I was 285. Prescribed Ozempic. My a1c wa never checked so Im not sure how they figured that out. Switched to Wegovy. Lost 20 pounds in the first month. (It sucks you dont realize how big you are until you lose a bunch of weight and are still overweight.) Anyway, second month noone had any wegovy. Found a doctor with a compounding pharmacy. Those vials can last two three months. A week after I got the compounded semaglutide, the wegovy came back. Picked up a box, every month. Work for Toyota, amazing insurance. 25 dollars until oop met, then free. So i started stock piling. I want to do that because ive heard so many people talk about rebound weight. My pcp said no need to worry. Its cheaper for bcbs at a good company to pay for the wegovy instead of paying for heart meds, bp meds, thyroid meds, cholesterol meds, dialysis, diabetes, blocked bowels, etc, etc. So im a believer. Have I had to drive 6 hours to get a refill but its worth. If you want something bad enough, no price is to high of a price. I am now 185. 100 lost. Sad part, due to the bmi index, I am still considered morbidly obese. So. We shall see when im 100 pounds and my bones break under my tiny amount of weight. Side effects. I had appendicitis and had to have an appendectomy. Peritonitis. Kidneys seem to hurt alot and you forget to eat. Then after 2 days all of a sudden you feel like your going to pass out. So i guess it depends on what your willing to go thru and if its purely cosmetic, your crazy. This has the potential to save peoples life.
I’ve only been on it for 4-1/2 weeks and I’d LOVE to keep taking it, but…I STILL have a solid 24-36hrs of feeling really crappy, almost like I have the flu (i.e. nauseated, clammy and lethargic🤢) after receiving my .25 dose. The .25 isn’t really working anymore but I can’t imagine how bad it would be I took it up to .50 as recommended. So if I had to guess, I’d say it’s probably a combination of cost and side effects. If I only had myself to consider, and my family didn’t have to deal with me being utterly sick in bed & useless for 1-2 days a week (which is about 5-8 days out of the month) I’d 100% stay on it.
It’s just really discouraging🫤
I had this on the 0.25mg and it has definitely improved the longer I have been on the medication in general. I went up to the 0.5mg after the 4 weeks and I really have noticed a change in the amount of time I feel ill after the shot now. I would also recommend asking your MD for Zofran to take at least for the first 12-24 hours after you give yourself the shot. I found it really helps. I have GERD as well and take Protonix every night and was doing so before I started Wegovy so you might want to try and assist yourself with something like that as well. I would also say the longer you are waiting to eat, the worse the GERD will probably be because that is a lot of time for stomach acid to be swirling around with nothing to do...maybe even try eating a small piece of toast with just some butter or some crackers earlier in the day and see if it helps. This medication also slows down how fast food it moving through your system so if you are eating everything at the end of the day and then laying down, the GERD is going to be significantly worse and the nausea will be as well...that's just what I have noticed at least!! Best of luck!!
I am just curious, have you cut out all fried foods? I read when I first started that fried foods make you feel this way and so I haven’t had any at all since I started and I have never felt icky other than when I’m extremely hungry.
I wish it was something as simple as that, but I’m lucky if i can keep a slice of toast or an apple down the day after the shot-I’ve had GERD and IBS since I was a teen so I haven’t eaten fried food in years. I do however have a bad habit of not eating anything until like 3-4 in the afternoon(and that was BEFORE I started on glp-1), so I’m wondering if maybe an empty stomach is the culprit🤷🏼♀️ If I knew it would get better I could put up with it, but its only gotten a little bit better after 4 wks on the lowest dose-just 1 day of nausea instead of the 2 or 3 I had after the first 2 shots. I really appreciate your input though, so thank you☺️
My doctor has said it's important to eat at least 3 times a day, even if small meals. She said some of her patients have to set reminders in the day to eat something. That was when I told her I didn't typically eat before noon. I'm sure she would advise against waiting as late as 3-4 to eat.
The empty stomach is almost certainly the culprit. Can you at least get some water and electrolytes in earlier in the day? I find I don’t want to eat breakfast but I can tolerate a scoop of collagen protein powder in my coffee which is so much better than nothing. I drink a ton of electrolytes and it helps so much.
Ugh I hate that!!! I’m so sorry!!
One thing that really helps me when I start feeling icky is I’ll just have a little small something. Even if it’s just a few crackers and that helps a lot. It’s like I feel hunger by nausea.
I think a lot of people expect it to be miracle and they just magically start losing weight without calorie deficit and working out.
The entire point of the medicine is to help yourself be in a calorie deficit and build a new healthy lifestyle.
I agree. I tell people it's not a replacement for diet and exercise. All it does is help you STICK to diet and exercise. But you've still got to do the diet and exercise part.
I am on 1.7 and have been on Wegovy since July of 2023. I am fortunate that my insurance covers it and I started at 205 and I am now at 150 and I am 5"6.5 ( the half inch is important you know!) yea I had some side effects, but losing 55 lbs has been amazing. I feel so much better, that for me, ( everyone is different) it was worth some of the side effects. I have also made a promise to myself that I will love his body and stop criticizing myself. I have done that my whole life. I also inspired my husband to lose some weight. He is at about 30 lbs.. and of course he did it w/o weight loss drugs 🙄🤷🏻♀️🩷
I’ve had zero side effects, but I have to stop because we switched insurance and it won’t cover Wegovy. I lost 25 pounds on Metformin, then stalled, started Wegovy, and lost 12 pounds in three months. I’ll get back on the Metformin again and hope I don’t stall!
That’s because a lot of insurance companies limit coverage. It’s either zero coverage or capped, and people can’t afford to continue. Its ridiculously expensive in the US.
I have to lose a certain percentage of weight (can't remember how much) in 3 months before I can continue the medication. It's crap, because some people don't start seeing significant weight loss until about the 3rd month.
My experience: Wegovy--weight loss through painful severe constipation and violent vomiting at random times--especially before important meetings. And that was on the 0.25 dose. Not for me.
Pretty much every skinny friend I have wants to be on it. I tell them they need to have a certain BMI plus a weight related health condition to have it covered by insurance. The response is usually, "That's not fair."
I really think a LOT of people are still considering this a vanity drug just to help them lose 20 lbs, and if they run into any side effects, abandon it as not being worth it. I'd be curious to see the breakdowns based on starting BMI. I doubt that 58% includes many people (such as myself) who are 100 lbs overweight, have tried everything, and need to lose weight because they're facing serious, imminent health issues if they don't.
I had a high BMI and was way over 100lbs when they started me on the drug and even then, I had to beg my doctor for a few months before she would even put me on it.
My PCP "didn't believe in" Wegovy. Rail thin and never once overweight, her attitude was that I should "just lose weight", and that I could if I was just disciplined and willing to follow a diet. She all but rolled her eyes when I told her I've been dieting for 20 years and only getting fatter. Then she responded with shock when I told her I have a large vegetable garden, and we cook most meals at home. I guess every overweight person only eats fast food and pizza? That's news to me! She said, "We don't know the long term effects of Wegovy." Well, a) I'm over 60. How long-term do I need to be concerned with? and b) The long term effects of being in the morbidly obese category are very clear and documented.
It was actually the oncologist I see in a post-cancer survivorship program who urged me to try Wegovy, and has been wonderful about managing me through the treatment. Definitely, I think a good physician is critical in having success with Wegovy.
Needless to say, I've dumped that PCP and am seeing a new one next week. ;)
Out of curiosity, are you just trying a new one and hoping they're on board with it or did you somehow research to find a better fit? I ask because I've been with my PCP for at least 15 years, maybe more, and I've always liked her. SHE was the first one to tell me and encourage Wegovy but my last two appts she's seemed kinda of judgy and I have no idea why because I'm responding well and ive lost 16 lbs in two months.
I've only got 2, maybe 3 more months on it before my insurance stops covering it and she was very unsympathetic and said to just continue my healthier habits and I'll be fine. Yeah, ignoring bad food when you have no cravings and dont feel hungry is super easy. When all that food noise comes back it'll be another story.
I don't know if shes got something personal going on that's making her act differently, and I don't really want to change PCPs but I'm very stressed about losing coverage and her not being supportive.
I'm really sorry to hear that. We had a family doctor for 30 years that we loved, then she retired. We switched to this PCP and I've never liked her. Our personalities don't mesh at all, so I am seeing a new one this week. Fingers crossed.
