I wasn’t intending to imply any relationship - sorry for going off topic. Ozempic was only approved for weight loss in 2022 and I feel that suddenly we are being flooded with ads and apparently easy access to these drugs. Side effects for some users are frightening (anyone for a paralyzed stomach?). People become desperate to lose weight (I’ve been one of them). I’d really like to know how use of these drugs is being monitored by a medical professional IF you were connected to them by a program such as Found.
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IMHO, if Ozempic became part of identity politics as the vaccine has, you’d get pushback.
I think I wrote this on the health and fitness thread early last year, before the Ozempic craze started. I went to my PCP for my annual visit and told him that I was a little bummed that I had plateaued at about 60 pounds with my weight loss, which had taken about five years at that time. I was all about slow and steady this time, no “diets.” i wanted to lose about 15 more. One reason I loved this doctor is that he doesn’t push pills; he’s pretty conservative. So I was shocked when he mentioned going on Ozempic, which I had never heard of at the time. He said, “Do you remember the nurse who walked you back? She’s lost more than 100 pounds.” I did remember her; she was tiny. I would’ve never guessed.
I was shocked that he would offer it for me on a trial basis. I mean, I had lost so much weight on my own, and, generally, this guy is reluctant to prescribe medicines. I’ve had to beg for an antibiotic for a UTI before. I do wonder whether he was getting some kind of kickback as I had so little weight left to lose.
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I do agree that use of these GLP-1 meds should be monitored by a healthcare provider. But as someone who works in healthcare, I also understand why many don’t feel comfortable talking to their providers about their weight. Many overweight patients feel fat shamed or embarrassed by comments or recommendations. Even my own doctor initially dismissed my post covid heart complaints as anxiety (until she ordered a stress test which they had to stop midway because I failed it). Many also feel its the pot calling the kettle black.
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News > Medscape Medical News > Conference News > EASD 2023
Weight Loss With Semaglutide Maintained for up to 3 Years
Becky McCall
October 03, 2023
I don’t know how doctors can effectively treat their patients if they have to live in fear of being honest about the need to maintain a heathy weight and lifestyle.
People can lie about their alcohol consumption to their doctors. I know my mil does. But, you cannot argue with a number on the scale. And yes, I know some people are more muscular, that BMI alone isn’t very telling, the number on the scale doesn’t tell the whole story, etc. Physicians should consider many factors in assessing the health of their patients. However, if a patient needs to lose weight, a doctor needs to communicate that.
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Yes, that is a clear short term benefit to the employer for covering alcohol treatment.
There is some talk among some employers that currently cover obesity drugs that they may drop coverage, due to the high cost and expected high use. Obesity reduction may be more of a long term benefit, but by then, the employee may have left the employer or retired, so the benefits of reduced health care spending on obesity related conditions do not accrue as much to the current employer.
I’ll never forget being in an exam room waiting for my turn with a new to me doc. I was quite young and she was quite old. She didn’t mess around! I could hear her in the next room telling a patient, “I’m not going to candy cost it. You’re overweight. You’re fat. Your weight is starting to affect your health. Do t look to me to baby you!”
She was a pistol! 
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This is a very vulnerable post for me to share.
30 years ago I was twice admitted to in an inpatient psych facility for depression and an ‘eating disorder’. I am 5’9 and weighed under 100 1b’s I was released and had 10 years of therapy. My husband threw away the scale and I was determined to live a happy life
More background. My whole family live in a different country and are all morbidly obese. I live in the USA and I became obese after therapy. My husband is a skinny 150 pound person.
I had high BP, migraines, 2 surgeries on my knee and was holding out on getting a knee replacement, all my joints hurt and ankles stayed swollen. I was gestational diabetic (which increases my chance of developing diabetes and A1C was pre diabetic range.
I knew I had to lose weight but was very afraid that the eating disorder would return if I started a restrictive calorie count. But I tried anyway. It was hard work but I lost 20 pounds in 2 years. My husband and I then went on a hiking trip, we hiked the same distance, cooked and ate the same food well he lost 2 pounds and I gained 4. It was then that I knew I couldn’t win the battle of the bulge. Genetics are not on my side.
I went for a visit with my own PCP who prescribed mounjaro as off label use. I had to check in every month for a weight check and monitor labs every 3 month. Well from from Oct-Feb I had lost 50 pounds with no real thought. I just didn’t feel hungry or crave anything. I had to set my alarm to remember to eat in order to get enough calories in, and because of this I could make better choices. Since Feb I started taking the injection every other week and lost another 30. Total weight loss 100 pounds (2 year on own) and 80 pounds on Mounjaro in 1 year.)
Now for the bad, this was never about vanity for me it was about improving my health.
My Cholesterol has increased ( as I’m losing fat) I lost a lot of hair and I have lost muscle, I can’t hike the same distance I could when I was obese. My saggy crepey skin looks horrible and I can’t have my bat wings uncovered anymore. I also look older as my face is skinny with new wrinkles.
The other negative is I’ve lost the joy of social eating.
The good news is, I never had a single side effect from the drug, my ankle and joint pain improved within 2 weeks of starting the med, I no longer need anti inflammatory meds for knee pain, no longer need a knee replacement and no longer need my anti depressants. My plan is to now stretch it to every 3-4 weeks as I truly don’t want to lose anymore. If 1 box can last me 10-12 weeks it makes the cost doable especially that I’m no longer eating out, I buy less groceries, spend less on MD specialists and no longer get steroids injected into my knee
Please don’t believe that being obese is a choice, it’s not. And if anyone could diet their way to cuter clothes they would have done that already. The weight loss journey is hard however you decide to do it,
Sorry for the long post
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thank you for sharing sly123. what a journey you’ve had. It is nice that this is a anonymous forum; your thoughts can help others. thanks.
my question is why can’t you hike as long as before? why have these meds affected your physical stamina, even though you carry much less weight?
