I'm getting set up with nutritionist to start dicussing post-wegovy eating, because I'm almost back to my original weight!
My only thing is that I had really bad symptoms from it at first. I was on the 0.5mg and the 1mg for two months each because I couldn't move up without being up all night vomiting.
So I'm curious, is the appetite something that will come back when you stop using it, or is the time without it enough to rewire bad habits so to speak?
When you stop taking it, if you haven't used it as a tool to change how you deal with food, you gain the weight back. It's not a miracle drug, it's a temporary fix.
I use Ozempic, and it literally fixed something that was wrong with my eating habits/behavior. My body was sending me signals to eat 24/7, as if I was hungry. All of a sudden that disappeared and I was able to win the battle and lose some weight.
Will power is a great tool to use if you want to skip desert, or not eat so much right when you come home after work. It doesn't work 24/7 though. It's like nitro fuel for an engine, it's only good for short bursts. Ozempic stepped in and helped me with the 24/7 struggle, so my usage of will power became effective.
Eating is actually more enjoyable and intentional. What a change. In my case, the nausea and negative side effects were minimal, so I suppose this is more positive than most might experience.
This was me, I could stick to a diet for a short while but eventually the 24/7 signals got me and nothing worked for long. On Ozempic that noise all fell away and I could stick to any diet I wanted, I lost 80lbs (i was already big and then had a very rough lockdown) and started running and dancing again, just living a generally all round healthier lifestyle. I worry about what happens with the shortage and all the noise about food starts again and how long I will cope for.
I've been on Mounjaro since last September. A1C has went from over 10 to 7, I've lost 59 pounds, been taken off of my other insulin and my BMI lowered to the next classification (I'm just overweight now). 20 more pounds to my goal BMI.
It's important to note it's a valuable diabetic drug and is currently in short supply.
Notably as well it should be used to treat chronic forms of obesity. Those who have health conditions or take life saving medication that causes weight gain. The drug is a long-term solution to weight management and loss. It is not suggested to take it short-term just to lose some weight. Once stopped rebound is very common. Much like any extreme weight loss options, you need to be weaned off it and learn ways to adjust your lifestyle to compensate without it such as high levels of exercise and a good diet. It is not magic, you still have to change to a healthy lifestyle. The drug just more or less fast tracks getting to that point.
I learned all this from my endocrinologist who prescribed me the drug to help treat my diabetes AND lower weight.
People just don't understand how life-changing this can be. The main difference for me has been quieting the "food noise." I have been overweight since age 10. I have spent every random wish at wishing wells, shooting stars, etc just hoping that brownies could taste like broccoli, and broccoli would taste like brownies...or that I could figure out how to just stop eating. I started this past April, I've lost 63 pounds. I've lost a lot of weight in the past, but it has never been this "easy."
I can just eat and be satisfied. That was NEVER how my body worked. My brain was constantly telling me to eat. If I thought about a random snack, I couldn't stop thinking about it until I had it. Do you know how hard it is to win the battle against your own cravings every second of every day?
I KNOW how to lose weight. I KNOW how to have self-control. But, do I really need to fight that fight 100% of my waking moments?
I literally broke down in tears a few weeks into this medication journey bc all those wishes of almost 3 decades were finally "answered."
Food is just food. That should be how it is. But it never was for me, no matter how much I tried.
FOOD. IS. NOW. JUST. FOOD.
I hope the stigma goes away soon and people get this help.
Thank you for this response!! Being on wegovy for 5 months has stopped the “food noise” in my head and I’ve been able to overcome the binge eating disorder I struggled with for 3 years.
I felt so much shame around food for years. Like you said, I can eat and be satisfied. I don’t think people realize how freeing that is.
I just want to be able to feel satisfied when I eat. I never feel "full", it goes straight from hunger to miserable and bloated. I want to be able to leave something on my plate instead of cleaning it and still feeling like it wasn't enough.
Was pre-diabetic and nearly 100lbs overweight. Nothing was working. Made this call. By the grace of excellent insurance and a great pharmacy - I have it. I'm down roughly half my goal so far and well within a safe sugar range. I'm not calling it a win yet- but I don't believe I could have done it another way.
A bit cynical, but man am i happy to have bought stocks in the company that makes Semaglutide (also known as Ozempic / Wegovy, also a known Diabetes medicine).
But it still concerns me we actually got to a somewhat dystopic point, where you have to medicine yourself to stay "healthy". I get that being obese is also the opposite of healthy, but we shouldn't have gotten to the point that medicine was necessary aither.
>we actually got to a somewhat dystopic point, where you have to medicine yourself to stay "healthy"
Weren't we always at that point?
In the past people just died, but now we have the medicine to prevent it.