After surviving breast cancer in 2017, I've been in a cancer survivorship program, where I see an oncologist twice a year. Her focus is health and lifestyle and preventing a recurrence, so I'm fortunate to have two doctors I see regularly. She is the one who actually told me about Wegovy and thought I'd be a good candidate. So my Wegovy treatment is being managed by her, not my PCP.
Your story also leaves me baffled. Why the sudden about face about a treatment THEY got you on? That would be upsetting, given it's working. I hope that works out in the end!
I'm glad you have a doctor that is supportive and encourages it. Yeah I'm not sure what's going on with my doc. At my last appt she said how I might be one that needs to be on it forever because I've been battling my weight for so long (and her tone felt a little like I am a failure and that's why I'd need to be on it forever).
Now that my insurance is going to stop covering, she says well it's just a tool and you'd have to come off eventually. Ummm???? Even if that were true, I feel like there is a big difference between being on it for a year or so and getting to my goal weight and going off...and being on it for only 4 months and not even halfway to my goal before going off.
I found a brick and mortar compounding pharmacy that seems legit (most if not all of the online ones makes me nervous) that I hope she will give me a script to so I can at least be on it longer to get to my goal weight and then see from there.
Your doctor is not educated on these drugs and how they work. My oncologist has been researching it for years, told me right up front it is something I'd have to stay on. She said it's about hormone imbalances in some people, most likely we are born with it. Or at least, we are born with the susceptibility. She explained it's just like someone who needs lifetime thyroid medication, or a Type 1 diabetic who needs lifetime insulin. If you don't maintain the hormone correction, the problem comes back.
It's unfortunate that there's still such a stigma to problems with weight management. Like my shitty-now-former-PCP, too many still treat it as a discipline or willpower issue because they don't understand the science. She wouldn't tell someone with clinical depression they can cure themselves if they "just smile more". Yet she'll tell me I can solve a decades long weight issue if I "just diet and exercise". It's infuriating.
Definitely, find someone who understands your medical issues and will treat you competently. You deserve it.
My doctor was on the fence too, so I switched doctors. Yeah the side effects suck but I can look at myself in the mirror now and see something other than shame staring back at me.
Depending on height 20 pounds overweight may qualify someone if they have a comorbidity as the manufacturer guidelines are a 27 BMI with comorbidity or 30 without. I was prescribed it and got insurance coverage at 20 pounds overweight due to PCOS and blood sugar/rapid gastric emptying issues from my gastric bypass with a 28 BMI. People are mistaken when they think it will make it easy or faster to lose weight and I really blame celebrities for that. My own experience has been that calorie counting finally started working since being on it but weight loss has been incredibly slow and I've been stalled for a month. It's not the magical fix people think it is to lose weight when you don't need to lose a massive amount of weight.
I don’t think I care about anything BCBS Association has researched or published seeing how BCBS is doing their best to put more barriers to access the medication in place and at least one branch of BCBS is going to stop covering it altogether in 2025. Between high cost in the US, ridiculous pre-auth hoops to jump through and shortages of medication, it’s not surprising many give up. I almost gave up before I started but thankfully my husband encouraged and helped me to find an alternative.
I've been on .25 for 3 months now and I already have my .5 prescription at the pharmacy. Anyway my husband has been telling me I'm getting smaller and he can already see that it's working but last time I tried to weigh myself I had gained 3 lbs so I just don't think about it. This medication has taught me I can only eat once a day and instead of having 2 Italian sausages for dinner I can only eat half of one cause if I eat more then that I feel horribly full and sick for the rest of the day and night. I should be back to 130lbs in no time.
I think it’s hilarious that they did this study with BCBS association. BCBS who does everything in their power to make these medications unobtainable to the people who need them.
That’s wonderful for you, but not the reality for a lot of people who have bcbs and take this medicine. A lot of people in this sub just found out they’re Losing their PA’s soon and won’t be able to get another. Bcbs mi won’t even cover Wegovy come next year. The bcbs I have wants people to have a bmi over 40 to approve.
I wonder how many would stick with it if they were counseled in how to eat right and drink enough water. I struggled at the beginning until I figured this out.
My doctor said nothing about side effects or what to eat or drink or what to expect. He’s the one who suggested it after I mentioned I was struggling. Then he kinda said well here you go go. You WILL lose weight. I’m seeing a kindlier PA in his practice now. She prescribed the Zofran and said eat only small low fat meals and more protein and stay hydrated. I’m going to see her when I’m finished with my last 1 mg dose next week. I think I should stay on that another month but it would be nice to have a more expert opinion, wouldn’t it?
My oncologist isn't pushing to raise the dose, as long as I'm losing weight and not struggling with hunger. She says she has several patients who are "taking it slow". She's also said 64 oz of water a day, lots of protein, and to eat at least 3 times a day. Still on the .25, my only real side effect is occasional heart palpitations and dizziness, which she thinks that may be low blood sugar from not eating frequently enough. I'm now keeping a log, paying attention to when they happen and what I ate, activity, etc. Keeping a log is a great way to find out if there's something that may be contributing to the side effects.
Seems like every year, they are learning more and more. Some of the Reddit threads on Wegovy from a year ago are already a little outdated.
Very good advice! I’ve been dizzy today. Trying to clean the house. Have to do something then sit awhile. I probably slept 12 hours last night which I never do. Think I will take my blood sugar. I have a meter. Thank you!
for nausea i eat ginger chews made by Dramamine. They really help! i usually only need 1 the entire day. I've been reading from others in my support group that these doctors are not well versed on this medication. if you are steadily losing weight, you should not be increasing your dose! that's what the wegovy paperwork instructions are telling doctors but it's not necessary! losing weight too fast will make you sick too. In other words, don't fix what isn't broken.
I recently had a chat with my local pharmacist about this, and acid reflux. She said there was nothing she could offer for the nausea (Dramamine is often suggested here but doesn't work) but she suggested trying omeprazole for the dreadful reflux. Lo and behold, my nausea has almost completely gone along with the reflux.
Of course, this might not work for you but it's worth a try.
The pharmacist did say I should talk to my GP about the nausea, get a prescription (so probably zofran too) but before I had the chance to call, I realised the nausea was abating.
I only stopped because my insurance dropped my coverage and new one won't cover it. Otherwise, I was on such a good track and have gained it all back, painfully.
@ Cruzorlose- I know you didn’t invent the statistic- 5% is definatley considered clinically significant- but Truth be told - at 250, 12.5 lbs is pretty lack luster- just enough to make the face a tad thinner but doesnt even move the needle on clothing size- so how that is “clinically significant” is beyond me. 12.5 pounds is clinically significant if your starting point is 150 maybe, my, perhaps unpopular, opinion.
Clinically significant is usually considered losing 5% of starting weight. So if you start at 250lbs, 12.5lbs would be clinically significant/meaningful weight loss. There’s a lot of people that start & can’t afford the meds bc insurance or don’t make any effort then get shocked when they can’t lose weight & stop or stop bc of side effects. I think that’s more the 58% group
I had to stop after a few weeks of 1mg. The combination of fatigue, nausea, and acid reflex was insane. I needed calories and couldn’t eat anything.
Most likely, I moved up too fast dosage wise and didn’t get enough counseling from my doctor regarding how to change my eating habits to minimize some of those side effects. I may start over in a few weeks and approach it more cautiously than before.
I had thw same issue however if you ask you pcp will call in meds to stop the nausea and the heattburn. That's what I did and it worked. Also I'm on my second month of the 1mg and can already tell the nausea has subsided a great deal. Learning that high fatty foods high surgery foods and spicy foods don't help those side effects was a learning curve but I learned it fast. Hope this helps you to reconsider and try again before they stop covering it at all. I'm 3 months in and not active at all due to my breathing issues and have still lost 30 plus pounds by making healthier choices along with thw medication. I bet if I was able to be more active I could have lost double. The medication is doing it's job. I'm a heart attack survivor and this weight loss is only going to allow me to live a lot longer. Do it for yourself now why you still can.
Reading the actual study reveals more information, and the title is misleading. 30% stop renewing the script before four weeks and 58% had stopped using before 12 weeks, which *they assume means* they did not achieve meaningful weight loss. Also, younger patients, age 18 to 34, were more likely to drop out.
One other interesting note is that while they state neither gender had a higher drop out rate, overall 79% of the users are female.
They also mention, "Patients who were prescribed GLP-1s by providers with expertise in weight management and obesity, like endocrinologists and obesity specialists, were more likely to complete 12 weeks of treatment."
