My Experience with Semaglutide for Weight Loss
I am quite familiar with weight fluctuations, especially due to having polycystic ovary syndrome (PCOS), a condition that makes maintaining a stable weight extremely challenging. After gaining nearly 20 pounds in two years and being only 5’2”, I felt completely out of control. Despite exercising about three or four times a week for the past year, my body wasn't changing as I desired. My pants were still snug, and persistent bloating was the norm. So, when I heard about Ozempic, a type II diabetes medication being used off-label for weight loss, my interest was piqued – and after learning more, I obtained a prescription for semaglutide.
What Is Semaglutide?
More commonly known by the brand names Ozempic and Wegovy, semaglutide is a weekly injectable medication that operates in two ways to enhance satiety. It strengthens the communication between your brain and stomach, making you feel full sooner, and slows down your gastric emptying rate, keeping you feeling full for longer.
The question of who should be prescribed semaglutide has been a hot topic of debate recently, largely because of the current shortage of Ozempic, which makes it difficult for providers to fulfill prescriptions for their patients. This has led to some dissatisfaction, especially online. Houston-based registered dietitian nutritionist and content creator Dana Omari, also known as @igfamousbydana, who has been documenting her experience with the medication for several months, has been attempting to clear up this misunderstanding with her followers. "I keep hearing that we're taking away medications from those who truly need it, like people with diabetes," she says, noting that the manufacturer of Ozempic, Novo Nordisk, released a statement indicating that the shortage is due to patients receiving off-label prescriptions for weight loss.
According to the doctors we've interviewed on this subject as well as the medical representative sources Omari has spoken to, there have been supply chain issues and a problem with the Ozempic auto-inject pen, meaning that weight-loss patients aren't solely to blame. There's nothing inherently incorrect about prescribing medications off-label (for instance, Botox isn't indicated for lip flips), and Wegovy, the exact same semaglutide drug manufactured by Novo Nordisk, is specifically FDA-approved for weight loss.
But let's get back to the main point. Like Omari, I didn't pursue a brand-name prescription but opted for compounded semaglutide. This form of the medication involves the active molecule being mixed into a base formula (mine contains B12) by a compounding pharmacist. "I administer semaglutide very differently from what the manufacturer of Ozempic/Wegovy recommends," explains my provider, Dr. Jessie Cheung, a board-certified dermatologist in Chicago specializing in aesthetics, regenerative medicine, and hormone replacement therapy. Unlike many diets that have 6-week plans, semaglutide doses typically increase every four weeks, usually starting with.25 mg. "But we actually get our patients to a higher dose of semaglutide faster by increasing the dose each week instead of waiting four weeks between dose increments, as with Wegovy, and we increase the dose in smaller increments to avoid the common side effects of gastrointestinal discomfort."
Although using an auto-inject pen might be more convenient, injecting myself with a needle (superfine, like those used for insulin) has been easier than I anticipated – it's neither nauseating nor painful. I usually inject myself in the lower stomach because I have more fat there to pinch and inject. The drug needs to be refrigerated; on the advice of a friend who takes an injectable drug, I take it out of the fridge a few hours before injecting to avoid discomfort from the cold.
My Ozempic Results After 3 Months
13 weeks have passed since I started my semaglutide journey, and although it hasn't been completely smooth – I'm constantly extremely tired – I have no regrets. I've lost 13 pounds and three inches from my waistline, and I've gained a sense of body confidence that I haven't had before, even at my lowest weight. I also view food differently and continue to learn how different meals (and different meal sizes) affect my body. For example, I used to feel guilty when not finishing a plate of food (was anyone else indoctrinated with the "clean plate club" mentality?), and then feel ashamed if I overate, especially when dining out with no control over portion sizes. Now, I often start a meal by cutting the portion in half, knowing I'll be full by the time I finish, and that I can enjoy the rest later. I'm still understanding my limits; I recently went for breakfast and ordered two eggs, only to quickly realize that one would have been sufficient, which still surprises me. It's worth noting that as of my 13th injection, I'm taking a new form of compounded semaglutide. Instead of being combined with B-12, which is said to support a healthy metabolism, the semaglutide is mixed with carnitine, an amino acid that helps your body burn fat to produce energy before relying on carbohydrates. Clinical studies show that carnitine can aid in improving weight loss in obese patients. I'm eager to see how this change affects my overall progress; I still have a way to go.