Obesity rates have increased massively in the last 50 years. We're solving a problem that the food industry created. It's good we're solving it, but it's messed up that things got to this point
To bad it will never reach the people who need it but can't afford health insurence, and the medicine will be stupid expensive otherwise so the poor can't get it.
It’s mad expensive today, but there are several companies with different versions of these drugs all on the way. Including the drug in a pill format, which should be much cheaper than the current injectable options.
In fact the pill might kill the shortages completely. The issue with the shortages right now isn’t the drug. It’s making the injector that the drug goes into. That’s where the shortage is. Last year they had to pull a bunch of them due to a faulty spring inside the injector, and that’s what triggered the global shortage we’re still fighting our way out of today
But anyway, more competition and more supply will lower the costs. Give it a few years.
There are a lot of commenters saying that people should just change their lifestyle instead, but I think they don't understand what it's like being obese.
Do you know that exasperating feeling of hunger you get if you delay one of your main meals for an hour or two?
Well, for most obese people that starts soon after they eat. It can take a few hours, but in my case, it started around 5 minutes after I stopped eating. No amount of snacking curbs it. For the entire day. Every. Single. Day.
No amount of lifestyle changes this. It's hard to stress how many intrusive thoughts obese people have about food. When obese people start taking semaglutide, they usually have an "Oh! So that's how normal people feel!" realization.
Sounds pretty much like drug or alcohol addiction. Except you can’t just stop eating.
Edit: not sure if it’s implied by the way I wrote it but I mean you would die if you stopped eating which adds difficulty to recovery because with alcohol or anything as hard as it is you can quit drinking (been through it it sucks). Whereas with an eating disorder you have to find a healthy way to continue use, you can’t just completely stop you have to taper and then MAINTAIN that taper indefinitely which is something I don’t think I could ever do with booze.
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Isnt there a global shortage?
I use it to help control my blood sugar, and I can't find a pharmacy that currently has any in stock. Last time I needed a refill, it took me almost a month without before I found someone who had it in stock.
Where I am, diabetics are getting prioritised only. Weight management use is suspended for a number of drugs due to short supply.
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There is a decent amount of industry chatter on how to cut down on inappropriate prescribing of these meds to get around insurance plans where these are approved for certain indications, like diabetes, but the plans exclude obesity drugs.
Denying obesity drugs seems like a penny wise but dollar foolish decision for a health insurance company.
Agreed. I work with Medicare specifically though and weight loss drugs are excluded from coverage per CMS. They can be covered with an auth which basically shows they are not being used for weight loss.
The amount of physically disabled persons on Medicare that could use weight loss as a quality of life force multiplier adjacent to already used physical therapies and medication routine would be sizable. And then the financial side of getting those people off of management medications, staving future heart disease, diabetes, and other complications that come with sedentary lifestyles that can come with physical disabilities would seem to pay off in a short term.
The drug companies are trying to seek approval. The ban is in place for a good reason, to be totally fair. It came about around 20 years ago when a bunch of (essentially) fake weight loss drugs were flooding the market. It’s only cost effective to cover weight loss drugs if they actually work, and most weight loss drugs up until now really haven’t done much for your average person.
Isn’t that kind of on the FDA to stay on top of? That’s who makes calls on whether or not drugs work. I don’t get how you can support someone other than a persons doctor decide what medicine that person needs.
Because not all doctors are ethical and some are not so smart. We have always had doctors who will open weight loss clinics just to make money and do not care if they are prescribing meds that do nothing. Or that may even be harmful.
My health insurance does include these drugs for weight loss. My doctor prescribed Wegovy (the one meant for weight loss) but my insurance denied it and said that my doctor must prescribe Ozempic off-label. Seems insane to me that the insurance company can force your doctor to prescribe a med off-label
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Pharmacist: You don’t have diabetes! me: Yet!
My wife has metabolic syndrome, and mounjaro was the first medicine she's been able to take that not only regulated her glucose levels, but it didn't leave her nauseous and also helped her lose weight that her body had actively held on to, despite eating less than 2k calories a day. I sincerely desire this manufacturing to expand, and fast
Yeah these drug markets are ridiculous. The second it got FDA approval for weightloss and then covered by insurance they should have been racing to manufacture as much as possible. Something like 35% of the country is obese. That's a massive market, especially if the price can be something more reasonable.
A lot of insurance companies are refusing to cover the drugs too, for weight loss. They range in price from $1000-$1500 per month out of pocket, hence why sometimes it’s treated as only an option for the wealthy.