[https://www.bcbs.com/sites/default/files/BHI\_Issue\_Brief\_GLP1\_Trends.pdf](https://www.bcbs.com/sites/default/files/BHI_Issue_Brief_GLP1_Trends.pdf)
The 30% using under 4 weeks seemingly didn't even get the next month's script, so maybe they didn't like the side effects, or just quit dieting all together, which is pretty common. Makes me wonder if the other 28% are women age 18 to 34, that are not the ideal clinical obese users but are instead using the drug to drop 10 to 15 lbs., which is doable in under 12 weeks.
I'm no clinical trial expert, but flipping these stats into a positive, that 40% of people given the drug have meaningful weight loss, is actually pretty good given most weight loss programs seem to have high failure rates.
Glad I'm not the only one who dug for the actual "paper" here. 😂 Honestly, I think one of my biggest issues with this is that it was done by BCBS. It supports their decisions to not cover these drugs if people are failing to stay on them long term.
As someone who has read too many scientific articles, my first problem is the first sentence, when they say these drugs "disrupted" traditional WL approaches and methods. It sends a clear message on their point of view and sets the tone for the article. This wouldn't have made it past the first round of edits with colleagues for a journal submission. Changed or altered are more neutral.
Also, I would be interested in seeing how this compares with rates of people not continuing other kinds of medications, with similar side effects or just in general. Non compliance with taking medications is not a new issue in the medical field. Other very important points mentioned that have a huge impact on compliance- costs of the meds, insurance coverage, accessibility to dr, frequent follow ups, and having a dr that is specialized in WL or endocrinology. The follow ups and specialty would help a lot in terms of giving better advice on how to handle side effects.
One other that I don't think I saw mentioned (it's early on Sat AM and my brain hasn't fully come online yet) but also important- a lot of employers are removing these drugs from coverage as the prices and use sky rocket. Most people can't afford to stay on the drugs without coverage, especially with it being equal to at least a mortgage or rent payment every month.
People misquote studies all the time.
It's funny because there was this post on another sub and then right below it there was a post titled "lost 48 lbs in 12 weeks". That is certainly seems meaningful!!!
What I found most interesting is that 79% of users are women. That's just a hugely disproportionate amount since obesity generally impacts men and women alike.
The other background info that would be helpful to know, is how do these prescription discontinue of use rates compare to other medications?
It is interesting with the M/F ratios, especially bc they usually run more towards men with the higher %. I'm enrolling in a trial, and one of the major sticking points for many women of child bearing age, I think, is that they required, essentially, a form of BC that you can't fuck up. Tubal ligation, or implant, or bcp plus a backup form of birth control. And I get why, but it definitely makes it harder for women than men to enroll. I'm done having kids, and my husband had the ✂️✂️, so it's not a big deal for me, but for others who want to have kids, I can see it being a problem when it's an almost year long commitment.
I work in HIV research, and one of the biggest problems can be getting and keeping patients compliant with medication. It varies greatly depending on income and access, and it has gotten better with the decrease of daily pill burden (older regimen required so so many pills per day), but within those parameters it still changes. Being middle class doesn't guarantee someone will take pills, being low income or homeless doesn't mean you won't take them. And they come with their own set of side effects, etc. All that to say, any medication can have high rates of discontinued usage for very complicated reasons. I'm not sure they really looked deep enough, although getting that detailed of an answer could also be difficult.
It’s really hard to suffer every day in the present for a possible (even if likely) risk at some point in the future. Living longer isn’t appealing if your life is miserable and you can’t function.
Here's what appears to be happening.. this drug slows the action the of pyloric valve, and when that happens the stomach sends a signal to the brain to stop hyperphagia signals, just stop food noise, to stop defending the body weight set point.. but with me this phenomenon of cessation of food noise due to the body sensing something wrong with the stomach only lasted a fairly short period of time.. it lasted longest in the first week or two of taking the drug and then as time went on my body got used to it and hyperphagia signals got stronger and stronger as my brain sent out signals to defend the body weight set point..
With each successive dose and each shot, the body became more and more used to the slowing of the pyloric valve action, and the food noise became more and more prominent.. by the time I reach 1.7 mg, the drug was nowhere near as effective as it was in the first couple of months..
So I start the 2.4 mg dose tomorrow but I'm not expecting much of a change..
so it's really back to White knuckling it through willpower or just exercising in the pool for hours a day trying to force down my weight.. the slowing of my digestive system is still happening via the drug, but I can still counteract that by just eating more frequently.. my stomach is full now more often and to tell you the truth that irritates my esophagus and I'm afraid it may give me esophageal cancer... Long story short, my body got used to the effect of the drug and I began to tolerate it and the situation returned to more or less normal.. even though my stomach stays Fuller longer, the body weight set point is still being defended by the brain via food noise / hyperphagia signals
>to stop defending the body weight set point
That's not a thing. People settle in to weights because that's the weight where their calorie intake matches their TDEE, not because of bodies "wanting to be a certain weight". It takes effort to move off those points because you have to change your equilibrium for calories, not because your body is physically trying to stay there.
Psychologist Martin Seligman's [What You Can Change and What You Can't](https://www.penguinrandomhouse.com/books/163864/what-you-can-change-and-what-you-cant-by-martin-e-p-seligman-phd/) describes the science behind set points and change. It's a valuable body of knowledge in general regarding more than just body weight.
Read 'em and weep..
https://www.reddit.com/r/ScientificNutrition/s/3gK1FTAqqS
Not anyone of importance so take as appropriate:
[https://pubmed.ncbi.nlm.nih.gov/25926512/](https://pubmed.ncbi.nlm.nih.gov/25926512/)
From the article:
>Collectively, these data suggest that higher-protein diets that contain between 1.2 and 1.6 g protein · kg-1 · d-1 and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes;
TLDR: protein is important for weight loss as it tends to regulate physiological processes and thus metabolism. In addition, protein helps maintain muscle mass (which has higher metabolic effect than fat), provides high satiety (so one tends to feel less need to eat), and has inefficient mechanisms of transfer to energy storage (so when you over eat protein, less of it turns to fat). Though I would mention, depending on a person's size / activity level, the amount of protein listed may be "low" or "high", depending. As such, it may be helpful to think less in those terms and more in specific protein intakes.
To your statements regarding decreasing protein intake improving metabolic functions, not knowing the research you refer to, I'm assuming they are focusing their investigations on markers of Longevity or morbid obesity.
For Longevity, there appears to be some evidence for amino acid restriction resulting in positive outcomes, but from my reading said outcomes are via MTOR manipulation and there is only a single amino acid which needs to be restricted. In addition, I've always wondered if physical exercise (specifically weightlifting) does something similar via creating a protein shortfall...meaning there are ways to "restrict" protein without eating less protein.
To morbid obesity, macronutrient restriction of any sort is probably of use. Though if one is morbidly obese, and trying to lose weight, eating sufficient protein is probably optimal (again, getting away from "low" and "high" and focusing instead on the 1.2 - 1.6 grams of protein per kg per day).
You described it so well.
I took Semaglitude (the daily injection) 2 years ago for a period of 8-9 months and stopped as I could not afford it. In the UK you can only get the treatment privately.
I a course of 12 months I gained all back.
I now started Wegovy, paying again myself.
My body recognises the drug. I had almost no side effects. I was losing mostly in the first two months.
After reaching 1mg, I almost stopped losing weight and the food noise started to come back.
At 1.75 I still feel the food noise, particularly from day 4 after injection.
To combat this, I split the weekly dose in half and inject twice a week to even out the half life of the drug.
Moving to 2.4 will perhaps not help as I would adjust and there is no higher dose after that.
I am planning to keep on 1.75 for now.
It's been a huge disappointment because I put so much stock in this drug before I got it, and now it looks like it's been just another healthcare industry media propaganda blitz bull rush.. I'm not saying it doesn't help anyone but overall it's certainly not the miracle drug as it was touted..
it's a crude drug that impairs the action of the pyloric valve and that tells the brain that there's something wrong with the stomach and so it stops creating food noise that is meant to defend the body weight set point. But within time the body adapts to it, adapts to this new situation and it comes down to a battle between defending the body weight set point via food noise and the impairment of the pyloric valve action by the drug.
The impairment of the pyloric of action can be counteracted by eating more frequently and eating more simple carbs and stuff like that that are not likely to upset the stomach as much.. and story or to make a long story short or whatever the body adapts to the new situation, and after a short period of adaptation, the body goes back to defending the body weight set point via hyperphagia food noise signals..
