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June 12, 2023 – Johnna Mendenall had by no means been “the thin pal,” she stated, however the calls for of motherhood – together with a sedentary desk job – made weight administration much more tough. Nervous that household kind 2 diabetes would meet up with her, she determined to start out Wegovy photographs for weight reduction.
She was nervous about potential unwanted effects. It took 5 days of staring on the Wegovy pen earlier than she labored up the nerve for her first .25-milligram shot. And certain sufficient, the unwanted effects got here on sturdy.
“The nausea kicked in,” she stated. “Once I elevated my dose to 1 milligram, I spent the complete evening from 10 p.m. to five a.m. vomiting. I virtually give up that day.”
Mendenall is amongst a rising variety of individuals sharing private tales on-line in regards to the weight reduction treatment Wegovy – and related medication – delving into their generally disagreeable, and probably gut-wrenching, unwanted effects.
Whereas gastrointestinal (GI) signs appear to be the commonest, a laundry record of others have been mentioned within the information, on TikTok, and throughout on-line boards. These embody “Ozempic face,” or the gaunt look some get after taking the treatment, together with hair loss, nervousness, melancholy, and debilitating fatigue.
Mendenall’s major unwanted effects have been vomiting, fatigue, and extreme constipation, however she has additionally seen some optimistic adjustments: the “meals noise,” or the urge to eat when she isn’t hungry, is gone. Since her first dose 12 weeks in the past, she has gone from 236 kilos to 215.
Warning Label
Wegovy’s energetic ingredient, semaglutide, mimics the position of a pure hormone known as glucagon-like peptide, or GLP-1, which helps you’re feeling well-fed. Semaglutide is used at a decrease dose below the model identify Ozempic, which is permitted for kind 2 diabetes and used off-label for weight reduction.
Each Ozempic and Wegovy include a warning label for potential unwanted effects, the commonest ones being nausea, diarrhea, abdomen ache, and vomiting.
With the surging recognition of semaglutide, extra individuals are getting prescriptions via telemedicine firms, forgoing
extra in-depth consultations, resulting in extra unwanted effects, stated Caroline Apovian, MD, a professor of drugs at Harvard Medical College and co-director of the Heart for Weight Administration and Wellness at Brigham and Girls’s Hospital.
Specialists say beginning with low doses and regularly rising over time helps keep away from unwanted effects, however insurance coverage firms usually require a sooner timeline to proceed overlaying the treatment, Apovian stated.
“Insurance coverage firms are working towards medication for us by demanding the affected person go up in dosage [too quickly],” she defined.
Mendenall’s insurance coverage has paid for her Wegovy photographs, however with out that protection, she stated it might value her $1,200 monthly.
There are related drugs available on the market, like liraglutide, offered below the identify Saxenda. However it’s a every day, slightly than a weekly, shot and in addition comes with unwanted effects and has been proven to be much less efficient. In one medical trial, the individuals being studied noticed their common physique weight over 68 weeks drop by 15.8% with semaglutide, and by 6.4% with liraglutide.
Tirzepatide, branded Mounjaro – a kind 2 diabetes drug made by Eli Lilly that will quickly acquire FDA approval for weight reduction – might have fewer unwanted effects. In medical trials, 44% of these taking semaglutide had nausea and 31% reported diarrhea, in comparison with 33% and 23% of these taking tirzepatide, though no trial has instantly in contrast the 2 brokers.
Lack of Bowel Management
For now, Wegovy and Saxenda are the one GLP-1 agonist photographs approved for weight reduction, and their maker, Danish drug firm Novo Nordisk, is going through its second scarcity of Wegovy amid rising demand.
Private tales on-line about semaglutide vary from overwhelmingly optimistic – simply what some must win a lifelong battle with weight problems – to harsh situations with probably long-term well being penalties, and every part in between.
One non-public neighborhood on Reddit is devoted to a very disagreeable aspect impact: lack of bowel management whereas sleeping. Others have reported uncontrollable vomiting.