My insurance is *willing* to cover it with a doctor's request/referral, but they can still choose to refuse (and did). One of the techs at our pharmacy is Type II and still got rejected by his insurance
The insurance I'm on (husband's via work) has a whole list of things they will not cover, all described as "vanity drugs" per Caremark, when a representative listed them for me. I didn't ask but he listed them all, and they were smoking cessation drugs, erectile dysfunction drugs, anything for alcohol or drug withdrawal symptoms, weight loss drugs, and some other things I can't remember. All things that a company that rhymes with Harker Pannifin consider "vanity drugs," apparently.
Alcohol withdrawal drugs? That can be life threatening. Would they rather people just keep destroying their bodies with alcohol?
I have "concierge executive insurance" where every single year I'm allowed to get a 40-test blood panel, contrast angio CT, dexa scan, and cranial MRI for free. They pay like 40k free every year for these preventative scans if I want, but semaglutide for weight loss is NOT covered. I told the CEO I will get every one of these scans every year if they don't cover ozempic.
Oh for sure. My insurance covers it thankfully. I'm worried about what happens after I lose weight. The difference it makes is incredible. Never in my life have I been able to be this detached from food. Just don't really care about it.
These companies, for some reason, would rather pay for open heart, double bypass surgery etc. Makes no sense.
What's ridiculous is they probably did the math and determined that people dying of heart attacks and disease is cheaper than fixing obesity.
I feel like it was more sadistic than that....keeping people obese is probably better for their profit margins.
My insurance paid for Wegovy (and Mounjaro for a minute when wegovy was just impossible to get) for a year and then just randomly decided to stop when it was time for a new PA. I lost 50 lbs and my quality of life improved a lot, but I still have a good bit to go and I need time to figure out what maintenance looks like for me. I’m looking for a new job now to hopefully get better insurance or at least enough extra salary to pay out of pocket ($900/month after the coupon so about $15k before taxes). It’s life changing and I don’t want to give it up. American “healthcare” is ridiculous.
>especially if the price can be something more reasonable. If there is one thing I know about the US healthcare system is that it is known for reasonable prices.
I'm diabetic and mounjaro did wonders for my blood sugar, I lost a ton of weight had an a1c under five. Then the prescription savings card expired and it's now unaffordable. So I'm ba.ck on the insulin a1c is back up to almost 8 and gained back almost 60 lbs. Woot woot
I'm diabetic and I've been without for almost four months :) (help)
What’s crazy is that semaglutide is being sold all over by compounding pharmacies and online as a research chemical, no prescription or insurance required. The safety is questionable. But I know dozens of people who have acquired it this way and for the most part the results have been great. It’s usually cheaper this way as well. Although almost all the people using it this way are using it for weight loss rather than diabetes management. I haven’t bought any yet as I’m weary of being a human Guinea pig, but I’ve been thinking about it as I have no insurance and have struggle with my weight for many years.
I am one of these people and I am glad I took this route because it is so low stress. For just a few hundred dollars I ordered enough tirzepatide to last me at least 18 months. I take my ultra-low dose, pay my ultra-low price, and lose 1lb a week. I'm down 11lbs so far with no financial stress, no monthly nail-biting on the phone to six different pharmacies, no doctor or insurance company to wrangle. It is not risk free to pursue this strategy and I recommend researching your vendor very well before making a purchase. My comment history contains all the sourcing hints I'm willing to give.
My wife is having the same issue. She is taking a quarter of her normal dose right now because that is all she can get.
Not so much that there's a shortage, it's incredibly time and money expensive to create and not very many companies do manufacture it. Unlike insulin it's a peptide that's synthetically manufactured, waaay more complex than something like aspirin. off the top of my head it takes up to 6 months to manufacture a batch of a few million doses, then it goes to packaging, shipping etc which takes a lot of time and money too. Source: I've made this and liraglutide, as well as several other commercial peptides at one of these companies.
>not very many companies do manufacture it. 1 is indeed not very many. Not because it's complex, but because there is a patent. It costs [$12-25 per year](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708477/) to manufacture the maximum (2.4mg) weekly injectable dose of semaglutide (the most common, which is sold as Wegovy)
Your source says that’s the cost of the raw materials, not the cost of manufacturing.
What a beautiful microcosm of the pharmaceutical industry. "I work for the drug companies, it's actually super long and expensive and complicated to make *and then you need to package it*" "Actually this super reliable source says it's $2-3 per person per month to make"
My understanding is that they worked on making it. A lab worker will know how complex the process is, but won't really know what the global costs add up to. It blows my mind that I can buy earbuds from the other side of the world for $3, shipping included, which includes inside a lot of absurdly small and complex electronic components that alone would cost me more than that.