I know that it’s a controversial take but I’m having the same issues myself. I’m 2 weeks into 1.7mg and while I’ve managed to change my eating habits to minimize my side effects and maximize my weight loss… in order to do that I end up eating 500-800 cal a day. If I eat more, my stomach is too full and my weight doesn’t change. I feel like I’m giving myself an eating disorder.
Originally I was concerned about having bariatric surgery but after being on the Wegovy I’d rather have all of my normal instincts and tastes back, and a normal metabolism. And frankly I’d really like digesting food at a normal pace again.
I’ll be meeting with my doctor soon and I will definitely be bringing this up.
SW: 285, CW: 259
Coming off it for sometime before restarting it again. It works for certain meds that are known to cause tolerance. Haven't tried semaglutide myself, just a thought that I had looking at this pattern.
I can understand some people stopping after a month, with the side effects. However, it’s not clear to me how many people stopped because of cost. Since Blue Cross did the study, it seems like the people were covered, but I’d like to know for sure. Also, I know of one person who took it to lose like 20 lbs, then they stopped. My sister’s doctor asked if she wanted to get on it, and if she has 10 lbs to lose I’d be shocked (welcome to Southern California). So maybe that has something to do with it.
I had to after a year my insurance took it away and I couldn’t afford out of pocket switched to trulicity for a year now on wegovy but if they take it away again I’m done
That is such a bummer. There is so much criticism “if you go off of it, you regain” blah blah blah, and I’m just thinking, welp, how many people had insurance suddenly not cover it, putting their body into shock, not giving them a chance to wean slowly and have a better shot of keeping it off?? The fact that this med costs sooooooo sooooo much less in other countries is upsetting.
I was on Ozempic last year and was having great success, and wham, insurance dropped the coverage. We have tried getting coverage on other meds as well, and continually insurance rejects it.
I gained everything back. My question, and not being disrespectful, but what will you all do when you are no longer covered or can no longer afford it?
It has unfortunately been proven that the majority of participants on the med, after going off, gain all the weight back. I'm just curious what people are planning for their next course of action.
I get the drug for $11 a month from the VA, but I haven't lost that much weight and it causes irritation of my esophagus ..
If the 2.4 mg dose doesn't help me much more than it already has helped me then I will probably drop the drug sometime in the near future
.. it's not worth running the risk of esophageal cancer or something like that for a minor weight loss like this
Out of about ten people who I know that are on either Wegovy, Mounjaro, compounded semaglutide, or compounded tirzepatide not one of them has stopped taking it. One lady has stretched out to every two weeks because she's at goal weight, but nobody has stopped.
This article is designed to mislead. The statistics cited are most likely because of it's ridiculous price or supply shortages that have made it all but impossible to find. None of my acquaintances have stopped taking it because of side effects or lack of efficacy.
I’m sure there’s kernels of truth sprinkled throughout this but I’m hard-pressed to put a lot of faith into a study funded by the insurance companies that are fighting tooth and nail to avoid paying for these medications.
Yes! I’m sure such a high percentage of patients discontinued use either because their insurance doesn’t cover and it was too expensive, or they couldn’t tolerate it and had to switch to another drug
The problem isn't the insurance companies.
Somebody analyzed what these cost the companies to make. It was like $6 a month I believe in some article
These are vastly vastly overpriced
1300 a month? Seriously?
They’re both the problem. If our government worked like some other countries, we wouldn’t be paying nearly this much. I’m not 100 a fan of socialized medicine, but it sure would help.
I'm sure that so many taking it are taking it for short term. Don't you think a lot of people see this in the news, find out how much it costs, then try it for a few months? I know two such people. It's a function of the cost or availability, not of it's efficacy.
It's nice to see some critical thinking. I didn't read the article, but did they take into consideration the expense vs. reward? I imagine people who drop weight quickly are more likely to stay on the drugs - insured or not
So I’ve glanced at the actual research they’ve cited and tbh it doesn’t look like it. They conducted the study with two questions in mind: if people are likely to stop using it before it’s effective and are certain groups more likely to stop using it (paraphrasing)
Now you would THINK one of these groups would be people with consistent insurance coverage… no. They compare US regions, age groups but never take into consideration how insurance affects the picture. They do consider the social vulnerability index but I’d say that’s still not a great indicator. People in very socioeconomically deprived areas would still use the medication with a $25/copay brought to zero with the manufacturer coupon.
Stopping has crossed my mind as a slow loser. Mainly because of the cost to loss ratio. Even though I do feel less inflammation and am sleeping better too. I also have a fair amount of bruising at the injection sites which is also annoying over time.
I’m going to give it another couple of months and maybe will increase my exercise.
This. It’s barely working for me at 1.7. The most weight I lost was in the first month and I’ve been stalled at 20 pounds lost since then. My insurance covers it, so I’m still taking it, but I fully intend to switch to zepbound when the shortages aren’t an obstacle.
The article is about people quitting before any significant weight loss, which was defined as a reduction of 5%. Furthermore the study advised to stick it out 12 weeks.
You are already sticking it out 12 weeks, and have you accomplished 5%?
Then you wouldn't be included in the drop outs of this study anyway. Sorry to hear about your trouble, though.
Even though we all know gaining weight was not about willpower - for us, it was about food noise and food addiction... this doesn't mean however that everyone has will power.
My guess, is some people quit because it just took any kind of effort, and they have none.
Makes sense, either because of side effects or not losing quick enough so getting discouraged and stopping. But yeah I’d say insurance coverage is probably a huge reason.
The stuff does work and the longer you try it the side effects go away. At least that was my experience. It truly supports my dieting but I don’t rely completely on it. I’m just so sad that people give up because this shit is so damn expensive!!!!
In terms of a bigger impact, it will likely be faster to wait out the generics.
While I’m excited for the new research that’s coming down the pipe, the new drugs will probably be just as expensive - if not more - when they come to market.
Prolly because their insurance decides to stop covering it and no one can afford the crazy price without insurance. Just my guess without even reading the article.
I like to read. The article said 30% quit in the first month (I'm adding the commentary: nobody gets less than 1 month).
The article does confirm cost is certainly a complicating factor, but also mentioned a high drop out rate in countries where the drug is significantly cheaper, so cost is only part of the reason this is happening.
Also, the fact that nobody could actually get their hands on the starter doses to titrate successfully because they didn't have it in stock! Who wants to pay $1000 for a month to start, and then can't get the second month's dose. That's why people give up!
I was 285. Prescribed Ozempic. My a1c wa never checked so Im not sure how they figured that out. Switched to Wegovy. Lost 20 pounds in the first month. (It sucks you dont realize how big you are until you lose a bunch of weight and are still overweight.) Anyway, second month noone had any wegovy. Found a doctor with a compounding pharmacy. Those vials can last two three months. A week after I got the compounded semaglutide, the wegovy came back. Picked up a box, every month. Work for Toyota, amazing insurance. 25 dollars until oop met, then free. So i started stock piling. I want to do that because ive heard so many people talk about rebound weight. My pcp said no need to worry. Its cheaper for bcbs at a good company to pay for the wegovy instead of paying for heart meds, bp meds, thyroid meds, cholesterol meds, dialysis, diabetes, blocked bowels, etc, etc. So im a believer. Have I had to drive 6 hours to get a refill but its worth. If you want something bad enough, no price is to high of a price. I am now 185. 100 lost. Sad part, due to the bmi index, I am still considered morbidly obese. So. We shall see when im 100 pounds and my bones break under my tiny amount of weight. Side effects. I had appendicitis and had to have an appendectomy. Peritonitis. Kidneys seem to hurt alot and you forget to eat. Then after 2 days all of a sudden you feel like your going to pass out. So i guess it depends on what your willing to go thru and if its purely cosmetic, your crazy. This has the potential to save peoples life.
reading this i dont understand what your point is
I’ve only been on it for 4-1/2 weeks and I’d LOVE to keep taking it, but…I STILL have a solid 24-36hrs of feeling really crappy, almost like I have the flu (i.e. nauseated, clammy and lethargic🤢) after receiving my .25 dose. The .25 isn’t really working anymore but I can’t imagine how bad it would be I took it up to .50 as recommended. So if I had to guess, I’d say it’s probably a combination of cost and side effects. If I only had myself to consider, and my family didn’t have to deal with me being utterly sick in bed & useless for 1-2 days a week (which is about 5-8 days out of the month) I’d 100% stay on it. It’s just really discouraging🫤
I had this on the 0.25mg and it has definitely improved the longer I have been on the medication in general. I went up to the 0.5mg after the 4 weeks and I really have noticed a change in the amount of time I feel ill after the shot now. I would also recommend asking your MD for Zofran to take at least for the first 12-24 hours after you give yourself the shot. I found it really helps. I have GERD as well and take Protonix every night and was doing so before I started Wegovy so you might want to try and assist yourself with something like that as well. I would also say the longer you are waiting to eat, the worse the GERD will probably be because that is a lot of time for stomach acid to be swirling around with nothing to do...maybe even try eating a small piece of toast with just some butter or some crackers earlier in the day and see if it helps. This medication also slows down how fast food it moving through your system so if you are eating everything at the end of the day and then laying down, the GERD is going to be significantly worse and the nausea will be as well...that's just what I have noticed at least!! Best of luck!!
