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I've lost 60 pounds in 8 months on compounded semaglutide. I had pretty bad nausea issues a couple months into it, but it might've been from making too aggressive of a dosing jump (1.00 mg to 1.5 mg). The other annoyance is the price, as even the compounded stuff is pretty pricey and inuseance is loathe to cover it.
But still, it's been life-changing for me. Unless a doctor has a good reason to keep you off it, it's definitely worth a shot
400lbs is pretty dangerous- you should see if you can get those drugs covered. There are manufacturer coupons.
I have really bad sleep apnea and allergies that can make it hard to treat with a cpap. My doctor recommended a GLP1 for that, and it really helped the sleep apnea. It also is managing some weight gain that I experienced from steroids for bronchitis. The sleep apnea improvement has actually been separate from weight loss..that got better before my weight went down.
The side effects are really minor for a lot of people including me. I get weird occasional nausea for like 10 minutes a few times a week. Really not bad. It also makes you constipated but that's easy to treat.
Some people apparently feel like total shit, but not most people.
It works by just making you less hungry. You eat a normal amount of food and then you're full. It's really that simple. I thought it would make me not enjoy food- couldn't have been more wrong. Maybe if your main enjoyment of food is like eating 3 costco cheese pizzas- sure you can't do that, but tasty food is just as good as before.
The biggest thing for me is that I dont have to FUCKING think about food so much. I have ADHD and a little bit of hunger is extremely distracting and derailing which has caused a lot of weight gain. Now I don't care if I'm a little hungry. Now I can notice I'm a bit hungry, and just ignore it and go to bed, and I won't feel like shit from not eating.
The one other side effect is that your body, being designed to eat food, will try to find other ways to get you to eat... Now instead of hunger pangs when I haven't eaten, I get really sleepy. Like super sleepy. Black coffee doesn't really wake me up, sugar does. By the way, drinking calories is the one way to still gain weight on these drugs, so use sugar water as an emergency wakeup supplement when you gotta drive or whatever, and otherwise don't drink it.
Ignore the stigma, it's stupid and insane. Rich actors are using it to lose 15 pounds, but you are almost 400 pounds. That's unsafe and probably such a fucking shitty painful way to live. These drugs aren't magic but no drug is. Don't beat yourself up, take the best medicine for what ails you. Hoping to lose weight doesnt work, trying really hard doesn't work. Dieting makes you gain weight more often than it makes you lose it. These crazy new drugs actually do shit. I would never risk taking them to lose 15lbs but they are definitely less risky than being 380 or whatever. That much is clear by now.
It works by just making you less hungry. You eat a normal amount of food and then you're full. It's really that simple. I thought it would make me not enjoy food- couldn't have been more wrong. Maybe if your main enjoyment of food is like eating 3 costco cheese pizzas- sure you can't do that, but tasty food is just as good as before.
The biggest thing for me is that I dont have to FUCKING think about food so much. I have ADHD and a little bit of hunger is extremely distracting and derailing which has caused a lot of weight gain. Now I don't care if I'm a little hungry. Now I can notice I'm a bit hungry, and just ignore it and go to bed, and I won't feel like shit from not eating.
god that sounds wonderful
It really really is. It's the best thing about all of it.
After I gained weight my hunger started to really bother me more- I think it's hunger hormones from all the extra fat cells- my stomach would hurt bad, headaches would happen easily, I would get nausea from hunger, and so on. Now I feel so resilient.
If you end up with worse side effects than me, I would definitely recommend treating them aggressively. Fiber supplements, nausea pills, diet changes to reduce gas, etc. Most of the bad side effects people get are actually like... Pretty normal basic OTC stomach upset kind of stuff.
I also had a weird side effect for like 3 days after one of the dose increases, where my skin was sort of sensitive in an annoying way, kinda like having a sunburn. Never came back though.
putting it on the pile of things that might someday get me to go through the hassle of getting a new PCP. real race between that and somebody from a better country helping me do some visa fraud.
Yeah it's pretty cheap in other countries. They made a sleep apnea version as a pretty transparent workaround to force insurance to cover it for people without diabetes. The manufacturer coupons also really help. Insurance can be very fucking annoying about it but so far they have paid for it. At one point they fucked me and delayed it several days and I had to pay full price and get reimbursed via check a few weeks later.
Allow me to echo a common bit of advice. Any weight loss you do must be accompanied by an overall diet and lifestyle change in order to be permanent. Weight loss treatments and drugs are fine if you are using them with medical supervision (sounds like you are) as a way to kick start this transition in diet and lifestyle for a more healthy and manageable future for maintaining your weight and governing your health. But that lifestyle and diet change is key. Don't squander your chance to get on the right tract to start taking control of your health. Make the changes. Stick to them and you'll see success.