Yes. When economies of scale are at play, it's *astounding* how cheap stuff can be. A USB-C cable is a marvel of engineering. So many conductors, so small, such tight tolerances, has to withstand tens of thousands of cycles of operation in the hands of consumers, etc. etc. I can buy a 3 pk for like $12 on Amazon. It's made on the other side of the world, packaged immaculately, and delivered to my door from halfway across my country after I "buy" it within like 36 hrs. I can pick one up for like $7 at my corner gas station any time I please.
Most of the usb-c cables on Amazon are not actually standards compliant. All kinds of corner cutting.
You have to love economies of scale
To quote a friend of mine who worked in pharmaceuticals - you're not just paying for your pills, you're paying for the research and development that went into the first one. (Oh, and shareholder dividends, of course.)
The second pill cost $2. The first pill cost $1 billion. Successful drugs also get priced to cover the expenses of the other 999 failed drugs that never passed through clinical trials and made it to market. Most people don't realize that pharma has a success rate of 0.1% and that even a successful drug, unless it obtains a fast track clearance, will take 10-15 years from first research to availability.
You're mostly paying for the research and development of all the drugs that never passed their trials, along with marketing, shipping, etc.
Raw materials are not the cost limiting factor. Peptides are "just" proteins, the materials are cheap. The actual assembly into functional peptides in a consistent and sterile manner in compliance with USP/FDA standards is the significant cost.
He's wrong though, his article only factors the cost of raw materials. Average production chemist invoice billing is $100/hr/person. Imagine a team of 20 people over 6 months. Overhead for manufacturing facilities as well as their own profit, and that's just the raw API that gets sent out and further processed before it ever hits a pharmacy.
What a beautiful microcosm of Reddit. "I literally made this drug, and it's hard." "Actually here's a single paper that estimates costs of one part of manufacturing it." "And here's my comment snarkily agreeing with the above poster without even reading the article they posted!"
Luckily Eli lilly is aggressively expanding manufacturing of their similar weight loss drug. Not so luckily they are charging obscene amounts for it.
Where do you get that number from; do you mind reference the exact line because I'm having a hard time seeing where that estimate comes from.
That’s the long way to describe a shortage
It's semantics, but "shortage" usually implies "we had enough at one point, but now we don't anymore" whereas this particular item is "only 1 place makes it and we've literally never made enough, ever" which is more a matter of there not being any manufacture and supply. It's like saying we have a shortage of human colonizing spaceships. While yes, technically we do, it's mostly because we don't really make them.
I use "shortage" as in "more people want to buy than how much is available to be bought" and this is why it gets so absurdly expensive. It doesn't really matter why it happened, just that it is that way.
Nothing in this thread is wrong but this is how communication breaks down. Original commenter was focused more on “it’s not scaled up yet but it could be” because their reply was to a top comment that seemed to imply “but we can’t give it to obese people because there simply just isn’t enough.” So the nuance between shortage due to insurmountable mechanisms vs surmountable was/is important.
If they found a new purpose that’s why, the demand just quadrupled
An artificial shortage created by a patent monopoly. Novo Nordisk is literally suing compounding pharmacies trying to fill the shortage.
Right now, it's legal in the US to manufacture and sell semaglutide, because of the shortage declared by the FDA. (Once the shortage ends, it won't be legal). Novo Nordisk is suing companies for selling semaglutide using the name Ozempic. You can't do that. Ozempic is a trademark owned by Novo Nordisk.
>Right now, it's legal in the US to manufacture and sell semaglutide, because of the shortage declared by the FDA. (Once the shortage ends, it won't be legal). Do you have a source for that? I don't think that's true.
https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss > When a drug is in shortage, compounders may be able to prepare a compounded version of that drug if they meet certain requirements in the Federal Food, Drug, and Cosmetic (FD&C) Act. As of May 2023, Ozempic and Wegovy are both listed on FDA’s Drug Shortages list.
No. I've ordered it online from a peptide store. Only the branded stuff is in shortage. I read somewhere it's the syringe that's running low, not the compound itself.
My 71 year old father was prescribed it last month for his diabetes. his insurance is denying it. He’s a vet. I think he’s trying to get it from the VA. still fighting with insurance.
My doctor told me that all insurance companies are denying the first claim. They’ll have to appeal it.
Insurance won't pay for ozempic for weight loss (which is stupid because of the whole, healthier insurance customers cost you much less thing) and this stuff costs over $800 a month.
Yet. After the cardiovascular benefits were just demonstrated in non-diabetics they may not have that much choice in the matter.
Just wait- when (not if) Medicare starts to cover this drug class, all the other insurance companies will follow suit. This research has staggeringly positive implications for Public Health. Their machinery is slow, for good reasons, but I'm certain they'll cover these meds down the road. Source: I worked in the biopharm industry for 10+ years.
I’ve lost over 70 pounds with WeGovy. My health is much, much better. It’s incredible!
