tell me about Ozempic

January 5, 2023 12:55 PM

I was on Jardiance, now I'm not. I have an appointment with my endocrinologist next week to discuss other options, and Ozempic is on the table. I am reading scary things online and would love to hear first hand accounts from any people taking it, or opinions from medical professionals. Details inside.

Here's the deal:

I have PCOS that presents with insulin resistance, diagnosed 21 years ago. Was put on Metformin, never got over the GI side effects. Switched to Metformin extended release, didn't change my GI symptoms. After two decades of stomach distress I begged my endocrinologist to take me off of it at our last appointment.

At that appointment my most recent labs showed that my A1C was at 6.1 which technically tipped me into Type 2 Diabetes. On one level, no surprise as it runs on both sides of my family. On another level, I hate myself for not being able to shake my pandemic weight gain. But that's a different story.

Endocrinologist put me on Jardiance after a long battle with my insurance company. She was considering Ozempic or something similar (Wegovy I think?) but wanted to try something that was a pill rather than an injection first.

Jardiance was great! Except I started getting chronic yeast infections. Horrible ones. It's a potential side effect and I got nailed. Endocrinologist pulled me off of Jardiance and put me back on Metformin ER temporarily until our next appointment. I am now back in GI hell. My body simply cannot tolerate Metformin.

Next week is the appointment and I think she'll end up putting me on Ozempic and will fight my insurance company if they refuse to cover it - she has more than enough evidence that my body can't handle Metformin or Jardiance.

Question 1: how bad are the shots? I've been doing thrice weekly blood draws since the Type 2 diagnosis but that's just a finger stick.

Question 2: I have bipolar 2, insomnia, and anxiety disorder and am medicated for that. I take Lamictal and Seroquel for the bipolar 2 and Klonopin nightly for the insomnia (plus as needed for anxiety attacks - very rare at this point). I do have a history of suicidal ideation but have not been suicidal in many years. Is Ozempic risky for someone with my mental health diagnoses? I will obviously discuss with the doc but like to be pre-informed.

Question 3: If you take it or have prescribed it to patients, does it work? What kind of side effects have you seen and how common are they? I did Google for this info but found a bunch of extremely alarmist info from questionable sources so I'd rather get info from actual human people I know/the hive mind.

Question 4: Does it help with weight loss?

Thanks in advance.

posted by nayantara to Health & Fitness (13 answers total)

Best answer: I’ve been taking it for about two months, at a dosage less than many people take, so YMMV but:

The shots feel like nothing. The needle is *so* thin. I was nervous about this and didn’t need to be.

I can only speak to the anxiety part of this; I have not noticed any side effects or issues related to worsened anxiety.

Yeah. The side effects sound very scary and I don’t know of any way to know who will have them. For me, they have been much more minimal than I expected/feared. I have had two bad gastrointestinal days, one each right after increasing doses, and honestly they weren’t terrible. I have occasional bad stomach days anyway so honestly it may not even have been related, though the timing was suspicious enough that I think it was. Other than that there have been no noticeable side effects other than significantly decreased appetite. There’s a thread on the blue somewhere from earlier this year that I found really helpful about this med, and in it people discussed feeling like their satiety responses were actually working right for the first time ever. That’s what it’s been like for me - I feel full now in ways I haven’t before, after sensible portions of food, and it’s honestly a bit miraculous.

I’m not tracking my weight very closely but yes. I have had slow, steady weight loss in the range of what people recommend for sustainable, healthy weight loss during these weeks. Not at the first dosage - my doctor wanted to ramp me up slowly in case I did have negative side effects, so I started at the lowest dosage - but after that.

There are shortages of the medication and it can be hard to fill a script, so that’s something to be aware of - my initial script took a couple of weeks to fill because of that.
posted by Stacey at 1:25 PM on January 5, 2023 [1 favorite]

Best answer: I know a few people taking Ozempic or similar injectables. If you don't have a particular needlephobia, it's entirely tolerable. It's a subcutaneous injection (goes into fat under skin), so different from most random blood draws or injections you're likely to have had.

