The Wizard of Oz(empic)
I swear to god, I almost felt like crying a few times once I understood what was happening.
This is the unabridged version of my article published at The Banter earlier this week. It’s significantly longer and more detailed. You can dive into the full article here or read the highlights there. Whatever tickles your fancy. - JR
Last week, I gave you, dear readers, some background about my struggles with weight loss and how that led me to start taking Ozempic. This week, I’m going to walk you through the notes I took during my first several months. I’ll add comments to clarify some of the points and, of course, I will be cleaning up the writing so it’s not just shorthand gibberish that only I would understand.
So come take a trip with me back to the distant past of…June. After losing 30 pounds over the course of 2 long years, I had been stuck at 300 for months (and months). My doctor prescribed Ozempic and off we went!
Ugh. I can SEE the needle!
Day One: Monday 6/19. 300 lbs. I took the first shot at 4:08 PM. This was the starter dose of .25 mg. I was not thrilled when I realized I could see the needle. With Trulicity, you pressed the injector against your skin, the needle came out, and then retracted. With Ozempic, the needle was just…out. You inserted it yourself. Ugh. It’s so thin you don’t feel it but you can see it and that’s just awful. Whatever. Poke. Done.
I was crazy stressed about side effects. I had been taking Trulicity for a couple of years and lost over 20 pounds with no complications but that was no guarantee I wouldn’t have problems with Ozempic. I already have gastro issues and if Ozempic made them worse, then no Ozempic.
I was fine until I ate dinner and then got a weird headache. I don’t generally get headaches so I wasn’t sure what I was feeling. No, seriously. If I’ve had 3 headaches in the last 5 years, I’d be surprised. It’s so infrequent, I don’t always immediately recognize one when it happens. Happened again the next morning and after a small lunch, but it didn’t happen again after that. Nerves? Body adjusting? I’ll never know. My appetite was pretty much the same.
Day Two: Had to pop an Immodium because my stomach was not being friendly. It wasn’t bad but it was concerning. To be fair, I had taken one on Friday for unrelated reasons and when Imodium wears off, my stomach tends to be a hot mess. Combined with nerves, it could very well have been that instead of the Oz. No interest in finding out at the moment, though.
Ate a half a breakfast burrito, a few strawberry slices, and nothing else until a taco dinner. This was interesting: I didn’t even realize I hadn’t eaten anything else. Skipping lunch is normal on Trulicity and Topiramate but I tend to snack. On Ozempic (and Topiramate), no snacking. I also tend to eat more than 2 tacos and a bowl. It’s tacos, they’re not exactly filling. But not this time. After 9 hours of not eating anything at all, I was full after a modest meal and I stopped.
Day Three: Ate the other half of the burrito and a little bit of watermelon for breakfast. For dinner, I had a bowl of pasta and meat sauce. That was my entire food consumption for the day. I ate ⅔ of the bowl and felt slightly nauseous. I didn’t realize I hadn’t eaten anything again until dinner. I didn’t immediately make the connection with the nausea until the next day.
So that’s what that feels like!
Day Four: 298 on the scale and that was after eating way more pasta than I should have. Had half a mug of cereal. Had popcorn at the movie theater but popcorn is like eating air. Nothing else until dinner, which was a salad. Deb and I always split a bag of salad (usually a bag like this) but this time I felt nauseous. I had eaten too much. I knew part of the Oz would be losing my appetite. I wasn’t aware I would feel like throwing up after eating.
I suppose I could be upset about this because I really enjoy food but honestly, meh. Not that big a deal.
This is what I was referring to in last week’s article. The Guardian inexplicably labeled this effect making “food itself disgusting.” That’s unbelievably inaccurate. Food is not disgusting. Overeating is now disgusting. And really difficult to do.