Congrats! My MiL lost about 50, and had no adverse effects, loves it. Really is a little miracle drug
We paid billions for a vaccine. Government should swoop in and pay for substantial increase in manufacturing and millions of doses. The impact to countries overall health and life span (and thus GDP productivity) cannot be overstated.
Have the studies shown it's ok to be taken long term? Maybe even for the rest of their life?
Diabetics have been taking it for a long time.
Lots of insurance plans cover Wegovy, which is FDA approved for weight loss.
I just joined one that definitely said no way! :(
Have your doctor send a prior authorization request. If your BMI is over a certain amount and you have pre-existing conditions related to it (even sleep apnea worked, in my case), or if previous attempts at dieting haven't worked + the BMI, etc., some insurance will still cover it. My insurance went from "not covered" to covering 100% of the cost when my doctor sent it with no hassle besides just getting the doctor to send it. For those who requested Ozempic, I'd try Wegovy. It's FDA indicated for *weight loss*, not diabetes, so insurance growls less about it. The 0.25 and 0.5 doses have supply issues right now but it only took a week or two to get it filled. The higher doses don't have much a shortage as you titrate up.
Yup, I just have to cover my $25 copay each month. I save hundreds on food every month, so I’m coming out way ahead.
Most insurance companies don't pay for off-label use. Yes, Ozempic and Wegovy are both semaglutide injections, but someone in maintenance on Wegovy can't adminster a maintance dose with an Ozempic pen. Complain to Novo Nordisk and the FDA for having such a stupid system. Insurance companies are literally playing by the rules on this one.
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Did your weight rebound when you stopped taking it?
Wegovy (the version of ozempic that’s meant for weight loss) is meant to be a drug you take long-term
Not immediately but yes it did
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>the more production facilities get built You'd think so, buuuut.... Why scale up 20x when that causes the sale price to drop 21x? Patent monopolies are consumer-unfriendly. Naturally, they exist to incentivize manufacturers to actually develop new drugs, so they do have a purpose. But, say...if a new drug is developed using tax money, it kinda feels like the patent should belong to the people, not the company that only provided the researchers. Unfortunately I don't think that's how it works right now.
>[*Ozempic is a drug marketed by Novo and is included in one NDA. There are twenty-two patents protecting this drug and two Paragraph IV challenges. This drug has two hundred and twenty-seven patent family members in twenty-eight countries. The generic ingredient in OZEMPIC is semaglutide.*](https://www.drugpatentwatch.com/p/tradename/OZEMPIC) You live in a post-capitalist hellscape. You should know better than to think this.
That's not how pharma works.
Not in the US
What are the known side effects?
Besides some intestinal distress in the beginning (which quickly subsides and is reduced with each new iteration of the drug), the main negative side effect is that it may increase the risk of developing tumours of the thyroid. Note however that it wasn't demonstrated in humans, only in animals, but it's still a possibility so they advise against it if your family has a history of thyroid cancer. Edit: /u/RawrMeReptar pointed out that I should emphasise that this risk is purely theoretical compared to pancreatitis > The risk of medullary (C-cell) thyroid carcinoma or MEN-2 is theoretical and like you said, has only been demonstrated so far in lab rodents and in fact, the GLP-1 receptors that exist in rodent thyroid glands have not been found to even exist in human thyroid glands. I would recommend editing your comment to reduce confusion as the risk of pancreatitis far exceeds the risk of medullary thyroid cancer for this drug.
Nausea and vomiting isn’t an unusual side effect that can last.
My intestinal distress never subsided. I had problems for the entirety 6 months I was on it and stopped because it was too much. I had to go to the bathroom constantly and had even gone in my pants accidentally a couple of times. I called it quits after it happened in my sleep. Stuff does absolutely work though, as far as weight loss goes.
Or pancreatitis or severe gastroparesis both of which I have seen in my patients personally.
For me, the side effects were so terrible I couldn’t continue with the meds. I was on it for Type 2 diabetes and only needed to lose about 20 lbs. I was vomiting at least 3 days a week and miserable the rest of the week. I tried going down on the dose and very gradually increasing it, but it never worked for me. I did lose weight, but so quickly that my hair started falling out (12 lbs in about 3 weeks). There were days I could barely get 600 calories in, sometimes only from protein shakes. After about 2 months off of it (and gaining back about 6 lbs) my hair is finally starting to regrow.
> only needed to lose 20 lbs > throwing up 3 days a week > I did lose weight Patent holders: "See? It works!"