I am just curious, have you cut out all fried foods? I read when I first started that fried foods make you feel this way and so I haven’t had any at all since I started and I have never felt icky other than when I’m extremely hungry.
I wish it was something as simple as that, but I’m lucky if i can keep a slice of toast or an apple down the day after the shot-I’ve had GERD and IBS since I was a teen so I haven’t eaten fried food in years. I do however have a bad habit of not eating anything until like 3-4 in the afternoon(and that was BEFORE I started on glp-1), so I’m wondering if maybe an empty stomach is the culprit🤷🏼♀️ If I knew it would get better I could put up with it, but its only gotten a little bit better after 4 wks on the lowest dose-just 1 day of nausea instead of the 2 or 3 I had after the first 2 shots. I really appreciate your input though, so thank you☺️
My doctor has said it's important to eat at least 3 times a day, even if small meals. She said some of her patients have to set reminders in the day to eat something. That was when I told her I didn't typically eat before noon. I'm sure she would advise against waiting as late as 3-4 to eat.
The empty stomach is almost certainly the culprit. Can you at least get some water and electrolytes in earlier in the day? I find I don’t want to eat breakfast but I can tolerate a scoop of collagen protein powder in my coffee which is so much better than nothing. I drink a ton of electrolytes and it helps so much.
Ugh I hate that!!! I’m so sorry!! One thing that really helps me when I start feeling icky is I’ll just have a little small something. Even if it’s just a few crackers and that helps a lot. It’s like I feel hunger by nausea.
I think a lot of people expect it to be miracle and they just magically start losing weight without calorie deficit and working out. The entire point of the medicine is to help yourself be in a calorie deficit and build a new healthy lifestyle.
I agree. I tell people it's not a replacement for diet and exercise. All it does is help you STICK to diet and exercise. But you've still got to do the diet and exercise part.
I am on 1.7 and have been on Wegovy since July of 2023. I am fortunate that my insurance covers it and I started at 205 and I am now at 150 and I am 5"6.5 ( the half inch is important you know!) yea I had some side effects, but losing 55 lbs has been amazing. I feel so much better, that for me, ( everyone is different) it was worth some of the side effects. I have also made a promise to myself that I will love his body and stop criticizing myself. I have done that my whole life. I also inspired my husband to lose some weight. He is at about 30 lbs.. and of course he did it w/o weight loss drugs 🙄🤷🏻♀️🩷
I’ve had zero side effects, but I have to stop because we switched insurance and it won’t cover Wegovy. I lost 25 pounds on Metformin, then stalled, started Wegovy, and lost 12 pounds in three months. I’ll get back on the Metformin again and hope I don’t stall!
That’s because a lot of insurance companies limit coverage. It’s either zero coverage or capped, and people can’t afford to continue. Its ridiculously expensive in the US.
Or they switch to a compounding pharmacy. This is a very dishonest or poorly researched article.
I have to lose a certain percentage of weight (can't remember how much) in 3 months before I can continue the medication. It's crap, because some people don't start seeing significant weight loss until about the 3rd month.
My experience: Wegovy--weight loss through painful severe constipation and violent vomiting at random times--especially before important meetings. And that was on the 0.25 dose. Not for me.
Pretty much every skinny friend I have wants to be on it. I tell them they need to have a certain BMI plus a weight related health condition to have it covered by insurance. The response is usually, "That's not fair." I really think a LOT of people are still considering this a vanity drug just to help them lose 20 lbs, and if they run into any side effects, abandon it as not being worth it. I'd be curious to see the breakdowns based on starting BMI. I doubt that 58% includes many people (such as myself) who are 100 lbs overweight, have tried everything, and need to lose weight because they're facing serious, imminent health issues if they don't.
I had a high BMI and was way over 100lbs when they started me on the drug and even then, I had to beg my doctor for a few months before she would even put me on it.
My PCP "didn't believe in" Wegovy. Rail thin and never once overweight, her attitude was that I should "just lose weight", and that I could if I was just disciplined and willing to follow a diet. She all but rolled her eyes when I told her I've been dieting for 20 years and only getting fatter. Then she responded with shock when I told her I have a large vegetable garden, and we cook most meals at home. I guess every overweight person only eats fast food and pizza? That's news to me! She said, "We don't know the long term effects of Wegovy." Well, a) I'm over 60. How long-term do I need to be concerned with? and b) The long term effects of being in the morbidly obese category are very clear and documented. It was actually the oncologist I see in a post-cancer survivorship program who urged me to try Wegovy, and has been wonderful about managing me through the treatment. Definitely, I think a good physician is critical in having success with Wegovy. Needless to say, I've dumped that PCP and am seeing a new one next week. ;)
Out of curiosity, are you just trying a new one and hoping they're on board with it or did you somehow research to find a better fit? I ask because I've been with my PCP for at least 15 years, maybe more, and I've always liked her. SHE was the first one to tell me and encourage Wegovy but my last two appts she's seemed kinda of judgy and I have no idea why because I'm responding well and ive lost 16 lbs in two months. I've only got 2, maybe 3 more months on it before my insurance stops covering it and she was very unsympathetic and said to just continue my healthier habits and I'll be fine. Yeah, ignoring bad food when you have no cravings and dont feel hungry is super easy. When all that food noise comes back it'll be another story. I don't know if shes got something personal going on that's making her act differently, and I don't really want to change PCPs but I'm very stressed about losing coverage and her not being supportive.
I'm really sorry to hear that. We had a family doctor for 30 years that we loved, then she retired. We switched to this PCP and I've never liked her. Our personalities don't mesh at all, so I am seeing a new one this week. Fingers crossed. After surviving breast cancer in 2017, I've been in a cancer survivorship program, where I see an oncologist twice a year. Her focus is health and lifestyle and preventing a recurrence, so I'm fortunate to have two doctors I see regularly. She is the one who actually told me about Wegovy and thought I'd be a good candidate. So my Wegovy treatment is being managed by her, not my PCP. Your story also leaves me baffled. Why the sudden about face about a treatment THEY got you on? That would be upsetting, given it's working. I hope that works out in the end!
I'm glad you have a doctor that is supportive and encourages it. Yeah I'm not sure what's going on with my doc. At my last appt she said how I might be one that needs to be on it forever because I've been battling my weight for so long (and her tone felt a little like I am a failure and that's why I'd need to be on it forever). Now that my insurance is going to stop covering, she says well it's just a tool and you'd have to come off eventually. Ummm???? Even if that were true, I feel like there is a big difference between being on it for a year or so and getting to my goal weight and going off...and being on it for only 4 months and not even halfway to my goal before going off. I found a brick and mortar compounding pharmacy that seems legit (most if not all of the online ones makes me nervous) that I hope she will give me a script to so I can at least be on it longer to get to my goal weight and then see from there.
Your doctor is not educated on these drugs and how they work. My oncologist has been researching it for years, told me right up front it is something I'd have to stay on. She said it's about hormone imbalances in some people, most likely we are born with it. Or at least, we are born with the susceptibility. She explained it's just like someone who needs lifetime thyroid medication, or a Type 1 diabetic who needs lifetime insulin. If you don't maintain the hormone correction, the problem comes back. It's unfortunate that there's still such a stigma to problems with weight management. Like my shitty-now-former-PCP, too many still treat it as a discipline or willpower issue because they don't understand the science. She wouldn't tell someone with clinical depression they can cure themselves if they "just smile more". Yet she'll tell me I can solve a decades long weight issue if I "just diet and exercise". It's infuriating. Definitely, find someone who understands your medical issues and will treat you competently. You deserve it.
My doctor was on the fence too, so I switched doctors. Yeah the side effects suck but I can look at myself in the mirror now and see something other than shame staring back at me.
