I wish I could find where I read it, but I think the “you have to stay on it for life” thing may not be entirely accurate? There are some studies that indicate this, but it’s still early in usage and that may not end up being true for everyone.
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My doc says she doesn’t think so. She says people she’s worked with have gone off, gained a bit but not most back (true of most diets and treatments). She sees it as more of a reset. And if I decide to use it, and get insurance to cover, i would do so also.
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A few things:
- Small molecules that are orally active are under development. Those might well be game changers and bring cost down drastically.
- While it is certainly true that exercise and eating right can lead to weight loss, truth is that this approach does not work for ~95% of people.
- Obesity is a disease. I think the mindset needs to shift from OMG…this person is taking semaglutide to look good to this person is taking semiglutide to reduce the risk of diabetes, heart attack and kidney failure.
- Finally, I think gastric surgery and associated procedures have come a long way. For example, look up gastric balloons (Orbera), which can be inserted using an endoscope and can be reversed easily. Frankly, for me, the cost of semiglutide is hard to justify when compared to other costs.
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Keep in mind, for most users, weight loss is a health issue. For myself, i don’t have diabetes, high blood pressure, or other issues of that type, but carrying the weight makes it harder to avoid them–especially as it makes exercise more painful (though I do, anyway).
Joint and muscle pain issues are also quality of life issues. the fact that someone doesn’t have diabetes does not mean using this medicine is not for important health issues.
But, thank you for your in-depth explanations.
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The high price (which is not going to go down as long as demand is high relative to supply) is likely causing a lot of talk behind the scenes at insurance companies and employers offering medical insurance about whether to cover it in the future.
One of the other concerns I’ve heard about is muscle loss and some bone issue (and potential pancreatitis and GI issues). I wonder if the weight gain after d/c of the med is because appetite returns and bad habits return.
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I was talking about who is using the weight loss aid.
95%??? Your guess or some facts behind it?
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This can’t be true.
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I think there is an awful lot we don’t understand about metabolism and weight loss. Then we have a society that values certain body types. I grew up hearing the mantra “Nothing tastes better than being thin feels”. Exercising and dieting like a madwoman was simply unsustainable for me. No, diet and exercise doesn’t work for everyone and absolutely everyone should do what works best for them. I just think these weight loss drugs should come from a provider who is familiar with your history and will monitor you closely.
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I did a quick search but numbers I have seen are between 90-97%.
In any event, for the average Joe or Jane, it is statistically darn near impossible to sustain meaningful weight loss.
For funsies, read up on what happened to the Biggest Loser contestants after the show ended. Like all of them almost.
Edit: (apparently there was a class action lawsuit too)
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Ok, i see your linked articles but the fact that people are gaining weight back that they lost through diet/exercise just indicates to a degree that diet/exercise can lead to weight loss - but once that change of lifestyle stops or reduces, the weight comes back for 90% of people.
That’s a completely different situation than saying the approach of diet/exercise doesn’t work (for 95% of people). Or that it doesn’t work to a degree.
Back to the meds for weight loss topic.
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Well, if you are in that 5-10% of population that can sustain weight loss then all the power to you. Rest will need help.
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Weight loss (caused by anything, not just semiglutide) can result in muscle as well as fat loss. Exercise can be helpful to try to preserve muscle as much as possible.
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Yes but I believe this concern is in excess of that .
I did a lot of reading of primary scientific literature on weight loss when I was teaching some lectures about this topic for my neuroscience class a while back. This is a super complicated topic. And bodies are super complicated when it comes to weight.
One thing is very clear, however: weight is very stubborn. If it were simple to lose weight and keep it off long-term, everyone would do it. It is highly dependent on genetics and all sorts of other stuff. Keeping the weight off is exceedingly difficult, and almost no one can do it. Yo-yo dieting is not good for the metabolism.
We evolved to survive through periods of low calorie availability. Some people’s bodies will defend that bitterly. People are fighting against a drive to survive when they deny their hunger/cravings. It is very powerful, for some people more than others. It can change throughout the lifespan.
Eating a vegetarian (or even vegan) diet, in our current culture, is likely the healthiest and most moral thing to do. But not that many people do it. Why? Because eating animal products is pleasurable for most people, and is a convenient way to meet nutritional needs. I eat animal products, not because I think it’s healthier but because I like it. I have prioritized my pleasure and convenience over health and ethics in this category.
People feeling bad about their body size is not an effective way to change body size. And I absolutely think that all bodies should be celebrated.
I am considered normal weight. I am lucky that’s not super hard for me to do. I like to exercise but I am horrible at dieting. I absolutely loathe it. I have dipped briefly into the “overweight” category a few times and have gone on short diets to get out of it. It worked for me, in small part because know a lot about nutrition and exercise and how to do it effectively. But mostly it worked because I was lucky my body was amenable. I don’t know that I’ll ever diet again because I hate it so much.