My friend has had some significant GI issues but considers the tradeoff worth it. She's lost ~15-20(?) lbs on it.

I'm sure you already know this, but just to hear it from a random third party: your weight is not a moral issue, nor does it reflect on your worthiness for health care or your willpower.

I thought 7.0 A1C was the cutoff for type 2 diabetes?
posted by praemunire at 1:26 PM on January 5, 2023

Someone close to me with Type 2 diabetes took it for several months, and it was helpful for the diabetes. Unfortunately they had the reported side effect of severe diarrhea and vomiting, and when they discontinued the Ozempic it got better.
posted by matildaben at 1:40 PM on January 5, 2023

Best answer: I can only answer a very limited aspect of this question, but: I tried Ozempic and was ultimately unable to continue because of an insurance denial. After that, we tried metformin. I was really struggling with the gastro side effects of Ozempic, and have been totally fine on metformin. I was quite relieved when my insurance took Ozempic off the table as an option, so that I didn't have to make the decision of whether to continue and hope the side effects might resolve over time for me (as they seem to for many others).

Maybe the reverse will be true for you! So, I might recommend keeping an open mind. They are different mechanisms of action and you might have the good fortune of not having the same issue.

The shot was also very, very easy - as Stacey said above, the needle is very tiny and doesn't feel like much at all. It's also a simple mechanism that even I couldn't mess up. My doc demonstrated for me in the office and it seemed easy, but obviously that was without an actual needle and I was pleasantly surprised that it was no more difficult in the real scenario.
posted by neutralhydrogen at 1:50 PM on January 5, 2023

I came off of it because of side effects. Mostly the egg burps. Horrendously terrible burps that did not stop for hours and hours, and drove people out of the room. Thankfully I worked at home for most of it. There was no way I could have worked in an office with that. And I never got to the full dose. I tried for about 8 months and finally said no more. I'm now on Rybelsus which is the tablet form of Ozempic.

God love my family for putting up with the burps. Other side effects- nausea, and vomiting.

I did lose weight because I couldn't eat at all. As in, I'd eat a sandwich with a cup of tea. And I'd be full for hours. I'd have a banana for breakfast, and wouldn't be able to eat again until late in the evening. And I'd only manage a piece of toast. Essentially, I went down to eating one meal a day. So while the weight came off, it was not in a healthy way. Endocrinologist thought it was fine to just eat once a day. And that is complete and utter bullshit.

Rybelsus doesn't seem to have that same full effect. I can eat, I'm not nauseated, and the burps are 99.5% gone.
I haven't lost weight, nor have I gained what I had lost.
posted by Ftsqg at 1:59 PM on January 5, 2023

Best answer: I have been taking Ozempic for 3 weeks. I haven't had any terrible side effects yet - no weird burping. I have had a vastly decreased appetite and some nausea. The low appetite is frustrating - I often cook dinner and then can't bring myself to eat a bite - but I have lost 10 pounds in the past 3 weeks. I assume that will even out some over time. The needle is super tiny - I can't feel it at all - and the injection process is very easy.

I was diagnosed with Type 2 back in the fall - my A1c was 8.8 and fasting glucose was 320. They started me on 1000 mg metformin and my sugars came down some but not a lot. I wear a continuous glucose monitor and even with the metformin eating anything would send my sugar over 250 and fasting was always over 180. With Ozempic my fasting sugars are down around 100 and after meals around 150. As far as I'm concerned it's a miracle and I hope it works this well forever.
posted by Daily Alice at 2:16 PM on January 5, 2023 [2 favorites]

Best answer: I am a long-term diabetic who is currently on Ozempic, also on Metformin and Levemir. Prior to Ozempic being prescribed to me about six or seven months ago, I was on Victoza.

