June 12, 2023 – Johnna Mendenall had by no means been “the thin good friend,” she stated, however the calls for of motherhood – together with a sedentary desk job – made weight administration much more troublesome. Nervous that household sort 2 diabetes would meet up with her, she determined to begin Wegovy photographs for weight reduction.
She was nervous about potential negative effects. It took 5 days of staring on the Wegovy pen earlier than she labored up the nerve for her first .25-milligram shot. And certain sufficient, the negative effects got here on robust.
“The nausea kicked in,” she stated. “After I elevated my dose to 1 milligram, I spent your entire evening from 10 p.m. to five a.m. vomiting. I virtually stop that day.”
Mendenall is amongst a rising variety of individuals sharing private tales on-line concerning the weight reduction treatment Wegovy – and related medication – delving into their typically disagreeable, and doubtlessly gut-wrenching, negative effects.
Whereas gastrointestinal (GI) signs appear to be the commonest, a laundry checklist of others have been mentioned within the information, on TikTok, and throughout on-line boards. These embody “Ozempic face,” or the gaunt look some get after taking the treatment, together with hair loss, anxiousness, despair, and debilitating fatigue.
Mendenall’s major negative effects have been vomiting, fatigue, and extreme constipation, however she has additionally seen some constructive modifications: the “meals noise,” or the urge to eat when she isn’t hungry, is gone. Since her first dose 12 weeks in the past, she has gone from 236 kilos to 215.
Warning Label
Wegovy’s lively ingredient, semaglutide, mimics the position of a pure hormone referred to as glucagon-like peptide, or GLP-1, which helps you’re feeling well-fed. Semaglutide is used at a decrease dose below the model title Ozempic, which is permitted for sort 2 diabetes and used off-label for weight reduction.
Each Ozempic and Wegovy include a warning label for potential negative effects, the commonest ones being nausea, diarrhea, abdomen ache, and vomiting.
With the surging reputation of semaglutide, extra persons are getting prescriptions via telemedicine corporations, forgoing
extra in-depth consultations, resulting in extra negative effects, stated Caroline Apovian, MD, a professor of medication at Harvard Medical Faculty and co-director of the Middle for Weight Administration and Wellness at Brigham and Ladies’s Hospital.
Specialists say beginning with low doses and steadily rising over time helps keep away from negative effects, however insurance coverage corporations usually require a quicker timeline to proceed overlaying the treatment, Apovian stated.
“Insurance coverage corporations are working towards drugs for us by demanding the affected person go up in dosage [too quickly],” she defined.
Mendenall’s insurance coverage has paid for her Wegovy photographs, however with out that protection, she stated it might price her $1,200 monthly.
There are related medicines in the marketplace, like liraglutide, bought below the title Saxenda. However it’s a every day, slightly than a weekly, shot and in addition comes with negative effects and has been proven to be much less efficient. In one medical trial, the individuals being studied noticed their common physique weight over 68 weeks drop by 15.8% with semaglutide, and by 6.4% with liraglutide.
Tirzepatide, branded Mounjaro – a kind 2 diabetes drug made by Eli Lilly that will quickly achieve FDA approval for weight reduction – may have fewer negative effects. In medical trials, 44% of these taking semaglutide had nausea and 31% reported diarrhea, in comparison with 33% and 23% of these taking tirzepatide, though no trial has instantly in contrast the 2 brokers.
Lack of Bowel Management
For now, Wegovy and Saxenda are the one GLP-1 agonist photographs approved for weight reduction, and their maker, Danish drug firm Novo Nordisk, is going through its second scarcity of Wegovy amid rising demand.
Private tales on-line about semaglutide vary from overwhelmingly constructive – simply what some have to win a lifelong battle with weight problems – to harsh eventualities with doubtlessly long-term well being penalties, and every little thing in between.
One non-public group on Reddit is devoted to a very disagreeable aspect impact: lack of bowel management whereas sleeping. Others have reported uncontrollable vomiting.
