I decided this spring that my non-stop race towards morbid obesity needed to be addressed. I have been trying vainly for a couple of years to slow the process down by gradually increasing my activity levels and making a comically unsuccessful attempt to reduce my calorie intake. But it seemed as if my own willpower was insufficient to the task: the numbers on the scale kept going up. I made the decision to try a medical intervention via the modern ‘miracle’ of GLP-1 agonists.
This is my (hopefully succinct) story.
Research
I’ve been following the progress of GLP-1 and semaglutide research for the past two or three years. The discoveries and treatments regarding the gut-brain hormones and neurotransmitters have been ongoing for over a decade. They originally were looking for a weight loss treatment to help with Type 2 diabetes treatment, but the success of the semaglutide treatment has been expanded in recent years to cover general weight loss.
Semaglutide is a glucagon-like peptide-1 (GLP-1) hormone agonist: it mimics the behaviour of the natural GLP-1 hormone. This hormone acts as a communication channel between the gut and the brain: amongst other effects, it causes the brain to recognize ‘fullness’ and satisfaction of hunger. In essence, GLP-1 tells the brain you are full, and this hormone has been observed to be highly disrupted in people with chronic weight gain and obesity issues.
Some people naturally have a reduced level or effectiveness of GLP-1, thereby feeling more hungry when they are, in fact, already full. And somewhat ironically, excess fat reduces the production and effectiveness of GLP-1 as well. So someone who is already overweight lacks the benefit of the very hormones intended to tell them that they don’t need to keep eating.
The GLP-1 agonist drugs are the first truly effective weight loss treatment in decades, with most recipients of the drug experiencing between 15% and 20% reduction in weight during the first year of use. There are side effects, the most common of which relate to digestive disruptions. Like any medication, it is generally unwise to start treatment without considering the risk/benefit balance.
I read a lot before deciding to try a medical treatment for my weight. I can recommend at least one book that helped me with my decisions: The Ozempic Revolution: A Doctor’s Proven Plan for Success to Help You Reverse Obesity, End Yo-Yo Dieting, and Protect Yourself from Disease (Amazon). Ozempic is the trade name for the exact same drug as Wegovy when it is used to treat diabetes. The book covers how the drug semaglutide works, what to expect from treatment, and how to maintain a healthy diet and exercise while on the treatment.
In my case, I had reached a stage where my excess weight was having health impacts. My fat percentage/BMI peaked this year at 38% with a weight of 238 pounds. I had elevated cholesterol levels and was on a statin for treatment, and also have moderate to severe sleep apnea treated with a CPAP machine. I was also experiencing increased issues with my ankles, knees, hips, and back that could at least in part be blamed on the excess weight I was carrying.
Starting the treatment
My nurse practitioner agreed with my rationale for beginning treatment with a semaglutide product. The one that she prescribed was Wegovy. Unfortunately, this drug is not covered by my provincial (Pharmacare) or insurance (Sunlife) providers. This means that I am paying for the drug ‘out of pocket’ at a cost of about $500 per month currently.
I began the titration process with a minimal dose of 0.5 mg of the drug. It is injected subcutaneously by myself with an auto-injector. I found the weekly injection process to be easy and almost completely painless: the needle itself is extremely fine. Each month I was prescribed a slightly higher dose of the drug until reaching the standard ‘maintenance’ dose of 2.4 mg per week.
I experienced some of the ‘common’ side effects relating to digestion, but for me they were extremely minimal. I have IBS and therefore digestive problems are pretty much my daily normal. To be honest, I actually found that (to an extent) my digestion is actually somewhat better while taking Wegovy.
Mostly what I experienced was a nearly immediate and complete silencing of my never-ending hunger for more food. I would eat part of a meal and just feel sufficiently full: the desire to keep eating and eating went away. This was true even as early as my first month on the drug. I found myself putting unfinished meals into tupperware containers instead of eating the whole thing then immediately looking for more.
Progress thus far
The decrease in hunger was immediate, and so was the weight loss. The weight loss has continued until the past couple of weeks when I seem to have plateaued. I suspect I’ll need to start increasing my activity levels a bit more to lose any additional weight, but I think that will be okay.
The image of my scale readings at the top of this post is from a couple of weeks ago. Currently I am weighing in at around 195 pounds and 27% body fat: that’s over 40 pounds down from my start and a 10% decrease in fat percentage. I’ve gone from ‘highly obese’ to ‘slightly overweight’. My original ‘optimistic’ goal was to get my body fat percentage down to or slightly below 25% i.e.: ‘normal’ healthy levels, so I’m well on course for that. I need to have another blood panel soon to check on my cholesterol levels, but I suspect those will be at least somewhat improved.
Generally speaking I am feeling more ‘healthy’. My knees and ankles don’t hurt as frequently and going up and down the stairs is easier. I have work to do in terms of increasing my cardiovascular efficiency: my heart rate is still too high with a resting rate around 80 beats per minute. But this is nothing new, and I feel like gradually increasing my activity levels to improve my heart rate is going to be easier now that I’m not carrying so much excess weight.
One thing about semaglutide is that it isn’t a ‘one and done’ treatment. The general medical consensus is that the treatment should continue ‘indefinitely’. I’m not sure about that personally as the cost is significant, but at a minimum it is advised to continue for at least a year, preferably two, and I intend to stick at it at least that long. There is some hope that the cost of the medication will decrease soon as alternative suppliers become available.
For now, I would say that the treatment with Wegovy has been a success for me. That may change in the coming months, but I suspect not. Not everyone will have the same results- it is very important to communicate with your health professional particularly while titrating (increasing) the dose. For some folks the side effects become severe- that’s definitely not something to simply ignore.
Obviously it is far better to reduce weight and body fat naturally through increased exercise and better eating. But there is now an alternative when that does not work and excess weight begins to cause health problems.
Thank you for sharing! This year I also lost 55 lbs through exercise, but for those who don’t like or aren’t able to exercise, medical options might also be a great approach!!
Thank you for reading!
Managing weight is different for everyone. I spent 10 years trying unsuccessfully to develop better habits and came to the personal conclusion that losing the weight was more important from a health perspective than how I lost it. For me, the drugs (semaglutide) helped with a minimum of ‘risk’.
The real question, regardless of how the weight is lost, is whether better habits can be established afterwards to keep the weight off. For that I’ll have to see where things are a few years from now.