We unfortunately usually dont get to hear many chiming in to say that they tolerated it just fine. I do (2mg/week), down 45lbs.
Being heavy is really bad for you. Don't be so quick to write it off d/t the possibility of vomiting.
I get stomach upset and a bit of reflux when I overeat, but that makes total sense given the goal of the medicine.
Honestly the metformin I was prescribed at the same time as semaglutide makes me feel worse more consistently, and even that is tolerable.
I say go for it OOP. It shouldn't cause any permanent damage trying it out.
I suspect that the couple of cases of severe vomiting I had, may relate to either eating too much, or eating at the wrong time, or both. So I think that if I'm more careful in the future, I can avoid those occurrences.
Overeating is definitely bad, since Ozempic - as I heard it described - "slows down the movement of food through your digestive system, which leads to a feeling of fullness". That effect apparently being part of how/why Ozempic leads to weight loss. But that also suggests that you have to be really careful about not eating too much or you might overload your system in a way that exacerbates the side effects. My subject feeling is also that timing is an issue: I think that eating late makes it more likely that the bad side effects will occur. I'm trying to shift to making lunch my largest meal of the day, and then eating a very light dinner, and preferably earlier than in past years. Time will tell if this theory is right or not, but it's where I'm leaning at the moment.
At some point I start noticing an intense "bloat" / gas feeling - with lots of burping and farting - as well as possibly some nausea and diarrhea. This will last for a few hours. Maybe 3 or 4? I wasn't keeping notes unfortunately. Then, at some point I'll just have a sudden urge to vomit (it comes on fast) where I'm lucky to make it to the bathroom to expel everything into the toilet. The actual vomiting last 2-3 minutes, after which I go back to feeling relatively normal, other than slightly drained feeling, and that slightly acid-scarred feeling in my throat.
The worst part, in many ways, is cleaning up afterwards. Even though I've made it to the bathroom both times this has happened, the stream of vomit is so intense that I can't necessarily keep it all in the toilet. When I said "power vomiting" that was no joke. So inevitably some winds up on the floor, the wall beside the toilet, my clothes (if I'm wearing any), etc. Getting the bathroom clean and back to smelling normal is... not fun.
That said, even on days when there's no outright vomiting, I do experience moderately frequent nausea, which is rather annoying. Since I am diabetic, I've chosen to simply accept the side effects as being acceptable in service of the "greater good". But yeah, consider talking to you doctor and just see what he/she has to say. Maybe a smaller dose could help you with your weight, while not leading to the nausea / vomiting / etc. I'll note that I didn't start getting that stuff until my doc upped my dose from .25mg / week to 1mg / week. YMMV.
It’s gross, but didn’t last.
This has helped me learn to simply be happy with my size. Our bodies are not all meant to be skinny like the people we see on TV or instagram. There is a natural variance even for people with healthy diets and good exercise routines.
I can't enumerate everything that Aubrey Gordon shares in her excellent book, but I can say that learning to accept myself has been far more rewarding than constantly trying to chase weight loss schemes that only leave me back where I started. I feel confident and sexy now without any weight loss, and this is leading more people to be very obviously more attracted to me (because confidence is sexy!). I realized I never needed to lose weight to be attractive, I needed to accept myself for who I am.
I would urge anyone considering these treatments, whose lifelong effects we still do not understand, to learn about anti-fatness and how we have all been misled in to believing that everyone is supposed to be skinny.
Here's a great article from Aubrey to get started: https://www.npr.org/2023/01/12/1148169767/anti-fatness-keeps...
Finally I want to say that if anyone is just going to come in here and say being fat is unhealthy, or repeat any of the common tropes about weight loss, you're not going to get anywhere with me. The whole point of Aubrey's work is that these so-called common sense ideas are so deeply held in our society that few have really questioned them, and it takes more than a cursory examination to try to make sense of how we got here. Repeating the basic ideas does nothing to advance this conversation. If you must respond, read the article above before criticizing the basics of what I am saying. Aubrey can explain it far better than I can.