When I began injecting myself, I set a realistic and reasonable goal weight for myself, rather than the overly ambitious ones I'd come up with in the past. I recently met with a personal trainer, who performed a body composition scan that provided me with information including where most of my fat is (my torso) and a suggested target weight – which I was pleased to see was perfectly in line with my own goals. I'm another 13 pounds away from that number. Moving forward, I plan to increase my water intake, as I know it's crucial for weight loss, and further reduce the size of my meals but eat more frequently, which should help me obtain the nutrients I need without feeling overly full.
It's the change in my waistline measurement that truly convinced me that my semaglutide treatments were effective – although I'm not certain, as I didn't have a body scan before treatment, I suspect I've lost some visceral fat, the fat that surrounds the organs within the body's trunk, rather than the pinchable subcutaneous fat I inject. "Apple-shaped" people like me tend to have more of it.
Visceral fat is dangerous. "It's highly inflammatory – bad for many disease processes," says Dr. Cheung. "I'm happy if [a patient] loses any visceral fat because it leads to other problems." Excessive amounts of it are associated with diseases like diabetes and stroke. It's also linked to higher cortisol production levels (the fight-or-flight hormone). Cortisol levels are significantly higher in women with PCOS, as are diagnoses of diabetes.
Overall, I'm satisfied with my semaglutide experience so far and am excited to continue this journey.
What I've Learned from Using Semaglutide
Ozempic is currently very popular, which is not only why I chose to try it but also why I decided to write about my experience. Of course, no medication is suitable for everyone, but there aren't many personal accounts of taking semaglutide available online, and I wish I'd had more when I started. (And for what it's worth, much of the online feedback is extreme; semaglutide is either described as magical or toxic.) If you're considering trying semaglutide, here are a few things I've learned so far.
1. Some Ozempic Side Effects Are Dangerous; Some Are Just Uncomfortable
I'm fortunate in that I haven't experienced the more terrifying side effects of the medication, such as pancreatitis (so be sure to conduct thorough research and work with your provider to determine if it's suitable for you), but that doesn't mean I haven't noticed some unpleasant effects. Most people mention nausea, but for me, the most noticeable side effect at higher doses has been extreme exhaustion. In the first few days after the injection, I struggle greatly to get out of bed in the morning, hitting the snooze button for at least an hour after my usual wake-up time. However, this doesn't translate to restful sleep or even going to bed earlier. I go to bed at approximately the same time each evening but toss and turn all night.
Other effects of the medication that I encounter are difficulty concentrating – an issue I already had and undoubtedly exacerbated by lack of sleep – as well as burping (fun). Burping is not uncommon for those on this medication as it's related to the slowed gastric emptying.
But it's also an effect of being overweight – the extra pounds put more pressure on the stomach, which can in turn force air up and out.
The latter – as well as acid reflux (which I've already dealt with on and off for years) – are worsened by eating poorly or too late at night. Generally, I don't eat unhealthy foods; I just eat too much. But after one late night with friends eating spicy Thai-inspired sushi and, admittedly, a lot of sake, I suffered greatly. I was up all night with severe heartburn and only managed to get some restful sleep after propping myself up on a particularly steep wedge pillow.
That painful reflux from one meal persisted for more than two days, despite the fact that I was popping antacids like candy. I'd been informed this could happen: "Eating highly fatty and spicy foods – that's not the way to success," Dr. Steven Batash, a board-certified gastroenterologist in Rego Park, New York, had told me. "If you overeat, you're going to be a miserable person for at least three or four days because the food is just going to sit in your stomach and it's not going to let you live." Lesson learned.
2. It's an Excellent Appetite Suppressant and Truly Helps with Portion Control
By nature, I have a tendency to snack. I'm also someone who constantly thinks about food – the person who knows what she'll order several days before going on a dinner date, the one who has to "optimize" every meal experience – often to the point that when I start thinking about food, I can't stop until I eat, whether I'm hungry or not.