What Ozempic does is reset how your body responds to food. My entire life, I have never heard but the faintest protest from my body when I eat too much. If you do not suffer from obesity or have a fast metabolism, this is almost impossible for you to understand. It’s like explaining color to the blind. This pizza is delicious! I can eat another slice, right? Sure I can! And maybe another after that. There’s always room for Jell-O. And maybe a donut or two. And maybe a snack before bed. There’s -always- room for a little more food.
With Ozempic, my body has a megaphone that says, “You’re full!” and I, at long last, can hear it. I hear it loud and clear. So that’s what that feels like! I swear to god, I almost felt like crying a few times once I understood what was happening. It was literally like regaining a limb or accessing a sense you never had before.
I know there are people who are not actually overweight who are taking Ozempic. Models, both male and female, who need to go from a healthy weight to the unhealthy weight “needed” for the camera. Or influencers who just -have- to lose 5 pounds so that size zero bikini will look just right. For those people, who don’t normally overeat and can already hear their body, I imagine Ozempic might make eating all but impossible because it’s not meant for them. That’s like giving insulin to a non-diabetic. If it doesn’t kill them, they’re going to wish they were dead.
Day Seven 6/26: Time for the second shot and weighing myself. 297 lbs. Not bad considering I’ve been stuck at 300-301 for an annoying amount of time. And this was Claudia’s birthday weekend so we had gone out to eat. Naughty! And alcohol! I got really tired after the shot although no tummy issues this time. Less nerves or was I acclimated? Who knows? Don’t care as long as it went away. This was the first and only time I got tired after the shot so it probably was not related. Correlation is not causation and all that.
By 6/30 I was down to 295 which was as low as I had managed to get for a very brief spell before rebounding and getting stuck at 300. My birthday party was that weekend and despite the plethora of tasty foods, I didn’t eat much. I thought this would be annoying since I really do like to eat but, honestly, I didn’t really mind.
Week Two: I drifted up to 297 again which was irritating but that only lasted for a few days before I started drifting down again. Whew!
Week Four: A neutral week not really up or down. Boo.
I noticed the day after the shot was the most effective. I hardly eat on Tuesdays. It’s disconcerting. Need to ask about vitamins and other supplements. I am not good at eating multiple small meals. It feels weird and it’s difficult to do, one of the reasons I never seriously considered bariatric surgery.
This turned out to be a bit of an issue. I eat cereal for breakfast pretty much every morning, which is stuffed with a ton of vitamins to make it actual food instead of pure junk. If I didn’t, I might be running into some trouble. It takes a while to deplete your body’s store of vitamins and nutrients but I already wasn’t eating lunch on most days and I do not normally eat a ton of fruits and vegetables.
I had cut the amount of food I was eating by half, at least. Great for losing weight, but also great for not getting enough of the stuff my body needed to stay healthy.
Week Five: I dipped down to 293 which is another new low. Again, 7 pounds in a little over a month doesn’t sound like “a lot” but I haven’t weighed 293 in well over a decade. When I cracked 300 going down, that was a BFD. Especially because once I got there, I stayed there. If I can get down to 280? 270? And stay there on the lower (50 mg) dosage? Maybe I can get down to 250 on the higher dosage. (This is a wildly optimistic outlook) Yeah, that turned out to be -wildly- optimistic. Not entirely my fault, though.
7/24: I talked to my doctor at the end of my .25 mg prescription. We discussed my tolerance and moving up to .5 mg for a month before trying higher doses if necessary. Ozempic goes up to 2 mg. Wegovy goes up to…2.4 mg. Insert eyeroll emoji. Wegovy is literally the same medication but under a different label so it can be prescribed for weight loss as opposed to diabetes. That one goes up to 2 and the other 2.4 seems arbitrary, at best.
I was super gung-ho to try the higher dose, though. Since I had more than enough left over, I said, “Fuck it!” and bumped it up to .5 mg for my 6th, and last, shot of my original prescription. There was a pretty big difference between .25 mg and .5 mg.