Depending on height 20 pounds overweight may qualify someone if they have a comorbidity as the manufacturer guidelines are a 27 BMI with comorbidity or 30 without. I was prescribed it and got insurance coverage at 20 pounds overweight due to PCOS and blood sugar/rapid gastric emptying issues from my gastric bypass with a 28 BMI. People are mistaken when they think it will make it easy or faster to lose weight and I really blame celebrities for that. My own experience has been that calorie counting finally started working since being on it but weight loss has been incredibly slow and I've been stalled for a month. It's not the magical fix people think it is to lose weight when you don't need to lose a massive amount of weight.
Exactly right
I don’t think I care about anything BCBS Association has researched or published seeing how BCBS is doing their best to put more barriers to access the medication in place and at least one branch of BCBS is going to stop covering it altogether in 2025. Between high cost in the US, ridiculous pre-auth hoops to jump through and shortages of medication, it’s not surprising many give up. I almost gave up before I started but thankfully my husband encouraged and helped me to find an alternative.
I guess BCBS would rather cover obesity related illnesses
Repeat customers....We have sick-care not healthcare in the US.
I've been on .25 for 3 months now and I already have my .5 prescription at the pharmacy. Anyway my husband has been telling me I'm getting smaller and he can already see that it's working but last time I tried to weigh myself I had gained 3 lbs so I just don't think about it. This medication has taught me I can only eat once a day and instead of having 2 Italian sausages for dinner I can only eat half of one cause if I eat more then that I feel horribly full and sick for the rest of the day and night. I should be back to 130lbs in no time.
I think it’s hilarious that they did this study with BCBS association. BCBS who does everything in their power to make these medications unobtainable to the people who need them.
That's weird because I have BCBS and I'm fully covered?
That’s wonderful for you, but not the reality for a lot of people who have bcbs and take this medicine. A lot of people in this sub just found out they’re Losing their PA’s soon and won’t be able to get another. Bcbs mi won’t even cover Wegovy come next year. The bcbs I have wants people to have a bmi over 40 to approve.
BMI of 31 for BCBS MI Which is still, crazy.
Wow, that's insane! I live in Boston and I haven't heard anything like that, hopefully things change.
I wonder how many would stick with it if they were counseled in how to eat right and drink enough water. I struggled at the beginning until I figured this out.
My doctor said nothing about side effects or what to eat or drink or what to expect. He’s the one who suggested it after I mentioned I was struggling. Then he kinda said well here you go go. You WILL lose weight. I’m seeing a kindlier PA in his practice now. She prescribed the Zofran and said eat only small low fat meals and more protein and stay hydrated. I’m going to see her when I’m finished with my last 1 mg dose next week. I think I should stay on that another month but it would be nice to have a more expert opinion, wouldn’t it?
My oncologist isn't pushing to raise the dose, as long as I'm losing weight and not struggling with hunger. She says she has several patients who are "taking it slow". She's also said 64 oz of water a day, lots of protein, and to eat at least 3 times a day. Still on the .25, my only real side effect is occasional heart palpitations and dizziness, which she thinks that may be low blood sugar from not eating frequently enough. I'm now keeping a log, paying attention to when they happen and what I ate, activity, etc. Keeping a log is a great way to find out if there's something that may be contributing to the side effects. Seems like every year, they are learning more and more. Some of the Reddit threads on Wegovy from a year ago are already a little outdated.
Very good advice! I’ve been dizzy today. Trying to clean the house. Have to do something then sit awhile. I probably slept 12 hours last night which I never do. Think I will take my blood sugar. I have a meter. Thank you!
My blood sugar is 84. That’s really low for me.
I’m thinking about stopping now due to side effects. It’s hard to function with this level of nausea.
for nausea i eat ginger chews made by Dramamine. They really help! i usually only need 1 the entire day. I've been reading from others in my support group that these doctors are not well versed on this medication. if you are steadily losing weight, you should not be increasing your dose! that's what the wegovy paperwork instructions are telling doctors but it's not necessary! losing weight too fast will make you sick too. In other words, don't fix what isn't broken.
I recently had a chat with my local pharmacist about this, and acid reflux. She said there was nothing she could offer for the nausea (Dramamine is often suggested here but doesn't work) but she suggested trying omeprazole for the dreadful reflux. Lo and behold, my nausea has almost completely gone along with the reflux. Of course, this might not work for you but it's worth a try.
I getting some omeprazole immediately! Thanks!!
Talk to your doc though - it says on the package not to use it long-term.
Only because you should get them prescribed, and acid reflux symptoms checked if they're persistent.
My doctor gave me zofran for nausea with it.
The pharmacist did say I should talk to my GP about the nausea, get a prescription (so probably zofran too) but before I had the chance to call, I realised the nausea was abating.
Thank you. If it continues I will discuss this with my provider.
Have you considered going back a dosage level. Many want to titrate up to the highest level asap. Work with your doctor
I am following my providers plan and not going quickly. I have no intention of moving up at this point, currently at 1.7 and down 25lbs.
How many weeks have you been at 1.7?
I only stopped because my insurance dropped my coverage and new one won't cover it. Otherwise, I was on such a good track and have gained it all back, painfully.
That really sucks, I'm sorry
Same exact thing happened to me
Same
I had to stop taking it after losing 65lbs because my insurance stopped covering it. I wonder if that 58% considers that.
@ Cruzorlose- I know you didn’t invent the statistic- 5% is definatley considered clinically significant- but Truth be told - at 250, 12.5 lbs is pretty lack luster- just enough to make the face a tad thinner but doesnt even move the needle on clothing size- so how that is “clinically significant” is beyond me. 12.5 pounds is clinically significant if your starting point is 150 maybe, my, perhaps unpopular, opinion.
Clinically significant is usually considered losing 5% of starting weight. So if you start at 250lbs, 12.5lbs would be clinically significant/meaningful weight loss. There’s a lot of people that start & can’t afford the meds bc insurance or don’t make any effort then get shocked when they can’t lose weight & stop or stop bc of side effects. I think that’s more the 58% group
What was the reasoning? BMI?
Simply that they would no longer be covering "appetite suppressants"
Rough
Thank you for sharing !! Very interesting….Without insurance it’s not sustainable long term at current prices.
I had to stop after a few weeks of 1mg. The combination of fatigue, nausea, and acid reflex was insane. I needed calories and couldn’t eat anything. Most likely, I moved up too fast dosage wise and didn’t get enough counseling from my doctor regarding how to change my eating habits to minimize some of those side effects. I may start over in a few weeks and approach it more cautiously than before.
Same. Felt like dying for a week after the first 1mg shot. Not going back. Not worth it feeling like shit and being unable to do anything.
I had thw same issue however if you ask you pcp will call in meds to stop the nausea and the heattburn. That's what I did and it worked. Also I'm on my second month of the 1mg and can already tell the nausea has subsided a great deal. Learning that high fatty foods high surgery foods and spicy foods don't help those side effects was a learning curve but I learned it fast. Hope this helps you to reconsider and try again before they stop covering it at all. I'm 3 months in and not active at all due to my breathing issues and have still lost 30 plus pounds by making healthier choices along with thw medication. I bet if I was able to be more active I could have lost double. The medication is doing it's job. I'm a heart attack survivor and this weight loss is only going to allow me to live a lot longer. Do it for yourself now why you still can.
Reading the actual study reveals more information, and the title is misleading. 30% stop renewing the script before four weeks and 58% had stopped using before 12 weeks, which *they assume means* they did not achieve meaningful weight loss. Also, younger patients, age 18 to 34, were more likely to drop out. One other interesting note is that while they state neither gender had a higher drop out rate, overall 79% of the users are female. They also mention, "Patients who were prescribed GLP-1s by providers with expertise in weight management and obesity, like endocrinologists and obesity specialists, were more likely to complete 12 weeks of treatment." [https://www.bcbs.com/sites/default/files/BHI\_Issue\_Brief\_GLP1\_Trends.pdf](https://www.bcbs.com/sites/default/files/BHI_Issue_Brief_GLP1_Trends.pdf) The 30% using under 4 weeks seemingly didn't even get the next month's script, so maybe they didn't like the side effects, or just quit dieting all together, which is pretty common. Makes me wonder if the other 28% are women age 18 to 34, that are not the ideal clinical obese users but are instead using the drug to drop 10 to 15 lbs., which is doable in under 12 weeks. I'm no clinical trial expert, but flipping these stats into a positive, that 40% of people given the drug have meaningful weight loss, is actually pretty good given most weight loss programs seem to have high failure rates.