To say that I'm completely amazed by semaglutide's ability to suppress my cravings or the desire to overeat is an understatement. Even in the first week, at the lowest dose, I found myself forgetting to eat a meal on days when I was running errands. More notably, I would open the fridge and stand in front of it, staring blankly and waiting for snack inspiration to strike, only to end up closing the door and walking away. Choosing a meal has also become less difficult; when cooking dinner for my partner and myself, I go with what makes sense based on available supplies and the season without having to adjust for a daily craving.
At mealtime, I become full from smaller amounts of food than I thought possible. An English muffin with half an avocado is often too much in one sitting. I've replaced some meals with things like Carnation Instant Breakfast powder mixes, which are filling and can help me incorporate vitamins, minerals, and nutrients into my body without the discomfort I usually get from a kale smoothie (bloat city). And aside from reconsidering meals at restaurants to prevent acid reflux, I've discovered that dining out has been helpful for gauging fullness – the pacing of the courses makes me recognize how much "space" I have left, and the often smaller plates allow me to eat without overdoing it.
3. Ozempic Isn't a Miracle Cure
Yes, semaglutide's effects can seem miraculous, but it alone won't necessarily correct the existing patterns you have with food. For people like Omari, who has never had a problem maintaining a stable weight until the pandemic and moving to a city with great food – and has a foundation in healthy living – semaglutide can be fantastic. "This was truly the first time in my life that I've been overweight," she says. "It's all been very new to me in the past couple of years, gaining weight and attempting to lose it." As of the time of writing, she has lost nearly 30 pounds; once she stops the medication, she's prepared to maintain healthy habits.
For someone like me, though, who not only struggles to lose weight due to medical issues but also has a complex relationship with food because of that, it's best to combine semaglutide with a fitness routine (I have one) and nutritional counseling (not there yet). "It's crucial to be under the guidance of a nutritional counselor who holds your hand and shows you how to take small steps," says Dr. Batash. "Nutritional counseling is a vital part of the success of any of these weight-loss procedures."
Interestingly enough, semaglutide has removed a lot of the emotion and impulsiveness from my eating and has allowed me to observe my own patterns objectively, which has been powerful. One of my typical habits is snacking at night, even when I'm not hungry. While on semaglutide, I've noticed that I still have the mental urge to snack but am clearly not physically hungry – this medication has made it easier to confront the reason.
"We eat for reasons other than hunger," says registered dietitian nutritionist and intuitive eating advocate Elena Toumaras, MS, RDN, CDN, from Queens, New York. "We eat to celebrate, when we're stressed, due to peer pressure, and from boredom – with intuitive eating, we don't label those other reasons as right or wrong but recognize them in the moment." By coming to terms with why you're eating, it becomes easier to figure out how it makes you feel physically – or if you actually want to eat in the first place.
With the help of semaglutide, I've realized that the restless feeling I get at night that I want to soothe with a snack is boredom. "It's important to analyze what's happening internally as to why we go for that snack," says Toumaras. "You can do a hunger check, and if you're not hungry and just bored, you can ask yourself, 'Can I read a book, take a walk, watch a TV show and maybe have a little snack?' – finding some sort of middle ground between the behaviors."
This brings me to another point: after years of disordered eating, I have no idea when I'm hungry or thirsty. According to Toumaras, this is not at all uncommon and can take years to learn. "So many of us actually have no clue how we feel in our bodies," says Toumaras. "A good way to do it is to ask yourself how your body feels in the moment when you're really hungry, at a 1 of starving, and then, if you've eaten too much, what a 10 feels like. With time, you'll be able to start sensing where the middle ground is. Unfortunately, it's not going to happen immediately because of how out of touch with our bodies many of us already are." She told me that she is still learning these sensations herself. "With years of diet culture, many of us have been told to drink water or coffee when you're hungry or [alternatively] to always finish your plate – all of these things have disrupted our internal cues." Thanks to the delayed gastric emptying and the accelerated feeling of fullness, I've been able to better sense these cues, although I still have a way to go.
Slow and steady wins the weight loss race – celebrity claims of losing 16 pounds in three weeks are not healthy, sustainable, or likely accurate, considering much of it could be water weight – so I'm being patient with my one-pound-per-week progress and using the support of semaglutide to better understand my habits and learn which foods give my body energy or make it feel drained. Although the experiment isn't cheap, with a month's dose costing several hundred dollars, it seems worthwhile to me – I have next month's syringes waiting in the fridge.
Ozempic Before and After Results
