By Jean Brannum and Maja Clasen
Christopher Maestas knew he needed to drop extra pounds. The Denver resident was as much as 250 kilos and had been recognized with prediabetes. His physician informed him that the one method to reverse it was via weight reduction.
It wasn’t simple. Christopher began dropping pounds at the start of 2020, however pandemic stress prompted him to realize it again by the tip of the yr. By the point he began utilizing semaglutide, the medicine bought as the load loss and kind 2 diabetes blockbuster Ozempic, he was again as much as his heaviest weight.
Instantly, the 53-year-old observed a distinction in his urge for food. For the primary few weeks, he might abdomen solely a single boiled egg for breakfast. Now, he has in a single day oats and possibly a banana. Even on days when he chooses heavier, fattier breakfasts, he eats solely a portion of what he used to.
How Semaglutide Works
Semaglutide is a GLP-1 receptor agonist. In response to the Mayo Clinic, medication on this household stimulate insulin manufacturing when the physique’s blood sugar is excessive. Although initially developed to assist handle sort 2 diabetes, these medication additionally assist create unprecedented weight reduction in ways in which consultants are nonetheless making an attempt to decipher.
Amanda Velazquez, MD, the director of weight problems drugs on the Cedars-Sinai Middle for Weight Administration and Metabolic Well being, mentioned that semaglutide mimics the intestine hormone that makes the physique really feel full. This suppresses urge for food, resulting in simple weight reduction.
Three U.S. Meals and Drug Administration (FDA)–authorized medication include semaglutide:
- Ozempic, an injection that’s authorized to deal with sort 2 diabetes
- Wegovy, an injection that’s authorized to deal with weight problems
- Rybelsus, a less-powerful oral type of semaglutide authorized to deal with sort 2 diabetes
Slicing Out Meals Noise
Urge for food suppression is just one impact of semaglutide’s results; it additionally has a exceptional capability to quiet the intrusive, obsessive ideas about meals that many individuals deal with on daily basis. Fixed enthusiastic about meals is commonly known as “meals noise,” and like many others, Christopher observed that his meals noise disappeared when he began taking semaglutide. He says that he by no means realized how a lot he thought of meals till the medicine quieted the ideas.
How {powerful} is the change? Christopher mentioned that he’ll utterly overlook to eat generally. Someday, Christopher put his lunch on a warming plate at 10:30 a.m. and continued working. Earlier than he knew it, it was 1:30 p.m. and he had not even thought of his lunch.
“The great factor about it’s, I’ve been ready to spend so much of time in my mind and in my life not enthusiastic about what are we gonna have for dinner. ‘What do we’ve got for tomorrow?’ ‘Do we’ve got sufficient?’ ‘Do we have to go to the shop?’ ‘We want this.’ ‘We must always get some snacks,’ I imply, there’s loads of that chatter that went on in my head I don’t assume I actually realized.”
It’s additionally turn out to be simpler to make nutritious diet selections. At his favourite Mexican place, he orders a ceviche tostada as a substitute of a big combo meal. When he dines out along with his husband, there’s an understanding that he won’t need appetizers. Generally, he eats a mix of aspect dishes.
“What it has accomplished for me is sort of modified my relationship with meals, however it additionally taught me that I don’t need to have the large breakfast each morning to get via the day. I don’t want 20 grams of protein at breakfast. I all the time thought I did.”
Accessing Semaglutide
Christopher by no means consulted his main care doctor. He knew that he may need hassle getting insurance coverage protection for Ozempic or Wegovy — and that the drug would value him dearly.
So, he determined to show to an internet clinic for a prescription. Specialists have warned sufferers to be cautious about on-line clinics, a few of which seem to offer very meager medical oversight. After finishing a questionnaire and digital assembly, Christopher acquired a prescription for cheaper compounded semaglutide. It prices him about $200 per 30 days.
Compounded medication dwell in a regulatory grey space with the FDA. The FDA doesn’t regulate compounded medicines the identical approach it does the common variations accessible at regular pharmacies, and lots of consultants concern that they are often unsafe or ineffective. Christopher’s semaglutide is combined with vitamin B12 and isn’t equivalent to Ozempic or Wegovy.
Dr. Velazquez says that we are able to’t be assured that compounded kinds are efficient: “You can be spending $1,000 on water or one thing, possibly one thing akin to Wegovy or Ozempic, however we’ve got no clue.”
For the compounded kind, Christopher attracts up his personal dose from a vial with an insulin syringe. He used to offer B12 photographs to his canine, so drawing injectables and utilizing needles was not a scary idea for him. “There’s a couple of two-second hesitation if you’re about to stay it in as a result of it’s just a bit bizarre.”
At first, the uncomfortable side effects have been a burden, however they weren’t insufferable and he was proud of the preliminary outcomes.
“The uncomfortable side effects and the urge for food suppression positively get extra intense as you titrate up in doses,” Christopher mentioned. “However I began to drop extra pounds instantly.”
The most typical uncomfortable side effects for semaglutide embody nausea, vomiting, and indigestion. Christopher mentioned that consuming much less helped so much with minimizing their severity.
The medication has been very efficient. Christopher has misplaced about 43 kilos since beginning his weekly semaglutide shot, and his blood sugar numbers have improved too.
Trying to the Future
As soon as he reaches his purpose weight, he wish to focus on getting off the medicine along with his main care doctor. Many who cease taking semaglutide regain weight, in line with Velazquez. After stopping Ozempic, the urge for food often returns and folks will ultimately achieve weight again.
Throughout the preliminary questionnaire from his telehealth supplier, he by no means mentioned whether or not semaglutide is a long-term medicine. Nevertheless, Christopher mentioned he wish to attempt getting off the drug if his physician thinks it’s best.
“I wish to attempt as a result of I really feel like if I’ve accomplished sufficient habits modification, and if I get the outcomes that I actually need to get, I feel that’s gonna be a giant driving pressure for me.”
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