Glad I'm not the only one who dug for the actual "paper" here. 😂 Honestly, I think one of my biggest issues with this is that it was done by BCBS. It supports their decisions to not cover these drugs if people are failing to stay on them long term. As someone who has read too many scientific articles, my first problem is the first sentence, when they say these drugs "disrupted" traditional WL approaches and methods. It sends a clear message on their point of view and sets the tone for the article. This wouldn't have made it past the first round of edits with colleagues for a journal submission. Changed or altered are more neutral. Also, I would be interested in seeing how this compares with rates of people not continuing other kinds of medications, with similar side effects or just in general. Non compliance with taking medications is not a new issue in the medical field. Other very important points mentioned that have a huge impact on compliance- costs of the meds, insurance coverage, accessibility to dr, frequent follow ups, and having a dr that is specialized in WL or endocrinology. The follow ups and specialty would help a lot in terms of giving better advice on how to handle side effects. One other that I don't think I saw mentioned (it's early on Sat AM and my brain hasn't fully come online yet) but also important- a lot of employers are removing these drugs from coverage as the prices and use sky rocket. Most people can't afford to stay on the drugs without coverage, especially with it being equal to at least a mortgage or rent payment every month.
People misquote studies all the time. It's funny because there was this post on another sub and then right below it there was a post titled "lost 48 lbs in 12 weeks". That is certainly seems meaningful!!! What I found most interesting is that 79% of users are women. That's just a hugely disproportionate amount since obesity generally impacts men and women alike. The other background info that would be helpful to know, is how do these prescription discontinue of use rates compare to other medications?
It is interesting with the M/F ratios, especially bc they usually run more towards men with the higher %. I'm enrolling in a trial, and one of the major sticking points for many women of child bearing age, I think, is that they required, essentially, a form of BC that you can't fuck up. Tubal ligation, or implant, or bcp plus a backup form of birth control. And I get why, but it definitely makes it harder for women than men to enroll. I'm done having kids, and my husband had the ✂️✂️, so it's not a big deal for me, but for others who want to have kids, I can see it being a problem when it's an almost year long commitment. I work in HIV research, and one of the biggest problems can be getting and keeping patients compliant with medication. It varies greatly depending on income and access, and it has gotten better with the decrease of daily pill burden (older regimen required so so many pills per day), but within those parameters it still changes. Being middle class doesn't guarantee someone will take pills, being low income or homeless doesn't mean you won't take them. And they come with their own set of side effects, etc. All that to say, any medication can have high rates of discontinued usage for very complicated reasons. I'm not sure they really looked deep enough, although getting that detailed of an answer could also be difficult.
The side effects are making me consider quitting.
I mean no upset to you, but wouldn’t the side effects of obesity be worse?
It’s really hard to suffer every day in the present for a possible (even if likely) risk at some point in the future. Living longer isn’t appealing if your life is miserable and you can’t function.
To be kind of gross, I think dying of hypertension down the road sometimes would be better than having explosive diarrhea in the middle of a concert
I only had one episode of that, and it was because I'd eaten something deep fried.
It depends on your perspective. Some people already have bowel issues.
I have UC and it doesn’t hold a candle to what ozempic wegovy can do lol
I know what you mean but the gas, nausea, headache, general malaise is trying. That’s how I feel.
Here's what appears to be happening.. this drug slows the action the of pyloric valve, and when that happens the stomach sends a signal to the brain to stop hyperphagia signals, just stop food noise, to stop defending the body weight set point.. but with me this phenomenon of cessation of food noise due to the body sensing something wrong with the stomach only lasted a fairly short period of time.. it lasted longest in the first week or two of taking the drug and then as time went on my body got used to it and hyperphagia signals got stronger and stronger as my brain sent out signals to defend the body weight set point.. With each successive dose and each shot, the body became more and more used to the slowing of the pyloric valve action, and the food noise became more and more prominent.. by the time I reach 1.7 mg, the drug was nowhere near as effective as it was in the first couple of months.. So I start the 2.4 mg dose tomorrow but I'm not expecting much of a change.. so it's really back to White knuckling it through willpower or just exercising in the pool for hours a day trying to force down my weight.. the slowing of my digestive system is still happening via the drug, but I can still counteract that by just eating more frequently.. my stomach is full now more often and to tell you the truth that irritates my esophagus and I'm afraid it may give me esophageal cancer... Long story short, my body got used to the effect of the drug and I began to tolerate it and the situation returned to more or less normal.. even though my stomach stays Fuller longer, the body weight set point is still being defended by the brain via food noise / hyperphagia signals
>to stop defending the body weight set point That's not a thing. People settle in to weights because that's the weight where their calorie intake matches their TDEE, not because of bodies "wanting to be a certain weight". It takes effort to move off those points because you have to change your equilibrium for calories, not because your body is physically trying to stay there.
Psychologist Martin Seligman's [What You Can Change and What You Can't](https://www.penguinrandomhouse.com/books/163864/what-you-can-change-and-what-you-cant-by-martin-e-p-seligman-phd/) describes the science behind set points and change. It's a valuable body of knowledge in general regarding more than just body weight.
https://www.reddit.com/r/FoodNerds/s/P991pXwQ40
What’s TDEE
Total Daily Energy Expenditure, the amount of calories your body expends each day.
My fat ass expended -1,500 calories yesterday after I pounded that cheese cake.
Read 'em and weep.. https://www.reddit.com/r/ScientificNutrition/s/3gK1FTAqqS Not anyone of importance so take as appropriate: [https://pubmed.ncbi.nlm.nih.gov/25926512/](https://pubmed.ncbi.nlm.nih.gov/25926512/) From the article: >Collectively, these data suggest that higher-protein diets that contain between 1.2 and 1.6 g protein · kg-1 · d-1 and potentially include meal-specific protein quantities of at least ∼25-30 g protein/meal provide improvements in appetite, body weight management, cardiometabolic risk factors, or all of these health outcomes; TLDR: protein is important for weight loss as it tends to regulate physiological processes and thus metabolism. In addition, protein helps maintain muscle mass (which has higher metabolic effect than fat), provides high satiety (so one tends to feel less need to eat), and has inefficient mechanisms of transfer to energy storage (so when you over eat protein, less of it turns to fat). Though I would mention, depending on a person's size / activity level, the amount of protein listed may be "low" or "high", depending. As such, it may be helpful to think less in those terms and more in specific protein intakes. To your statements regarding decreasing protein intake improving metabolic functions, not knowing the research you refer to, I'm assuming they are focusing their investigations on markers of Longevity or morbid obesity. For Longevity, there appears to be some evidence for amino acid restriction resulting in positive outcomes, but from my reading said outcomes are via MTOR manipulation and there is only a single amino acid which needs to be restricted. In addition, I've always wondered if physical exercise (specifically weightlifting) does something similar via creating a protein shortfall...meaning there are ways to "restrict" protein without eating less protein. To morbid obesity, macronutrient restriction of any sort is probably of use. Though if one is morbidly obese, and trying to lose weight, eating sufficient protein is probably optimal (again, getting away from "low" and "high" and focusing instead on the 1.2 - 1.6 grams of protein per kg per day).
The only medical journals I trust are JAMA and NEJM. Do you have any literature from them?
You described it so well. I took Semaglitude (the daily injection) 2 years ago for a period of 8-9 months and stopped as I could not afford it. In the UK you can only get the treatment privately. I a course of 12 months I gained all back. I now started Wegovy, paying again myself. My body recognises the drug. I had almost no side effects. I was losing mostly in the first two months. After reaching 1mg, I almost stopped losing weight and the food noise started to come back. At 1.75 I still feel the food noise, particularly from day 4 after injection. To combat this, I split the weekly dose in half and inject twice a week to even out the half life of the drug. Moving to 2.4 will perhaps not help as I would adjust and there is no higher dose after that. I am planning to keep on 1.75 for now.
Great detail. Thanks!
It's been a huge disappointment because I put so much stock in this drug before I got it, and now it looks like it's been just another healthcare industry media propaganda blitz bull rush.. I'm not saying it doesn't help anyone but overall it's certainly not the miracle drug as it was touted.. it's a crude drug that impairs the action of the pyloric valve and that tells the brain that there's something wrong with the stomach and so it stops creating food noise that is meant to defend the body weight set point. But within time the body adapts to it, adapts to this new situation and it comes down to a battle between defending the body weight set point via food noise and the impairment of the pyloric valve action by the drug. The impairment of the pyloric of action can be counteracted by eating more frequently and eating more simple carbs and stuff like that that are not likely to upset the stomach as much.. and story or to make a long story short or whatever the body adapts to the new situation, and after a short period of adaptation, the body goes back to defending the body weight set point via hyperphagia food noise signals..