Eat food that you enjoy, try to eat plenty of plants, don’t eat too much in general. Move your body often in a way that you enjoy. If your doctor thinks these drugs are right for you, have a discussion with them about that.
Some people eat too much and don’t exercise enough. Some people will always be “overweight”, no matter what they can reasonably do. And you know what? That’s okay if they’re okay with it. Those people should be able to enjoy their lives also, without being judged by others. And it’s okay if they’re not as “healthy” as other people. I would hate for certain folks get on these drugs hoping to finally get to the size that is expected of them, spend a fortune, and either have bad side effects or go off the drugs and gain it all back only to be worse off than they started. There has got to be an association of weight stigma with the use of these drugs — I don’t see how it could possibly not be the case in our culture.
I am happy that these drugs are available for people that need them for whatever reason. Were I overweight, I don’t think I’d care enough about that for it to be worth it to me unless my doctor felt strongly about me taking the drugs for diabetic reasons. But I’m not going to judge anyone who takes them, because I’m not in their shoes. I sympathize with those who feel bad about how their bodies are perceived by others and I wish them peace and acceptance. I truly hope these drugs can improve people’s wellbeing overall, not just make people lighter 
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I took the initial topic of this thread to be about people looking to get these meds off facebook ads and asking if anyone had experience with this method and obtaining compounded rx vs the name brand and they would not be working with hospital affiliated obesity doctors and or their own doctors.
Seems like a lot of “clinics” are popping up and jumping on the bandwagon with their own compounds and only posted about my friends experience with a legit hospital because it made our friend group all realize how monitored one has to be on these medications and how they are not really a fast fix and have their own health risks.
I spoke to her this morning and she is Wegovy not Ozempic - as she is not prediabetic even though she is classified as obese and the doctor can not/will not prescribe Ozempic off label. Wegovy is the only one approved for weight loss and covered by some insurance companies for weight loss - but appears many doctors are still willing to write Ozempic off label.
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Time to share, I guess. I’ve been on Mounjaro since January. Paying out of pocket as my insurance doesn’t cover any weight loss drug or off-label use of Ozempic or Mounjaro, which are FDA-approved only for diabetes at this point. And once Mounjaro gets the OK for weight loss, it looks like it won’t be covered for me anyway.
If you use a GoodRX coupon you can get it for about $980. It’s still a “wealth” drug for most, though, and I feel incredibly privileged to fit it in the budget.
I had a couple of ankle surgeries and then menopause hit and I could not exercise for a couple of years. And then covid. And the weight just ballooned.
I used to be 150 pounds, give or take 10 pounds, before the ankle surgery. I was 200 lbs when I took the first shot, this despite trying all manner of diets, exercising with a personal trainer, getting advice from a nutritionist and eating “clean” (my husband cooks from scratch and there is very little processed stuff in our house). Today I’m 146 pounds. My goal is about 130.
I know it’s for life; the thinking is a maintenance dose, not as often - maybe once every two months, maybe a lesser dose. It’s kind of trial and error for everyone who’s taking it not because of diabetes. You want to maintain, not keep losing, but you don’t want to gain, and it’s different for everyone.
The difference is life-changing. You know how when you’re on a diet, all you can think about is your next meal, and how hungry you are? How you clean your plate and want more? Or, if you have always struggled with eating habits, how there’s a constant background hum about what you want to eat, or what snacks are in the pantry? Or you go out to eat and you can order appetizer, entree and dessert and not blink an eye at finishing it all?
Well, that doesn’t happen on this drug. The “food noise,” as it’s called, vanished instantly. I just don’t think about food. I think this must be how it is for folks who do not have a problem with their weight. I eat once a day, sometimes twice. I drink protein shakes and a ton of water with electrolytes (Liquid IV etc). Lots of vitamins and calcium. My cholesterol and BMI and blood glucose (which was borderline diabetic) are all normal now. Side effects: some fatigue in the first two days after the shot, but nothing else.
It’s not a “cheat” and I’m tired of reading comments from people who denigrate those who are trying this. It’s not “easy” - I cannot eat high-fat greasy foods and if I do, I will pay for it. I work my butt off to afford the medication. I work my butt off in the gym. I have only seen results since starting this drug. So please, back off with the judgy stuff. Nobody is built the same, and nobody has the same response to “eat less and exercise more.” It’s just not that simple.
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I remember your determined motivation when you joined in on the Diet/Exercise/Wellness thread that you were working with a personal trainer (I hope I remember right that it was you!) I am so happy to hear that you continue to take care of your health in many ways. Sounds like you have a great “team” - your healthy cooking husband, your medical providers, your trainer. Along with you (and the meds!) making a healthier you. Be proud of that.
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