The next day, I had to make myself eat a half a cup of cereal. It’s not that the food was repellant (as The Guardian suggested), I just wasn’t hungry at all and kind of enjoying it. I could have easily not eaten until noon. I had to eat something, though, because I was going out to a concert later and didn’t want to eat on the road. While at the concert, I had 3 rice cakes but honestly, I probably could have skipped them completely. Again, the day after a shot is always the most effective. I ate a PB&J sandwich when I got home but only because I figured I really should put some food in my stomach.
Started to take a multivitamin - concerned that if I kept this up, I would not get enough nutrition. I don’t eat enough fruit and veggies as it is and now it was REALLY hard to grab one as a snack because snacking is hard. Which is both good and bad.
Doctor warned me about muscle loss. I do not seem to have lost any muscle that I’m aware of but something else happened around October that pleased me to no end. We’ll get to that.
8/3 291.4 another new low. I’ve found that it helps to eat a small lunch even if I don’t want to. Which is weird. Eating to lose weight is extremely counterintuitive. I’m starting to have trouble finishing my cup of cereal in the morning which is smaller than my previous cup which was smaller than the bowl I used to eat from. I eventually settled on a 12 oz. mug that was just the right size.
Another thing I noticed but had to look up to confirm: Food digests slower. Doctor didn’t mention THAT, either. Look, I get it: Doctors can’t explain -every- little thing. But what the actual hell? She didn’t explain literally anything at all about what Ozempic does or what I should expect. The manual that comes with the Ozempic injector is 20,000 words long in teeny tiny print. No one is going to read that and frankly, I have no idea if it even explains any of the stuff I had to figure out.
On the plus side, knowing that food takes much longer to digest, I understood why I had zero interest in snacking. It also meant I had to be careful about when I ate breakfast. If I ate really late in the morning, say 11 or later, it would be very difficult to eat dinner by 6. There have been multiple days I woke up late or didn’t get to breakfast until close to noon and that ended up being the only meal of the day. I’m a (really) big guy so I have the reserves to burn off. I would not recommend this for most people, especially if you have to keep a close eye on your blood sugar.
I’ve noticed that the snacks I buy for me (rice cakes, popcorn, etc.) are starting to pile up because I’m not eating them. This is a good problem to have, I guess. I really do need to switch to different snacks juuuuust in case the nutrition thing becomes an issue.
8/10: Slow week (darn chicken wings…) but I got down to 290. I’m hoping REALLY hard to break the 290 barrier tomorrow but we’ll see. Found out that even a fruit smoothie will make me feel overfull if I drink too much (in this case, about 24 oz). Still, 10 pounds in 7 weeks is not terrible. 3 more weeks until I move up to 1 mg of Oz.
Also read about the unexpected side benefit of a 20% reduction in heart complications. Guess that means I might live past 65 and die from some other terrible thing when I’m older. So….yay?
I have always assumed, because of my weight, I would die from a heart attack. And not at a ripe old age, either. Even when it looked like cancer was a very real possibility, I still had my money on a heart attack. Now? I’ve been told I’m as low risk as it gets for cancer and here’s a drug that can reduce my chance of a cardiac event. Sweet.
Took goddamn forever but I cracked 290 on 9/4. GEEZ! 287. Again, 3 months for 13 pounds may not sound like a bullet train but from my perspective, it’s lightning fast. Remember, Ozempic doesn’t speed up your metabolism or “make” you lose weight. You can’t eat the same way and expect the pounds to come off like magic.
My friend Glenn is on Ozempic and he has “cheat days” during which he eats appallingly bad. He’s been complaining that the shots have lost their effectiveness and I’m not surprised at all. My guess, from my whole three months I’ve been on Ozempic, is that if you train your body to eat larger amounts of food again, you’ll be able to. That, of course, defeats the purpose of Ozempic.
After 6 months, I still don’t know if this is true and I haven’t taken the time to read up on it. But I suspect my intuition is correct. If Ozempic is essentially a “reset,” it can be overridden with time and effort. If you really want to eat large meals, you will. And then you will put weight back on.