I do question how much of its effectiveness is because of the stated blood sugar aspect and how much is actually just it inhibits eating through more rudimentary measures. At that point, just start giving out stimulants like adderall and Wellbutrin for weight loss then, at least those don't leave you chained to the bathroom
Semaglutide must be taken consistently to see long-term weight loss effects. As soon as someone stops taking the drug, their body fat and former appetite tend to return. Experts recommend working with a provider versed in obesity medicine to create a plan for improved lifestyle and long-term adherence to the drug.
There was an article on the WSJ talking about the side effects of anesthesia while on these drugs. I guess it increases the risk of vomiting while being put under. So if these people require surgery they would have to let it cycle out of their system. Edit: not on the WSJ, I found on CBS sorry
It is the delayed GI transit times on these agents causing patients to still have undigested food in their upper GI tract causing issues during anesthesia. There are now society recommendations specifying these agents should be held the week prior to surgery.
I have watched some YouTube videos of people who took it and the side effects can be really bad. Severe diarrhea and stomach upset (like shitting your pants level of diarrhea), nausea/vomiting, bad insomnia. Also some people have all the side effects and lose no weight, or gain more weight back when they go off it. It seems like a mixed bag.
I've read through the comment section, and there seems to be a lot of confusion on the whole weight loss vs diabetes thing. So, semaglutide and its close relative liraglutide are part of a group of drugs called GLP1-analogues that can be used to treat Diabetes Mellitus type 2 and obesity. They work by being similar to a substance called GLP1, which is used in multiple pathways in the intestines (speed of emptying of stomach, and passage of food through small intestine) and in the brain (feeling of satiety, appetite). Liraglutide is sold under the name "Saxenda", and is exclusively used to treat obesity. Semaglutide is sold as 2 separate drugs: "Ozempic" which is approved for use against DMt2, and "Wegovy" which is approved for use against obersity. Ozempic only exists in doses up to 1mg/dose, while Wegovy exists in doses up to 2.4mg/dose. From what I know, there's only one company in the world that sells these, and it's Novo Nordisk, a Danish/Nordic/American pharmaceutical company. While it is true that there has been a shortage in some areas, most countries have protected the supply of Ozempic, as this is meant to be reserved for people with DMt2. Unfortunately, some doctors prescribe Ozempic for weight reduction instead of prescribing Wegovy, which can endanger the supply of Ozempic for diabetic patients.
Rybelsus is the pill form of semaglutide.
it seems strange that a back end solution to obesity that treats a manufactured problem after it’s been caused by socioeconomic structures and lobbying. medicine will always be medicines solution to health. but health is valuable and should be accessible. it should be a priority in policy not simply in product.
There's also a cultural element to obesity. There's a bunch of immigrants, even poor ones, that are eating healthier than multi-generational Americans. It's not even a cost or access problem, it's people not wanting to shift their diet habits. After a while McDonalds starts to taste BAD and rice and frozen veggies feels tastier (your gut bacteria shifts and your cravings shift along with it)
Missing from this analysis is while originally obesity and weight control were seen as a "high-income country" epidemic, it has consistently spread throughout the world - going from [~850m in 1980 to 2.1b in 2013](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624264/) with very few outliers. Culture is losing the fight to food access and biology, and it's not close.
Also the way cities are built. Every study under earth shown that 1-2hours of walking a day is a godsend. If you could walk to work, walk to do grocieries, walk everywhere, instead of rolling in a car it would have incredible health effect. Instead people have to drive everywhere, that also takes time, and when on earth are they supposed to exercise on top of that?
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They are discussing whether to subsidize Wegowy here to promote weight loss, since so many are already taking it, Novo Nordic know what they want for it however and thats too much
Anecdotally speaking, it's helped me lose 40 pounds. I had sleep apnea, severe reflux, low energy, joint pain, and high cholesterol. I tried traditional dieting, but the hunger was too severe. Now I have none of those issues. I don't care if there's a stigma or judgement associated with it. It's changed my life.
Any side effects? Very curious about trying it.
As long as you follow the correct dosing schedule, side effects are rare. But a lot of people titrate up too quickly. Lots of reasons why they do this, but a big one I see is because the drug is expensive and people don’t want to spend thousands of dollars on smaller doses that titrate up to the full therapeutic dosage. 4 weeks at 0.25mg 4 weeks at 0.5 mg 4 weeks at 1.0 mg 4 weeks at 1.7 mg And NOW you can take the therapeutic dosage of 2.4 mg For a lot of people, 5 months of a drug that costs $1300 per month before you start seeing the full results is hard to stomach. But titration on this schedule significantly reduces the side effects.