Kimberly Carew of Clearwater, FL, began on .5 milligrams of Ozempic final yr after her rheumatologist and endocrinologist prompt it to deal with her kind 2 diabetes. She was informed it got here with the bonus of weight reduction, which she hoped would assist along with her joint and again ache.
However after she elevated the dose to 1 milligram, her GI signs, which began out gentle, grew to become insufferable. She couldn’t preserve meals down, and when she vomited, the meals would usually come up entire, she stated.
“One evening I ate ramen earlier than mattress. And the following morning, it got here out simply because it went down,” stated Carew, 42, a registered psychological well being counseling intern. “I used to be getting extreme heartburn and couldn’t take a pair bites of meals with out getting nauseous.”
She additionally had “sulfur burps,” a aspect impact mentioned by some Ozempic customers, inflicting her to style rotten egg generally.
She was identified with gastroparesis, the weakening and paralysis of abdomen muscle contractions that make it more durable to digest meals. Some varieties of gastroparesis may be resolved by discontinuing GLP-1 drugs, as referenced in two case stories within the Journal of Investigative Medication.
Intestine Hormone
GI signs are commonest with semaglutide as a result of the hormone it imitates, GLP-1, is secreted by cells within the abdomen, small intestines, and pancreas, stated Anne Peters, MD, director of the USC Medical Diabetes Packages.
“That is the deal: The unwanted effects are actual as a result of it is a intestine hormone. It is rising the extent of one thing your physique already has,” she stated.
However, like Apovian, Peters stated these unwanted effects can doubtless be prevented if photographs are began on the lowest doses and regularly adjusted up.
Whereas the typical beginning dose is .25 milligrams, Peters stated she usually begins her sufferers on about an eighth of that – simply “a whiff of a dose.”
“It’s going to take them months to stand up to the beginning dose, however what is the rush?”
Peters stated she additionally avoids giving diabetes sufferers the utmost dose, which is 2 milligrams per week for Ozempic (and a pair of.4 milligrams for Wegovy for weight reduction).
When requested in regards to the medication’ unwanted effects, Novo Nordisk responded that “GLP-1 receptor agonists are a well-established class of medicines, which have demonstrated long-term security in medical trials. The most typical adversarial reactions, as with all GLP-1 [agonists], are gastrointestinal associated.”
Is It the Drug or the Weight Loss?
Nonetheless, non-gastrointestinal unwanted effects like hair loss, temper adjustments, and sunken facial options are reported amongst semaglutide customers throughout the web. Whereas these circumstances are sometimes what’s recognized within the medical world as “anecdotal,” that are private, however not at all times simply verified medical experiences, they are often very heartfelt.
Celina Horvath Myers, also called CelinaSpookyBoo, a Canadian YouTuber who took Ozempic for kind 2 diabetes, stated she started having intense panic assaults and melancholy after beginning the treatment.
“Who I’ve been these final couple weeks, has most likely been the scariest time of my life,” she stated on her YouTube channel.
Whereas extreme melancholy and nervousness will not be established unwanted effects of the treatment, some individuals get anhedonia, or the “decreased capacity for pleasure,” stated W. Scott Butsch, MD, MSc, director of weight problems medication within the Bariatric and Metabolic Institute at Cleveland Clinic. However that may very well be a pure consequence of decrease urge for food, he stated, provided that meals provides most individuals pleasure within the second.
Many different reported adjustments come from the load loss itself, not the treatment, stated Butsch.
“These are medication that change the physique’s weight regulatory system,” he stated. “When somebody loses weight, you get the shrinking of the fats cells, in addition to the atrophy of the muscular tissues. This fast weight reduction might give the looks of 1’s face altering.”
For some individuals, like Mendenall, the unwanted effects are value it. For others, like Carew, they’re insupportable.
Carew stated she stopped the treatment after about 7 months, and regularly labored as much as consuming stable meals once more.
“It’s the American method, we have all bought to be skinny and delightful,” she stated. “However I really feel prefer it’s very unsafe as a result of we simply don’t know the way critically our our bodies will react to those issues in the long run. Individuals see it as a fast repair, but it surely comes with dangers.”
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