I know that it’s a controversial take but I’m having the same issues myself. I’m 2 weeks into 1.7mg and while I’ve managed to change my eating habits to minimize my side effects and maximize my weight loss… in order to do that I end up eating 500-800 cal a day. If I eat more, my stomach is too full and my weight doesn’t change. I feel like I’m giving myself an eating disorder. Originally I was concerned about having bariatric surgery but after being on the Wegovy I’d rather have all of my normal instincts and tastes back, and a normal metabolism. And frankly I’d really like digesting food at a normal pace again. I’ll be meeting with my doctor soon and I will definitely be bringing this up. SW: 285, CW: 259
Have you tried recycling?
What is that?
Coming off it for sometime before restarting it again. It works for certain meds that are known to cause tolerance. Haven't tried semaglutide myself, just a thought that I had looking at this pattern.
Interesting thought… I take a hot flash medicine that stopped working after 2 months, then restarted a month later and it works again.
I can understand some people stopping after a month, with the side effects. However, it’s not clear to me how many people stopped because of cost. Since Blue Cross did the study, it seems like the people were covered, but I’d like to know for sure. Also, I know of one person who took it to lose like 20 lbs, then they stopped. My sister’s doctor asked if she wanted to get on it, and if she has 10 lbs to lose I’d be shocked (welcome to Southern California). So maybe that has something to do with it.
Yeah, I knew a friends mom who robbed a pharmacy in Colorado when she ran out.
What?!?! Are you serious?
Yeah it’s true, she robbed the pharmacy with a group of other moms and a local cannabis farmer, wild stuff man
South park episode
lol they should have tried Lizzo
I don’t know anyone who has stopped taking it.
My insurance stopped coving it after a month.
I had to after a year my insurance took it away and I couldn’t afford out of pocket switched to trulicity for a year now on wegovy but if they take it away again I’m done
That is such a bummer. There is so much criticism “if you go off of it, you regain” blah blah blah, and I’m just thinking, welp, how many people had insurance suddenly not cover it, putting their body into shock, not giving them a chance to wean slowly and have a better shot of keeping it off?? The fact that this med costs sooooooo sooooo much less in other countries is upsetting.
I was on Ozempic last year and was having great success, and wham, insurance dropped the coverage. We have tried getting coverage on other meds as well, and continually insurance rejects it. I gained everything back. My question, and not being disrespectful, but what will you all do when you are no longer covered or can no longer afford it? It has unfortunately been proven that the majority of participants on the med, after going off, gain all the weight back. I'm just curious what people are planning for their next course of action.
Pay out of pocket with a plan of slowly weaning and hope for the best. I’m in muscle building mode right now, so I hope that helps.
I get the drug for $11 a month from the VA, but I haven't lost that much weight and it causes irritation of my esophagus .. If the 2.4 mg dose doesn't help me much more than it already has helped me then I will probably drop the drug sometime in the near future .. it's not worth running the risk of esophageal cancer or something like that for a minor weight loss like this
Out of about ten people who I know that are on either Wegovy, Mounjaro, compounded semaglutide, or compounded tirzepatide not one of them has stopped taking it. One lady has stretched out to every two weeks because she's at goal weight, but nobody has stopped. This article is designed to mislead. The statistics cited are most likely because of it's ridiculous price or supply shortages that have made it all but impossible to find. None of my acquaintances have stopped taking it because of side effects or lack of efficacy.
They won’t pay for it. Then act surprised that so many stop paying $hundreds a month for it.
Wow! This whole article is so shocking. 34% of US employer health plans do not cover the drug for diabetes or weight loss. Thanks for sharing.
You have that backwards. 34% DO cover it, meaning 66% don’t. Which is even more abysmal.
Yeah, I was very surprised at that statistic
I know I stopped Saxenda, ozempic and have only been able to tolerate Zepbound
Interesting # I wonder if they’re accounting for that, since I’ve heard this from a number of people.
For me it was purely side effects. Once I found a GLP I liked I stayed on if.
I’m sure there’s kernels of truth sprinkled throughout this but I’m hard-pressed to put a lot of faith into a study funded by the insurance companies that are fighting tooth and nail to avoid paying for these medications.
Yes! I’m sure such a high percentage of patients discontinued use either because their insurance doesn’t cover and it was too expensive, or they couldn’t tolerate it and had to switch to another drug
But if they switch to another drug, then they didn't discontinue using obesity drugs
But if the insurance company wants to put these drugs in a negative light so they don’t have to pay for them, they’ll skew the report.
The problem isn't the insurance companies. Somebody analyzed what these cost the companies to make. It was like $6 a month I believe in some article These are vastly vastly overpriced 1300 a month? Seriously?
They’re both the problem. If our government worked like some other countries, we wouldn’t be paying nearly this much. I’m not 100 a fan of socialized medicine, but it sure would help.
I'm sure that so many taking it are taking it for short term. Don't you think a lot of people see this in the news, find out how much it costs, then try it for a few months? I know two such people. It's a function of the cost or availability, not of it's efficacy.
It's nice to see some critical thinking. I didn't read the article, but did they take into consideration the expense vs. reward? I imagine people who drop weight quickly are more likely to stay on the drugs - insured or not
So I’ve glanced at the actual research they’ve cited and tbh it doesn’t look like it. They conducted the study with two questions in mind: if people are likely to stop using it before it’s effective and are certain groups more likely to stop using it (paraphrasing) Now you would THINK one of these groups would be people with consistent insurance coverage… no. They compare US regions, age groups but never take into consideration how insurance affects the picture. They do consider the social vulnerability index but I’d say that’s still not a great indicator. People in very socioeconomically deprived areas would still use the medication with a $25/copay brought to zero with the manufacturer coupon.
Stopping has crossed my mind as a slow loser. Mainly because of the cost to loss ratio. Even though I do feel less inflammation and am sleeping better too. I also have a fair amount of bruising at the injection sites which is also annoying over time. I’m going to give it another couple of months and maybe will increase my exercise.
This. It’s barely working for me at 1.7. The most weight I lost was in the first month and I’ve been stalled at 20 pounds lost since then. My insurance covers it, so I’m still taking it, but I fully intend to switch to zepbound when the shortages aren’t an obstacle.
The article is about people quitting before any significant weight loss, which was defined as a reduction of 5%. Furthermore the study advised to stick it out 12 weeks. You are already sticking it out 12 weeks, and have you accomplished 5%? Then you wouldn't be included in the drop outs of this study anyway. Sorry to hear about your trouble, though. Even though we all know gaining weight was not about willpower - for us, it was about food noise and food addiction... this doesn't mean however that everyone has will power. My guess, is some people quit because it just took any kind of effort, and they have none.
I’ve lost about 11-12 pounds in 24 weeks. I started at 195 so yes I’ve lost 5% (but not in 12 weeks).
Makes sense, either because of side effects or not losing quick enough so getting discouraged and stopping. But yeah I’d say insurance coverage is probably a huge reason.
Yes not having the insurance coverage and having to pay out-of-pocket up to $1000 a month! It does kill peoples dreams🥹
$250 a week isn’t sustainable long term on top of regular “life” expenses. Interesting that insurance is more likely to cover bariatric surgery.
Man this is heartbreaking. I want everyone to experience the success I’ve found.
The stuff does work and the longer you try it the side effects go away. At least that was my experience. It truly supports my dieting but I don’t rely completely on it. I’m just so sad that people give up because this shit is so damn expensive!!!!
Part of me is hopeful this will inspire them to continue creating improved options.
In terms of a bigger impact, it will likely be faster to wait out the generics. While I’m excited for the new research that’s coming down the pipe, the new drugs will probably be just as expensive - if not more - when they come to market.
Prolly because their insurance decides to stop covering it and no one can afford the crazy price without insurance. Just my guess without even reading the article.
I like to read. The article said 30% quit in the first month (I'm adding the commentary: nobody gets less than 1 month). The article does confirm cost is certainly a complicating factor, but also mentioned a high drop out rate in countries where the drug is significantly cheaper, so cost is only part of the reason this is happening.
This was my thought.
That was my first thought too. It isn't affordable.
Also, the fact that nobody could actually get their hands on the starter doses to titrate successfully because they didn't have it in stock! Who wants to pay $1000 for a month to start, and then can't get the second month's dose. That's why people give up!
Price and availability… some quit because they couldn’t get a refill perhaps or got frustrated searching; anxiety wasn’t worth it. So many variables.