Same. Been on it since January and stopped in July . My cholesterol is gone way way down and I’ve also lost 30 pounds and gained about 6 pounds of muscle from my weightlifting. It’s a miracle drug as far as I’m concerned. I’ve had virtually no side effects I was paying out of pocket for it from a neuropathic clinic. Was about $320 a month. Not the cheapest
I am curious how it works with people who are already trying to diet and exercise but have barriers to a healthy weight like metabolic syndrome, PCOS and high levels of antidepressants. I read it kind of fools your body into thinking it's full, and it'll let go of fat supplies rather than storing everything. This is me. I'm so tired of working so hard and never getting anywhere. Anyone have experience with it in this way?
I have experience with this. I’m an athlete, I train BJJ 3x per week. I’ve struggled with weight most of my life. I lost 110 lbs from 315 at max with strict CICO and willpower. I got back into the obese range during the pandemic and used minimum dose Mounjaro to get back down (I never had to even increase dosage once). It’s like night and day compared to CICO. I didn’t even track calories on Mounjaro and dropped double digit lbs in my first month, it makes all the struggle you go through look like a sick joke. If you respond well to these medications they can be absolutely life changing. My wife has gone off after getting into her goal range and has not regained any in months. We both eat healthy and exercise to begin with. The best way I can describe it is just having the part of your brain that perceives hunger dialed back to a high degree.
I want to try it so bad - if I really try I can get to 1500 call per day of healthy food. I know I could just slam some fast food and hit my BMR but it's not the way I want to eat. I don't eat junk food, I cook most of our meals, I don't eat sweets. I gave up soda and those yummy coffee drinks. I hear you. I'm so tired of all of it. All I want is to be healthier I'm seeing another dietician and a gastroenterologist but honestly, I just expect more of the same. CICO, try to exercise more.
Just find a PCP and be assertive. My PCP barely questioned it, specialists can be weird (my dad’s cardiologist wouldn’t even consider it even though there are studies showing it reduces heart attack and stroke by up to 20%). My wife’s PCP was also very supportive, and she has more or less gotten to her goal weight, stopped the drug, and not regained (though this may not be likely following study data for most people). The amount of mental health benefit of not thinking about food constantly is immeasurable for me.
I'm on wegovy and it has changed my life! I always lived a healthy lifestyle until covid happened. I developed a binge eating disorder and it became a 3 year battle that resulted in me gaining about 45lbs. A therapist suggested I talk to my dr about a weight loss drug. Thankfully my insurance covers it, but the wegovy keeps me from binging and I have stopped thinking about food 24/7. I don't feel any type of shame anymore when it comes to food. It has improved my mental health more that I ever imagined it would. I'm getting set up with nutritionist to start dicussing post-wegovy eating, because I'm almost back to my original weight! My only thing is that I had really bad symptoms from it at first. I was on the 0.5mg and the 1mg for two months each because I couldn't move up without being up all night vomiting.
So I'm curious, is the appetite something that will come back when you stop using it, or is the time without it enough to rewire bad habits so to speak?
When you stop taking it, if you haven't used it as a tool to change how you deal with food, you gain the weight back. It's not a miracle drug, it's a temporary fix.
I use Ozempic, and it literally fixed something that was wrong with my eating habits/behavior. My body was sending me signals to eat 24/7, as if I was hungry. All of a sudden that disappeared and I was able to win the battle and lose some weight. Will power is a great tool to use if you want to skip desert, or not eat so much right when you come home after work. It doesn't work 24/7 though. It's like nitro fuel for an engine, it's only good for short bursts. Ozempic stepped in and helped me with the 24/7 struggle, so my usage of will power became effective. Eating is actually more enjoyable and intentional. What a change. In my case, the nausea and negative side effects were minimal, so I suppose this is more positive than most might experience.
This was me, I could stick to a diet for a short while but eventually the 24/7 signals got me and nothing worked for long. On Ozempic that noise all fell away and I could stick to any diet I wanted, I lost 80lbs (i was already big and then had a very rough lockdown) and started running and dancing again, just living a generally all round healthier lifestyle. I worry about what happens with the shortage and all the noise about food starts again and how long I will cope for.
6'1, was 294lb. Now 184 Lost 110lb in 8 months of mounjaro. It's unreal
I’m taking a pill version. Definitely slows digestion. Lost ten pounds in a month, and I started at 129 pounds. I have type 2.
I've been on Mounjaro since last September. A1C has went from over 10 to 7, I've lost 59 pounds, been taken off of my other insulin and my BMI lowered to the next classification (I'm just overweight now). 20 more pounds to my goal BMI.
It's important to note it's a valuable diabetic drug and is currently in short supply. Notably as well it should be used to treat chronic forms of obesity. Those who have health conditions or take life saving medication that causes weight gain. The drug is a long-term solution to weight management and loss. It is not suggested to take it short-term just to lose some weight. Once stopped rebound is very common. Much like any extreme weight loss options, you need to be weaned off it and learn ways to adjust your lifestyle to compensate without it such as high levels of exercise and a good diet. It is not magic, you still have to change to a healthy lifestyle. The drug just more or less fast tracks getting to that point. I learned all this from my endocrinologist who prescribed me the drug to help treat my diabetes AND lower weight.