You should know that some evidence suggests weight loss via GLP1 drugs might be stable e.g. https://www.nature.com/articles/s41591-024-02996-7 while some contradicts this. The overall picture of long term weight loss is extremely bleak: https://pmc.ncbi.nlm.nih.gov/articles/PMC5764193/
Lifestyle changes aren't really a more sustainable intervention than anything else. For a lot of people it seems like losing weight = feel hungry for the rest of your life and commit to calorie counting forever.
Feeling hungry all the time has a lot to do with diet, I've found. You can feel more satiated with better diet choices like eating healthy fats and proteins which give a full feeling for longer than carbohydrates.
Diet and lifestyle changes are the ONLY sustainable way to keep the weight you lost off. Saying these aren't more "sustainable" than other "interventions" is wrong. Like, dead wrong. You are throwing out buzzwords here to qualify your wrong assertion in way to make it sound more right but it's still wrong. GLP-1 is an intervention. Diet and lifestyle changes are not. They are what you are doing long term. It's a different step or element to the weight loss and healthy living journey.
I'm not against GLP-1. I think it's it's great to get yourself on the path. Kick start it. I'm saying that once you stop taking it you'd better have changed some things about your relationship to exercise and food. If you go back to the way things were before, you'll gain it back. It's how you got it in the first place.
I had a colleague tell me that GLP-1s inhibit individual fat cell (adipocyte) growth, but can ultimately lead to adipocyte proliferation, especially if lifestyle modifications aren't made, and that this is a major factor in rebound weight gain. Can't speak to the veracity myself and am having trouble interpreting the literature off-hand.
Interestingly, it looks like a monoclonal antibody known as bimagrumab may be helpful in conjunction with GLP-1 agonists for focusing weight loss on bodyfat specifically, rather than general (incl. lean body mass. Since it's still in trials at Lilly, there's not a lot of good citeables yet but the combination therapy seems to be highly effective in causing the type of weight loss that is least susceptible to this issue.
Huh what the fuck? That's completely beyond my layperson understanding of human biology. Cool if true.
I tend to be of the opinion that weight is overemphasised in health (and also that socially it's completely fucking obnoxious to fuss over someone else's alledged health) relatively to stuff like cardio and muscular strength and endurance. Still it's undeniable that many people feel substantial psychological distress over their body weight and some people are severely impacted by being fat. Having actually effective interventions would be rad. As a trans woman I am on team modify your body however you like.
It's so horrible that the standard medical and social approach is basically "Bully people until they commit to a cycle of self denial, lapse, and repeat. This is cool and good."
Pharmacology aside, there's so much wrong with the way we handle obesity, which should be treated as a structural, societal disorder rather than an individual issue. Why does almost everyone relapse? Well, it's not like the carbohydrate snack hell at the grocery store got any better, and the advertising hell just keeps worsening apace. Protein is expensive, carbs are cheap. You can't walk anywhere and everything is built around cars and jobs where you sit around for 9+ hours and come home too exhausted to do any exercise. You try to create positive lifestyle changes, but everything around you is trying to push you into doing the exact opposite of that. Trying to push individualistic management rather than overall societal change is wholly ineffective as we've seen.
Obesity is absolutely a disease that dramatically worsens a person's quality of life and health in basically every way. The impact of body mass on joints and of bodyfat percentage on cardiovascular health are undeniable and there is simply no truth to the concept of "fat but fit." It's better to think of obesity as a progressive degenerative disorder, in that it takes a toll over time and its effects are more dramatic the longer a person is affected and the older they get.
While hopefully these therapies will help people, ultimately it's basically a problem of slapping a bandage over the actual problem: highly processed diets with little nutritional value and sedentary lifestyles made more or less mandatory by industrial capital.
I have some nitpicks, firstly vegetable based protein is extremely cheap in most places I've seen. I think when you say protein you really mean animal products?
Re obesity and health it's more complicated. At extremes being fat is inarguably detrimental, but a lot of medical focus is myopic and population trends cannot necessarily be directly applied to individuals. Like personally I'm thin, have been my whole life, I'm also active and almost every joint in my body is shot because I'm hypermobile and weak. Meanwhile my wife is a bit chubby and has been her whole life, she's inactive but strong. Her skeleton is in much better condition. Bloodswise we're ok but my liver is slightly damaged from alcoholism. If you looked at us you'd probably say that I look healthier, but that's because fatness of overemphasised. She is definitely much healthier and will likely outlive me and enjoy much greater quality of life.