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Thanks for sharing.
Somewhere upthread someone mentioned getting rid of the “food noise” and no longer thinking of food all the time. That sounds so unfamiliar to me … and like heaven.
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Thank you, sly, for your willingness to self disclose and to share your journey. Very
Much what I was hoping to hear from someone who has been there/done that.
I still go the the gym as before 3 x per week, but with muscle loss I tire quicker.
Thanks for sharing - believe me, I know how hard it is to lay yourself wide open, even on the interwebs 
A couple of things, as I think we’re very similar (I also was around 96 pounds with an eating disorder many many decades ago, and never want to go back there). I know we are all different, but maybe some of this will help; my apologies if I’m making any assumptions or offering tips that you’ve already tried unsuccessfully.
– The hair loss is normal when losing significant weight in any scenario. It will likely reverse itself, though bear in mind, if you’re near my age of 60, your hair is also naturally thinning so the hair we had at, say, 20, is not coming back.
– Cholesterol increase is also not unusual, but the good news is that it’s temporary:
– Muscle loss, bat wings and saggy/crepey skin can be at least addressed by focusing on a strength training program - skip the cardio and go for the weights if you are tiring too much. I was working out for a few years before starting this drug and so I had a decent base of muscle (hidden by fat). As the weight has come off, the definition in the muscle that was already there is coming to the fore, and my trainer is now brutalizing me with constant weight increases, because she hates me (haha, jk). There is noticeable improvement, though it’s slow and I’m impatient! And it might never be perfect, but my goodness, I am 60 and I don’t know too many 60YO women who can get away with sleeveless tops anyway 
– I don’t care about wrinkles and such nearly as much as I should but I know there’s Botox and all that - maybe something to treat yourself with? I may look into it when I’m happy with my muscles!
– On the joy of social eating: I agree that eating for 5 days a week is basically a chore to be reminded of by my phone alarm. But as the drug wears off, I do enjoy eating with the family the day before my next shot. It’s less food, but it’s yummy and I am happy to have that day and savor the meal.
I’m really glad that you’ve found better health through Mounjaro, and I am hoping that the next year brings you even better strength and energy.
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Thank you for your very supportive tips. We do sound very similar as I’m almost 60. I will do the weight training for muscle strength.
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Yes, and due to her fat-shaming, her patient may well have avoided going back to see her, for fear of being shamed again when the patient’s attempts at weight loss don’t work, or she gains back any lost weight after successfully losing weight. There have been many studies that show that weight stigma by healthcare professionals leads to delayed medical care and poorer health outcomes. No one WANTS to be overweight, given how poorly people with obesity are treated. If just telling patients to eat less and exercise more were effective, there wouldn’t be many patients (or doctors!) with obesity.
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This exactly. I have a very astute, empathetic primary who knows me well, and knows how I live. She followed MY lead, letting me bring up weight issues myself. Because she already knew how I eat and how I exercise.
Healthy eating does not have to be couched into “you’re obese” terms. All people need to know about healthy eating and healthy exercise, at every weight.
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But I could imagine some doctors who don’t want to have repeated challenging conversations, might find it easier to just prescribe a drug, rather than telling patients they have to change their lifestyle?
It’s not the same, but one thing I took away from the Dopesick series about OxyContin is that “magic” pills with supposedly no side effects were an easy choice for doctors to offer their patients compared to telling them to live with and manage their pain.
Fortunately it seems these weight loss drugs are safe, but they are likewise being portrayed in the media as a magic bullet compared to conventional weight loss strategies.
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You can have and continue to have conversations about healthy food and movement choices. You can talk about blood pressure and possible conditions (though many fat people do not have them).
You don’t have to have repeated “challenging” conversations, because for the vast majority of fat people-- healthy food and movement choices aren’t going to change it. Which we have been repeatedly saying here. I never needed to be challenged about something i am very, very aware of.
Don’t worry, society make certain that fat people know they’re fat.
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I am so glad this thread has remained mostly positive and supportive. I think many don’t realize how powerful even minor fat shaming can be. If we are self- disclosing, here’s my story : back almost 50 years ago when I was in grad school I had to have some surgery. So, post surgery, sitting in the hospital bed, being in healthcare I asked if I was allowed to see my chart. Now mind you I was maybe 22-23 yrs. old and was a mild - moderate exerciser. I am short (maybe 5’3.5”) and maybe weighed 133 then. Wore (still do) size 8 ( sometimes 10) clothes. So I open the chart and it says “patient is a 22 (or 23, can’t recall) yo. mildly obese female…. 
I closed the chart right then and handed it back. That was painful and unexpected. And to this day, almost 50 years later, I still remember it that clearly (and that the nurse kept calling me “bunny”, but that’s another story). So one comment like that still lingers in my memory all these decades later. Even if back then the definition for “mild obesity” might have been 10% over ideal body weight, it was quite stinging to see that. That’s why I do not begrudge my friend, who is using the self injectable to lose probably 15-20# (she is also short) is intriguing to me. She has a houseful of relatives at the moment. I plan to check in with her next week to see how she is doing.
Beware. Not approved.