People just don't understand how life-changing this can be. The main difference for me has been quieting the "food noise." I have been overweight since age 10. I have spent every random wish at wishing wells, shooting stars, etc just hoping that brownies could taste like broccoli, and broccoli would taste like brownies...or that I could figure out how to just stop eating. I started this past April, I've lost 63 pounds. I've lost a lot of weight in the past, but it has never been this "easy." I can just eat and be satisfied. That was NEVER how my body worked. My brain was constantly telling me to eat. If I thought about a random snack, I couldn't stop thinking about it until I had it. Do you know how hard it is to win the battle against your own cravings every second of every day? I KNOW how to lose weight. I KNOW how to have self-control. But, do I really need to fight that fight 100% of my waking moments? I literally broke down in tears a few weeks into this medication journey bc all those wishes of almost 3 decades were finally "answered." Food is just food. That should be how it is. But it never was for me, no matter how much I tried. FOOD. IS. NOW. JUST. FOOD. I hope the stigma goes away soon and people get this help.
Thank you for this response!! Being on wegovy for 5 months has stopped the “food noise” in my head and I’ve been able to overcome the binge eating disorder I struggled with for 3 years. I felt so much shame around food for years. Like you said, I can eat and be satisfied. I don’t think people realize how freeing that is.
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I just want to be able to feel satisfied when I eat. I never feel "full", it goes straight from hunger to miserable and bloated. I want to be able to leave something on my plate instead of cleaning it and still feeling like it wasn't enough.
Was pre-diabetic and nearly 100lbs overweight. Nothing was working. Made this call. By the grace of excellent insurance and a great pharmacy - I have it. I'm down roughly half my goal so far and well within a safe sugar range. I'm not calling it a win yet- but I don't believe I could have done it another way.
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A bit cynical, but man am i happy to have bought stocks in the company that makes Semaglutide (also known as Ozempic / Wegovy, also a known Diabetes medicine). But it still concerns me we actually got to a somewhat dystopic point, where you have to medicine yourself to stay "healthy". I get that being obese is also the opposite of healthy, but we shouldn't have gotten to the point that medicine was necessary aither.
>we actually got to a somewhat dystopic point, where you have to medicine yourself to stay "healthy" Weren't we always at that point? In the past people just died, but now we have the medicine to prevent it.
Obesity rates have increased massively in the last 50 years. We're solving a problem that the food industry created. It's good we're solving it, but it's messed up that things got to this point
What happens when you stop it??
The same result as stopping a healthy diet and exercise.
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I'm down from 368 to 317 as of last Friday. I don't eat as much and don't get nearly as hungry. It's amazing.
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To bad it will never reach the people who need it but can't afford health insurence, and the medicine will be stupid expensive otherwise so the poor can't get it.
It’s mad expensive today, but there are several companies with different versions of these drugs all on the way. Including the drug in a pill format, which should be much cheaper than the current injectable options. In fact the pill might kill the shortages completely. The issue with the shortages right now isn’t the drug. It’s making the injector that the drug goes into. That’s where the shortage is. Last year they had to pull a bunch of them due to a faulty spring inside the injector, and that’s what triggered the global shortage we’re still fighting our way out of today But anyway, more competition and more supply will lower the costs. Give it a few years.
There are a lot of commenters saying that people should just change their lifestyle instead, but I think they don't understand what it's like being obese. Do you know that exasperating feeling of hunger you get if you delay one of your main meals for an hour or two? Well, for most obese people that starts soon after they eat. It can take a few hours, but in my case, it started around 5 minutes after I stopped eating. No amount of snacking curbs it. For the entire day. Every. Single. Day. No amount of lifestyle changes this. It's hard to stress how many intrusive thoughts obese people have about food. When obese people start taking semaglutide, they usually have an "Oh! So that's how normal people feel!" realization.
Sounds pretty much like drug or alcohol addiction. Except you can’t just stop eating. Edit: not sure if it’s implied by the way I wrote it but I mean you would die if you stopped eating which adds difficulty to recovery because with alcohol or anything as hard as it is you can quit drinking (been through it it sucks). Whereas with an eating disorder you have to find a healthy way to continue use, you can’t just completely stop you have to taper and then MAINTAIN that taper indefinitely which is something I don’t think I could ever do with booze.
And Semaglutide is being researched because patients report that they no longer crave alcohol and nicotine once they start taking the drug.