The needle is ridiculously small compared to the 8mm ones I have for the Levemir. Honestly, it's tiny and I can barely feel it.

With the Ozempic, I do feel full quickly, sometimes bloated, but it was the Victoza I found gave me the horrid belches others have mentioned, and then only during the first few weeks, and sometimes when the dosage was increased. Ozempic hasn't been nearly as bad. In that regard, I haven't noticed any other significant side effects related to my GI tract.

I lost quite a lot of weight on Victoza, not so much on Ozempic yet. It is damping down my appetite, so maybe the loss will continue at a slower rate.

Blood sugars have been great, so much so that my diabetic specialist nurse has lowered my dose of long-acting insulin (the Levemir) and I am no longer taking the short-acting Humalog I was also on previously.

I am on citalopram for anxiety. One thing I have noticed is that I started feeling quite depressed a month or so before Xmas, so maybe about six months after I started Ozempic. I am going to ask my nurse about it when I see her, in case there is a proven link, so am glad to see you intend to ask your doc about it too. I would say though that we went through a hugely stressful time during most of 2022, which reached something of a peak just before I noticed the increased poor mood, so it's as likely to be a stress reaction as anything to do with the Ozempic I think.

I'm very happy to stick with it, as Ozempic (and Victoza) has really helped improve my blood sugars for what were really minimal and transient side effects.
posted by Martha My Dear Prudence at 4:57 PM on January 5, 2023

Best answer: I have PCOS and started the oral form of semaglutide (Rybelsus) in September and a household member is T2D and takes Ozempic since the summer. Both our side effects have been mild. I get heartburn sometimes, because you have to take the pills on an empty stomach with a very small amount of water. Stomach was upset the first week but now it’s fine. I mention Rybelsus because my insurance will cover that with no prior authorization, while they don’t cover Ozempic.

I found the r/semaglutide subreddit really reassuring when it came to understanding the potential side effects; there are a lot of personal stories there that run the gamut from worst to best case scenario.

2) I don’t find semaglutide affects my mental health (have anxiety disorder and PMDD) but it does slow gastric emptying, so it can affect the way medications work. My understanding is this is especially true for extended release medications. I’m not on any other routine meds so can’t give personal experience though.

3) Ozempic is working for household member’s T2D. My A1C was within normal limits when I started, and it’s too soon to see if it’s lowered since starting, but my appetite is regulated for the first time in my adult life. Pre-semaglutide I would either be starving or completely uninterested in food, no normal appetite at all. I no longer end up in starve-binge cycles so to me that’s “working.”

4)I’ve lost weight at about 2 pounds/week and that seems to be common with the oral form. Not the dramatic stuff you hear about Ozempic (and my Ozempic person lost more faster. In my case weight gain had been constant and gradual since puberty, regardless of my activity level or calorie consumption, so this is a major change that again makes me feel it’s working on my metabolic problems.
posted by assenav at 5:03 PM on January 5, 2023 [1 favorite]

Best answer: 1/ The needle is tiny….no, even smaller than that. If anything it feels like the tiniest scratch if I get the angle wrong but often I feel nothing at all. If you‘ve had the covid vaccine - that sort of diameter of needle, nothing like what is used for drawing blood.

2/ Can’t speak to 2 beyond saying it had no effect on my mental health.

3/ I am on it entirely for weight loss and it works great for that. I had mild side effects initially but at this point I sometimes have effects consistent with what it is supposed to do. One of the things it does is that it slows passage of food in your digestive tract so as a start you are feeling full for longer. If I eat a bit too much I am going to feel uncomfortably stuffed for much longer and I may burp (not in an eggy, offensive way). I‘ve not had a recurrence of initial effects as the dose increased.

4/I am on it for weight loss and have lost just under 60 pounds.
posted by koahiatamadl at 5:38 PM on January 5, 2023

Best answer: From an anonymous user:

I'm not ready to have this linked to my profile, but I am on wegovy/ozempic and have been for the past year. This is for weight maintenance and to prevent diabetes, which runs in my family.