This is a willpower thing but in reverse. Before, it was hard -not- to eat. Now? To eat enough to put on the weight I lost would be…difficult. I could do it but I would have to really work at it and it would not be fun. Maybe 6 months or a year from now, Ozempic will lose its effectiveness but I have not seen that mentioned anywhere and only Glenn has made that complaint.
I’m only halfway-ish through the max dosage allowed for Ozempic. That is a very good sign. I would very much like to get down to 275 on 1 mg before moving on to the higher doses. 275 is how much I weighed when Deb and I got married in 2006. I just like the idea of that being a starting point for what I think of as “Phase 2” for absolutely no reason other than I’m a nerd. Yeah, that didn’t happen. Still not my fault, though.
9/7: 286 lbs annnnd the scale broke. Clearly, it’s a conspiracy. You may keep your jokes to yourself, thank you very much. This is a recurring problem with this type of scale. It has these little plastic pads on the bottom that eventually wear out from being moved back and forth on the floor. This one lasted two years. I’d get a different scale but this brand is pretty accurate and it links to an app on my phone which tracks more than just my weight so it’s fine.
The new scale arrived a couple of days later and after a few minutes of futzing around with it, I got it to link to the app. Thank god it didn’t delete the old information.
The new scale matches the weight of the old one which does not always happen. So, yay there.
Finished 1 mg Oz and went back to the doctor for a refill/new prescription. Personally, I wanted to stick with 1 mg until I got down to 275 but I was told it would be better to go to 2 mg. This was a new doctor as my original had left the practice. This one said I would just be prolonging the time it takes to get to the end of the journey so I might as well move up the dosage.
That’s not quite what I was talking about but I didn’t want to spend all day arguing. Part of what I need to do is adjust how I eat, which has been difficult. Specifically dinner. Breakfast has actually been easy to adjust. I literally pour my food into a container. Smaller container, less food. As I quickly realized I needed to eat less cereal, I just used a smaller cup. Tadaaa!
Not as easy for a meal made up of multiple items. A protein, a starch, veggies. How does one cook one and half hot dogs? Half a hamburger? Don’t even get me started on buying food at a restaurant or fast food place. The servings are ridiculously large.
It’s also weird to make a plate of food at home smaller than what I make for my 13-year-old, 110 pound daughter. Part of my brain is aware that she is a growing teen. Part of my brain scoffs at the idea that she eats more than I do. Yet another part keeps insisting that I can’t possibly not be hungry after eating that small amount of food I just gave myself.
It’s really hard to break decades of behavior and the extra dosage will not only make it harder to eat, which is fine, but harder to break my eating habits gradually, which is what I really need to do.
I do not know how long I will be on Ozempic. Is there an off-ramp? Maybe. Maybe not. I am not experiencing any side effects at the moment so I’m fine being on it for the rest of my life, if necessary. At the same time, I’m very aware that my insurance could decide that, “Hey, you lost 50 pounds and your A1C is down to 5.8! That’s enough Ozempic for you, buddy!”
Accordingly, I am planning for that off-ramp. I want to know that if Ozempic goes away 6 months or 6 years from now, I will not immediately put the weight back on. For my own curiosity and for this article, I skipped an injection in November to see what would happen. When the effects wore off a week later (Ozempic is a weekly injection, remember), my appetite returned, but I found it much easier to stick to the smaller portions. Snacking was a bit of a problem, though. However, if I can stay on Ozempic for a few years and build new long-term habits, I feel that I will be in a much better position if I ever stop taking it, voluntarily or otherwise.
For the record, I did not put on weight. But I didn’t lose any, either. Now back to the show.
Still, I started 2 mg on 9/25. I had been wobbling around 285 which is 15 pounds down from where I had started in June. According to most of the literature, this is well within what the majority of people experience on Ozempic. While it was nice to, after almost 20 years, not have to say I was 300 or more pounds when asked about my weight, 285 wasn’t good enough. I’m just greedy like that.
