June 12, 2023 – Johnna Mendenall had by no means been “the thin buddy,” she mentioned, however the calls for of motherhood – together with a sedentary desk job – made weight administration much more troublesome. Apprehensive that household sort 2 diabetes would meet up with her, she determined to start out 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 positive sufficient, the negative effects got here on robust.

“The nausea kicked in,” she mentioned. “Once I elevated my dose to 1 milligram, I spent your entire evening from 10 p.m. to five a.m. vomiting. I nearly give up that day.”

Mendenall is amongst a rising variety of individuals sharing private tales on-line concerning the weight reduction medicine Wegovy – and related medicine – delving into their typically disagreeable, and probably gut-wrenching, negative effects. 

Whereas gastrointestinal (GI) signs appear to be the most typical, 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 medicine, together with hair loss, nervousness, melancholy, and debilitating fatigue. 

Mendenall’s main negative effects have been vomiting, fatigue, and extreme constipation, however she has additionally seen some optimistic adjustments: 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 energetic ingredient, semaglutide, mimics the function of a pure hormone referred to as glucagon-like peptide, or GLP-1, which helps you are feeling well-fed. Semaglutide is used at a decrease dose below the model title Ozempic, which is authorized for sort 2 diabetes and used off-label for weight reduction.  

Each Ozempic and Wegovy include a warning label for potential negative effects, the most typical ones being nausea, diarrhea, abdomen ache, and vomiting.

With the surging reputation of semaglutide, extra persons are getting prescriptions by way of telemedicine corporations, forgoing

 extra in-depth consultations, resulting in extra negative effects, mentioned Caroline Apovian, MD, a professor of drugs 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 step by step growing over time helps keep away from negative effects, however insurance coverage corporations usually require a sooner timeline to proceed overlaying the medicine, Apovian mentioned. 

“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 mentioned it will value her $1,200 per 30 days. 

There are related drugs in the marketplace, like liraglutide, offered below the title Saxenda. However it’s a each day, quite than a weekly, shot and in addition comes with negative effects and has been proven to be much less efficient. In one scientific 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 acquire FDA approval for weight reduction – may have fewer negative effects. In scientific 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 straight 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 dealing with its second scarcity of Wegovy amid rising demand. 

Private tales on-line about semaglutide vary from overwhelmingly optimistic – simply what some have to win a lifelong battle with weight problems – to harsh eventualities with probably long-term well being penalties, and all the things in between. 

One non-public neighborhood 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 12 months after her rheumatologist and endocrinologist recommended it to deal with her sort 2 diabetes. She was instructed 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, grew to become insufferable. She couldn’t hold meals down, and when she vomited, the meals would usually come up entire, she mentioned. 

“One evening I ate ramen earlier than mattress. And the following morning, it got here out simply because it went down,” mentioned 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 varieties of gastroparesis could be resolved by discontinuing GLP-1 drugs, as referenced in two case experiences within the Journal of Investigative Medication. 

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, mentioned Anne Peters, MD, director of the USC Medical Diabetes Packages.

“That is the deal: The negative effects are actual as a result of it is a intestine hormone. It is growing the extent of one thing your physique already has,” she mentioned. 

However, like Apovian, Peters mentioned these negative effects can possible be averted if photographs are began on the lowest doses and step by step adjusted up. 

Whereas the typical beginning dose is .25 milligrams, Peters mentioned 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 stand up to the beginning dose, however what is the rush?” 

Peters mentioned 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 medicine’ negative effects, Novo Nordisk responded that “GLP-1 receptor agonists are a well-established class of medicines, which have demonstrated long-term security in scientific 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 adjustments, and sunken facial options are reported amongst semaglutide customers throughout the web. Whereas these circumstances are sometimes what’s identified within the medical world as “anecdotal,” that are private, however not at all times simply verified scientific experiences, they are often very heartfelt.

Celina Horvath Myers, also referred to as CelinaSpookyBoo, a Canadian YouTuber who took Ozempic for sort 2 diabetes, mentioned she started having intense panic assaults and melancholy after beginning the medicine. 

“Who I’ve been these final couple weeks, has most likely been the scariest time of my life,” she mentioned on her YouTube channel. 

Whereas extreme melancholy and nervousness usually are not established negative effects of the medicine, some individuals get anhedonia, or the “lowered skill for pleasure,” mentioned W. Scott Butsch, MD, MSc, director of weight problems drugs within the Bariatric and Metabolic Institute at Cleveland Clinic. However that could possibly be a pure consequence of decrease urge for food, he mentioned, on condition that meals provides most individuals pleasure within the second.

Many different reported adjustments come from the burden loss itself, not the medicine, mentioned Butsch.

“These are medicine that change the physique’s weight regulatory system,” he mentioned. “When somebody loses weight, you get the shrinking of the fats cells, in addition to the atrophy of the muscle 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 mentioned she stopped the medicine after about 7 months, and step by step labored as much as consuming stable meals once more. 

“It’s the American manner, we have all obtained to be skinny and delightful,” she mentioned. “However I really feel prefer it’s very unsafe as a result of we simply don’t know the way critically our our bodies will react to those issues in the long run. Individuals see it as a fast repair, nevertheless it comes with dangers.”

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