She might be even healthier if she lost some weight, maybe she would develop an ED and be way worse off. She'd probably be much healthier if she started each day with 5 km run but no doctor ever asks her about that, or me whether I've considered started running or weight training at a regular health check. Many doctors talk to her about weight loss. This bias, and focus on something visually apparent is not really justified.
To be honest, the average layperson's understanding of biology unfortunately becomes entirely useless and often counterproductive to having a useful understanding of pharmacology. You start talking about agonists and inhibitors and half the time common sense becomes actively detrimental to understanding and the peak of scientific knowledge is "we have no idea why or how this shit works, only that it does. Check back in with us in 10-30 years and maybe we'll know like 20% more of an answer."
You find a binding site that does some shit and you slap an inhibitor on that bad boy and suddenly all your lab rats are jacked. Then like 15 years later someone else accidentally finds a single antibody doing some weird shit and you start cloning it, and hey what the fuck jacked rats again? What if we make this into a muscular dystrophy gene therapy drug?
Then like another 10 years later somebody connects a couple dots between that old abandoned muscular dystrophy gene therapy drug and a weight loss drug and here we go!
These drugs modify the hormonal signals associated with hunger, side effects can include gastrointestinal upset including nausea but they don't work by making you nauseous no.
There's a lot of fucking terrible social stigma around fatness and losing weight through "improper" methods. Frankly I think people should fuck right off of telling other people what they should or should not do with their bodies.
These drugs appear to be relatively well tolerated, better than other effective weight loss drugs. Side effects appear manageable but that is in the context of other weight loss drugs that work being stuff like meth so... you know. Some people have great experiences, some don't. For people it works for they typically just describe not being hungry.
You should know that so far basically nobody knows how to reliably lose weight and keep it off at a population level. Evidence is emerging that these drugs may be no different. What I mean is that whatever causes someone to feel like the amount they eat is the right amount seems to be frustratingly persistent, and after interventions people often drift back towards wherever they were at prior. That said, each person is individual and what works for you might not work for others. Also if you'd feel better about yourself if you lost some weight and slowly regained it over the years then that's meaningful positive impact for you.
You should talk to a doctor, and discuss options. It's possible a combined approach or some other intervention would be more appropriate, you also need to know the state of your body before deciding if any particular thing would be safe and effective. Like are your organs healthy and whatever. If you want a bit of a dive into the meds from a critical but non judgemental angle: https://podcasts.apple.com/au/podcast/ozempic/id1535408667?i=1000630805156 is pretty thorough and goes over the good, the bad, and the bullshit.
You should know that so far basically nobody knows how to reliably lose weight and keep it off at a population level.
At a population level? Affordable healthy food, promoting an active lifestyle, and reduced stress...this stuff isn't a mystery. Weight gain in the average person isn't due to 'overeating' (ED or otherwise) it is due to sedentary lifestyle and the easy accessibility of nutrient poor, calorie dense, cheap food.
Some individuals find success with long term weight loss but there is no known approach that can be applied to a population that yields reliable results.
We can imagine many things that theoretically work but either compliance is low at the study recruit level (they don't work) or they are no practical in our current sociopolitical climate (they don't work).
The reality is we don't know what to do, we have ideas but we can't do experimental societal transformations to do the studies.
To my knowledge there is no good scientific evidence of what you propose, if you have it then by all means please share it.
To my knowledge there is no good scientific evidence of what you propose, if you have it then by all means please share it.
Calorie deficit. Burn more calories by avoiding sedentary lifestyles and reduce excess calorie intake (soda, high fat foods, calorie dense meals)
Honestly, you should try to speak with a weight management doctor. There are a lot of mental aspects to weight and weight loss that won't be handled by a medication.
It's also a good idea to try other (cheaper/safer) prescriptions before going to the expensive ones with potentially worse side effects. You might find the help you need without having to pay the exorbitant prices. For example, I lost about 20% of my body weight with phentermine and therapy for my ED and have not experienced any rebounds or relapses.
The focus should be on substantive and beneficial diet and lifestyle changes. You want to make slow progress every day by changing what you do and eat, rather than treating a medication like a magic bullet that will fix the problem. Treat appetite-suppressing meds are best used to manage the hunger/pain symptoms once you start making lifestyle changes, rather than as something that will create those lifestyle changes.