On October 1, I passed the 285 barrier. By the sixth, I was down to 282. It’s weird and almost certainly psychological. But I get to a weight and I get stuck for a week or two (or longer) and then I get over the hump and lose 3 or 4 more pounds. Again, a pound here or there sounds trivial but I was now almost a full 50 pounds less than my maximum weight of 330 from a few years ago. That’s an entire 7 to 8-year-old child.
Here’s the nifty thing that happened around October: Right around the time I lost about 15 pounds, I noticed my legs had become much more defined. Like most overweight people, I suffer from low self-esteem, but my legs? My legs have always been sexy as fuck. It’s a quirk of how I carry my weight that even at 330, I didn’t necessarily -look- 330. And my legs, particularly, have always been fantastic. Now, they had definition and I could see the muscles flex when I tensed them. That was new.
A few more pounds, and I could see the muscles flex in my arms, too. Even when I was younger and significantly stronger, I couldn’t see that. But I can now and it’s goddamn awesome. OK, vanity side quest complete.
At this point, my goal for the year is 275. That’s how much I weighed in 2006 when I was married. If I can get to that and hold it, that would be almost 2 full decades of weight gain reversed in just over 6 months. Now that I am past 285, that goal is very much in view. Although Halloween and a ton of candy is staring me in the face. But if I can get to that, the next goal would be 265 which would, at 6’1”, bring me out of obesity class 2 into class 1.
I have no illusions of thinness in my future. According to my doctors, my target weight is 175 pounds which seems…improbable. At 15, Jordan weighs more than that and he’s an inch shorter, barely has any fat, and far less muscle mass (it’s an autism thing). Hitting that goal would require a personal trainer and a life of austerity. I’m good, thanks.
I’ll be happy if I can get within spitting distance of 250. I honestly cannot remember when I last weighed that much. The late 90s? Maybe. Hopefully I don’t reach my new equilibrium before that. At some point, Ozempic or not, my body will decide, “This is the new norm” in terms of retaining weight in relation to the amount of food I’m eating. Even at a reduced amount. That’s just how bodies work.
They’re designed to hold on to calories as fiercely as possible. This is why regular dieting so often fails. It was never a matter of willpower or discipline. Evolution quite literally fights to keep every scrap of food you consume right where it is. That’s great when food is scarce, less useful when food is overly abundant or very unhealthy.
250 might be a lot to ask from the Wizard of Oz(empic) but if I can drop or reduce some of my other medications? Stick around a few extra years for the kids, especially to keep taking care of Jordan? Follow that yellow brick road! Or, in this case, the thin needle with the blue cap.
I got very busy in October and November and forgot to keep taking notes. Nothing particularly exciting happened. I took my shots, I went down some weeks, stayed the same on others. A few I went up before going back down.
I successfully made it through both Halloween and Thanksgiving without putting on weight. Not an easy task for anyone, much less someone like me who really enjoys both holidays and the yumminess that comes with them (So. Many. Thanksgiving. Potatoes!). But I did it. Go me!
There are 3 weeks left to the year. Will I make it to my goal of 275? Will I undo 20 years of weight gain in time for 2024?
Well, actually…
250 doesn’t seem that far away now. Merry Christmas from the Opinionated Ogre.
Post Script: A few days after this article was originally published in The Banter, I went to my doctor for bloodwork and a refill. The two main goals for me using Ozempic is to lower my blood sugar (A1C) and my weight. The weight is coming off (hooray!) but much to my surprise:
I’ve been trying to lower my A1C for well over a decade. I’ve managed to dip down to 6.2 but never 6 and certainly never below 6. And yet, there it is. Not just under 6 but at target! I am not just no longer officially diabetic (depending on how you measure it). I’m not even pre-diabetic! That’s a neat trick for just 6 months.
The journey continues.
Thanks Justin. I am in Zepbound and hopefully following in your footsteps