Yes, these issues have been studied and questioned. In traditional hunter-gatherer societies (people whose diet and lifestyle matches what humans evolved for), obesity is almost unheard of, as are diabetes and other metabolic diseases. But when these same hunter-gatherers adopt a modern lifestyle and diet, their rates of these diseases go way up. From this evidence, we can conclude that obesity is not a purely natural phenomenon, but caused in part by modern lifestyles.
Do you actually have studies you can link to that can show this? With a quick search I see a study [1] that both acknowledges that data on hunter-gatherers is light and also finds that total energy expenditure (which I assume is what you mean by the "lifestyle" part of "lifestyle and diet") is roughly the same between this hunter-gatherer society and western cultures:
"Like other complex, continuous traits (e.g., stature), environment can clearly influence TEE, as is evident in the elevated energy expenditures of traditional farmers (Table 1). Nonetheless, TEE is remarkably similar across a broad, global sample of populations that span a range of economies, climates, and lifestyles (Fig. 1, ,2).2). Not only is TEE statistically indistinguishable between Westerners and Hadza foragers, but the range of TEE within Western, foraging, and farming populations largely overlap, both at the individual and population levels (Table 1, Fig. 1, ,2).2). We hypothesize that TEE may be a relatively stable, constrained physiological trait for the human species, more a product of our common genetic inheritance than our diverse lifestyles."
It's also well documented that obesity rates have skyrocketed in recent decades (for example https://ourworldindata.org/grapher/share-of-adults-defined-a... ).
From this evidence, we can conclude that obesity isn't a purely natural phenomenon, it's cause by modern lifestyles. But what part of said lifestyles?
We need to look for a culprit(s) that:
a) hunter-gathers are insulated from, and
b) has greatly increased in just the past few decades, following the trend in rising obesity rates.
As you note, there seems to be big change in energy expenditure between hunter-gatherers and us, so that can be ruled out. That would seem to leave us diet changes and environmental contaminants.
Sugar is commonly cited as a cause of obesity, but recent increases in obesity rates have been much higher than those in sugar consumption (https://onlinestatbook.com/2/case_studies/sugar.html ). Also, there are hunter-gatherers who eat lots of honey (https://journals.plos.org/plosone/article?id=10.1371%2Fjourn...) and they are not obese.
So what could it be? I don't claim to know the answer, but there are two possibilities that seem plausible to me, that satisfy conditions (a) and (b) above:
- Environmental contaminants: http://achemicalhunger.com/
- Vegetable oils: https://www.jeffnobbs.com/posts/what-causes-chronic-disease
I feel as though your comment here only serves to underscore my original point. We can speak at the population level about fatness overall, but we still do not have any definitive answers for why we see rates increasing or what fat individuals could do to lose weight. Aubrey Gordon has extensively studied diet and weight loss trends that suggest fat people can become skinny people, and has done an incredible job documenting the ways in which these schemes fail to achieve results for most people. If what fat people really want is to be healthy and feel good about themselves, focusing on weight loss may be entirely the wrong objective. If you are eating a healthy diet and getting moderate exercise, you can be healthy even if you are not losing weight. Conversely, people who are naturally skinny can eat a horrible diet and be very unhealthy without being chastised as "unhealthy" by the casual observer. The focus on fatness and weight loss leaves people who struggle to lose weight feeling horrible about themselves, and helps perpetuate anti-fatness in our society which only serves to make fat people's lives even worse.
It can simultaneously be true that we are getting fatter as a population and also that common weight loss beliefs are incorrect. Aubrey Gordon's work is crucial in helping us understand how our society mistreats fat people and how common misconceptions about health, weight loss, and what it means to be fat perpetuate harm against fat people.
I broadly agree; current advice isn't working, and we shouldn't shame people for following bad advice and failing to achieve results. But that doesn't mean we should throw our hands up and ignore the problem either. Obesity is strongly linked to a host of health issues like diabetes and heart disease, it's an urgent problem to fix. At a societal level, we need more and more varied scientific research to find the causes of the crisis
At the personal level, it can be worthwile to keep trying different lifestyle changes; if you do eventually find something that works for you, you'll live a longer and healthier life.
(Addendum: everyone's metabolism is different. Something is causing the rise in obesity, but that something may affect you differently than other people. And maybe you would have had an unusually high weight naturally, even without the something.)