Imagine a ~~burger~~ a slice of Marvel slop. I wish I had something else in my canon that was more apt, but this fits so snugly in my mind. In the Tom Holland Spider-Man movies Tom bends the rules and fucks up. Iron Man comes over to him to take his suit. Tom goes "I'm nothing without the suit" and Iron Man goes "If you're nothing without the suit you shouldn't have it.[1]"
~~In this essay I will explain why~~ that's how I feel about Semaglutide drugs. The fundamentals of nutrition still matter. In fact, they matter more. If you endeavor to lose weight, you'll find that there's a few struggles you find. You need to get enough protein, you can't just stop eating without playing god with your metabolism, and you're going to be hungry. The thing is two of the three, usually, are knowledge checks. If you know what to do, you win, if not, you're in for a bad time. You can calculate protein requirements, you can know high protein foods, and you can plan what you're going to eat to hit the requirements. You can estimate your calorie requirements and, in my experience, that estimation is within 150 calories of a measured requirement. The big, bad time you're going to have is being hungry. The struggle when you know intellectually you're at your calorie limit but could totally smash another burrito and have to stop yourself with a willpower saving throw. That's where semaglutides shine in my mental model.
What if you just stopped rolling willpower saving throws? What if the only struggle was knowledge checks+side effects? It sounds too good to be true. I call it a superpower; that's probably why I reach for a superhero metaphor. Iron Man isn't saying that there shouldn't be a Spider-Man, on the contrary, he believed in Spider-Man and wanted his success in beating bad guys. So without the requisite int/wisdom (int for weight loss, wisdom for being a superhero) bad shit happens. You'll fuck with your metabolism if you don't get enough calories for too long. You'll fuck with your muscle tissue/tendons/potentially even worse if you have a couple shots of vodka and never think about your hunger. This is all in conjunction with the idea that if you stop taking semaglutide, without the knowledge, you'll have learned nothing but had a transient, difficult, expensive experience with weight loss if you don't learn anything.
If you make sure you understand your TDEE, your protein requirements, how to read nutrition labels, what to eat when you're hungry and tired, how to meal prep, and how to weight food, you'll move mountains with your super powers. If you don't, you give yourself more danger and suffering while learning nothing. I would recommend you lose 25-35lbs through conventional means before you pursue it. Learn what the hunger feels like and be amazed by how semaglutide suppresses it.
I found a YouTube link in your comment. Here are links to the same video on alternative frontends that protect your privacy:
I have not used it but I have purchased Tirzepatide with plans to start in a couple weeks (quit nicotine over a year ago and gained 20 pounds).
I found a Chinese seller that produces the peptides in their own labs without a huge markup (10 month supply was ~$250, could have been cheaper but I was a fool and ordered way more per vial than I had to, I'll be throwing away 3/4 of every vial since they're only safe to inject for 28 days after reconstitution).
I found them from a website that tests the purity from samples they purchase and provides the results to the public (Don't know if I'm allowed to link it here).
It got sent in its powdered form and I had to locate BAC water myself which is what caused the holdup of why I haven't taken it yet.
I can let you know how it goes once I start?
Reconstituting "research" peptides like 
Please filter your peptides, only use bacteriostatic water, and use new individually wrapped sterile items every single time. Don't fuck around with this stuff tbh.
Try and see if you can do this sublingually instead of via injection. It's so much safer.
Nausea and diarrhea are the most common side effects. GLP-1s are a part of a broader class of medications called incretin mimetics, which basically trick your body into thinking it has eaten recently. The nausea and diarrhea are due to this but there’s actually no food to digest.
They are amazing drugs to lose weight and improve overall health, but can be incredibly expensive even with insurance. You may need to wait up to a week after receiving the prescription for a prior authorization from your insurance. Get a manufacturer coupon if you have private insurance or ask your pharmacy to get one for you.
If you do start one, be sure you start at the very lowest dose and stay at that dose for at least a month. If you don’t start low the side effects can be crippling.
Definitely talk to your doctor, you will almost certainly need blood work to confirm that you take it.
I've used ozempic for a short time in the past and it worked wonders for me, and I know several other people who have had similar experiences. I didn't need to lose a huge amount of weight, but my weight gain was spiraling out of control due to depression and the lowest possible dose very quickly allowed me to reverse course.
I did not have a "rebound" weight gain after stopping like some people experience. I never experienced true nausea, just occasionally felt a little "icky" if that makes any sense. My snack cravings all but disappeared while I was taking it and I feel like there has not been any "rebound" issues after stopping, but again, I was on a very low dose.
At risk of a fatphobia struggle session, there are legitimate lifestyle and health reasons that one might want to lose weight. It's a crime that these drugs are being price gouged.
I've read that maintaining weight loss after stopping the drugs can be a challenge, but it does let you skip over the part where you feel hungry the entire time you're losing weight.
The bottom line for me is that these drugs are a rare weapon against the weaponized junk food we are inundated with every time we go to the grocery store.
It works by causing gastroparesis:https://my.clevelandclinic.org/health/diseases/15522-gastroparesis so I would recommend speaking with your healthcare provider and making a well-informed decision.
That is not how they work, and is in fact a rather rare side effect. At the bottom:
Thanks for the correction.