1 - The shots aren't bad. I had my partner give them to me when starting out, but now I can do them myself. Ozempic has a reusable pen, so you add a needle and see that go in; I can't watch it that part. Wegovy has the needle hidden; I can do this autonomously. Ozempic is nice in that you can dial in a dosage you need; wegovy has pre-determined doses. The needle is tiny, the shots don't hurt. As you get up in dosage, it can seem like a lot of medication going in, but it's not usually painful at all. If you experiment with different injection sites, you can find an "easier" spot. For me this is the back of my arm if someone else is doing the injections, or the outside of my thigh if I'm doing them. Note that 10 years ago I had mega needle phobia. If I can do it, it's really not bad.

2 - I cannot speak to this.

3 - Side effects: I get a day or so of some nausea. I take zofran to help with this; usually one zofran is enough. Weeks where I go up in dosage are harder. It was easier when I increased dosages very, very slowly - much more slowly than wegovy thinks I should. Hence I was on ozempic for a while because then I could increase in small quantities. I have noticed that migraines/stomach flu can be worse. I've also gotten diarrhea and been unable to eat completely when under massive stress, like unexpectedly losing two pets in the past year. That has not happened before. Overall, the side effects are tolerable, and I'm willing to tolerate them weekly because I am trying very hard to avoid diabetes and the ensuing complications.

4 - I'm taking this for weight management and diabetes prevention. It makes it much easier to do so - as in, my brain isn't constantly thinking about food, I can stop when I'm satisfied, and the amount needed to satisfy me is far less than it used to be. Weight Watchers always said "stop when you're satisfied" but I couldn't do that until this past year. This is an endocrine problem, not a moral or willpower problem, but the wegovy makes it manageable. It probably makes me much easier to live with because I'm not sad about my weight all the time and how hard it can be to lose it/keep it off.

Every couple months I do have to get labs done, but you're probably doing that anyway.

That said, it is expensive. I have a high deductible insurance plan, and the first few months of the year, I pay full price. It is worth it to me. It can be hard to get prescriptions filled. It sometimes makes me sad to think that I'm going to have to be on this drug, yet another prescription, for a long time, if not forever. But then I realize that I'm doing the things I need to do to stay healthy. My doctors have decided this is one of the things I need to do to stay healthy, and that's ok.

I hope this helps.

posted by travelingthyme at 5:48 PM on January 5, 2023

Best answer: My husband has bipolar among other things, and has not noticed Ozempic making a difference in his mood. He did have really severe gastric issues, which when I described them to our mutual doctor caused her to marvel that he didn’t give up - meanwhile he never bothered to mention it to her. They were wild bouts of diarrhea alternating with severe constipation, the “fart burps,” etc. He has lost weight and better still, his A1c is great. However it definitely can be difficult to get - sometimes the pharmacy is out for weeks.
posted by PussKillian at 7:55 PM on January 5, 2023

i took ozempic for 6 weeks. 6.5 days of the week i was horribly untenably nauseous. then as soon as i started feeling better it was time for another dose. on the ozempic i lost 1lb per week. off the ozempic i had been losing (average) .5 pounds a week for over a year. it just wasn't worth it to me. i was so miserable.
posted by misanthropicsarah at 9:15 AM on January 6, 2023

Can agree with much of what has been said here already, but several things to add:
- My physician prescribed an anti-nausea med at the same time as my first script. I didn't need it, but it helped to know I had it.
- YMMV, but the weight loss I've experienced from Ozempic stopped abruptly at a weight where weight loss has stopped for me before.
- I'm T2D, and I've dealt with shortages so many times in the last six months that it's negatively affected my A1c and, well, my attitude.
posted by gnomeloaf at 2:58 PM on January 6, 2023