Kimberly Carew of Clearwater, FL, began on .5 milligrams of Ozempic final yr after her rheumatologist and endocrinologist recommended it to deal with her sort 2 diabetes. She was advised it got here with the bonus of weight reduction, which she hoped would assist along with her joint and again ache.
However after she elevated the dose to 1 milligram, her GI signs, which began out delicate, turned insufferable. She couldn’t preserve meals down, and when she vomited, the meals would usually come up entire, she stated.
“One evening I ate ramen earlier than mattress. And the subsequent morning, it got here out simply because it went down,” stated Carew, 42, a registered psychological well being counseling intern. “I used to be getting extreme heartburn and couldn’t take a pair bites of meals with out getting nauseous.”
She additionally had “sulfur burps,” a aspect impact mentioned by some Ozempic customers, inflicting her to style rotten egg typically.
She was recognized with gastroparesis, the weakening and paralysis of abdomen muscle contractions that make it tougher to digest meals. Some forms of gastroparesis will be resolved by discontinuing GLP-1 medicines, as referenced in two case reviews within the Journal of Investigative Drugs.
Intestine Hormone
GI signs are commonest with semaglutide as a result of the hormone it imitates, GLP-1, is secreted by cells within the abdomen, small intestines, and pancreas, stated Anne Peters, MD, director of the USC Scientific Diabetes Applications.
“That is the deal: The negative effects are actual as a result of it is a intestine hormone. It is rising the extent of one thing your physique already has,” she stated.
However, like Apovian, Peters stated these negative effects can probably be prevented if photographs are began on the lowest doses and steadily adjusted up.
Whereas the common beginning dose is .25 milligrams, Peters stated she usually begins her sufferers on about an eighth of that – simply “a whiff of a dose.”
“It’s going to take them months to rise up to the beginning dose, however what is the rush?”
Peters stated she additionally avoids giving diabetes sufferers the utmost dose, which is 2 milligrams per week for Ozempic (and a pair of.4 milligrams for Wegovy for weight reduction).
When requested concerning the medication’ negative effects, Novo Nordisk responded that “GLP-1 receptor agonists are a well-established class of medicines, which have demonstrated long-term security in medical trials. The most typical adversarial reactions, as with all GLP-1 [agonists], are gastrointestinal associated.”
Is It the Drug or the Weight Loss?
Nonetheless, non-gastrointestinal negative effects like hair loss, temper modifications, and sunken facial options are reported amongst semaglutide customers throughout the web. Whereas these instances are sometimes what’s recognized within the medical world as “anecdotal,” that are private, however not all the time simply verified medical experiences, they are often very heartfelt.
Celina Horvath Myers, often known as CelinaSpookyBoo, a Canadian YouTuber who took Ozempic for sort 2 diabetes, stated she started having intense panic assaults and despair after beginning the treatment.
“Who I’ve been these final couple weeks, has in all probability been the scariest time of my life,” she stated on her YouTube channel.
Whereas extreme despair and anxiousness will not be established negative effects of the treatment, some individuals get anhedonia, or the “diminished skill for pleasure,” stated W. Scott Butsch, MD, MSc, director of weight problems drugs within the Bariatric and Metabolic Institute at Cleveland Clinic. However that may very well be a pure consequence of decrease urge for food, he stated, on condition that meals offers most individuals pleasure within the second.
Many different reported modifications come from the burden loss itself, not the treatment, stated Butsch.
“These are medication that change the physique’s weight regulatory system,” he stated. “When somebody loses weight, you get the shrinking of the fats cells, in addition to the atrophy of the muscular tissues. This fast weight reduction could give the looks of 1’s face altering.”
For some individuals, like Mendenall, the negative effects are value it. For others, like Carew, they’re insupportable.
Carew stated she stopped the treatment after about 7 months, and steadily labored as much as consuming strong meals once more.
“It’s the American approach, we have all acquired to be skinny and exquisite,” she stated. “However I really feel prefer it’s very unsafe as a result of we simply don’t know the way severely our our bodies will react to those issues in the long run. Folks see it as a fast repair, but it surely comes with dangers.”