June 12, 2023 – Johnna Mendenall had by no means been “the thin buddy,” she stated, however the calls for of motherhood – together with a sedentary desk job – made weight administration much more tough. Anxious that household sort 2 diabetes would meet up with her, she determined to start out Wegovy pictures for weight reduction.
She was nervous about potential unwanted side 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 unwanted side 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 folks sharing private tales on-line concerning the weight reduction remedy Wegovy – and related medication – delving into their generally disagreeable, and probably gut-wrenching, unwanted side effects.
Whereas gastrointestinal (GI) signs appear to be the commonest, a laundry record of others have been mentioned within the information, on TikTok, and throughout on-line boards. These embrace “Ozempic face,” or the gaunt look some get after taking the remedy, together with hair loss, nervousness, despair, and debilitating fatigue.
Mendenall’s major unwanted side 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.
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 identify Ozempic, which is authorised for sort 2 diabetes and used off-label for weight reduction.
Each Ozempic and Wegovy include a warning label for potential unwanted side effects, the commonest ones being nausea, diarrhea, abdomen ache, and vomiting.
With the surging recognition of semaglutide, extra persons are getting prescriptions by telemedicine corporations, forgoing
extra in-depth consultations, resulting in extra unwanted side 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 progressively growing over time helps keep away from unwanted side effects, however insurance coverage corporations typically require a quicker timeline to proceed protecting the remedy, Apovian stated.
“Insurance coverage corporations are working towards medication for us by demanding the affected person go up in dosage [too quickly],” she defined.
Mendenall’s insurance coverage has paid for her Wegovy pictures, however with out that protection, she stated it might value her $1,200 monthly.
There are related medicines in the marketplace, like liraglutide, offered below the identify Saxenda. However it’s a each day, somewhat than a weekly, shot and likewise comes with unwanted side effects and has been proven to be much less efficient. In one medical trial, the folks 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 sort 2 diabetes drug made by Eli Lilly that will quickly achieve FDA approval for weight reduction – might have fewer unwanted side 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 pictures 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 constructive – simply what some have to win a lifelong battle with weight problems – to harsh situations with probably long-term well being penalties, and all the pieces in between.
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 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, grew to become insufferable. She couldn’t preserve meals down, and when she vomited, the meals would typically come up complete, 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 generally.
She was identified with gastroparesis, the weakening and paralysis of abdomen muscle contractions that make it more durable to digest meals. Some sorts of gastroparesis will be resolved by discontinuing GLP-1 medicines, as referenced in two case experiences within the Journal of Investigative Medication.
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 Packages.
“That is the deal: The unwanted side 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 stated.
However, like Apovian, Peters stated these unwanted side effects can probably be averted if pictures are began on the lowest doses and progressively adjusted up.
Whereas the typical beginning dose is .25 milligrams, Peters stated she typically begins her sufferers on about an eighth of that – simply “a whiff of a dose.”
“It will take them months to stand 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 couple of.4 milligrams for Wegovy for weight reduction).
When requested concerning the medication’ unwanted side 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 commonest adversarial reactions, as with all GLP-1 [agonists], are gastrointestinal associated.”
Is It the Drug or the Weight Loss?
Nonetheless, non-gastrointestinal unwanted side effects like hair loss, temper modifications, 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 all the time simply verified medical experiences, they are often very heartfelt.
Celina Horvath Myers, also called CelinaSpookyBoo, a Canadian YouTuber who took Ozempic for sort 2 diabetes, stated she started having intense panic assaults and despair after beginning the remedy.
“Who I’ve been these final couple weeks, has most likely been the scariest time of my life,” she stated on her YouTube channel.
Whereas extreme despair and nervousness will not be established unwanted side effects of the remedy, some folks get anhedonia, or the “diminished capability for pleasure,” stated W. Scott Butsch, MD, MSc, director of weight problems medication 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 load loss itself, not the remedy, 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 might give the looks of 1’s face altering.”
For some folks, like Mendenall, the unwanted side effects are value it. For others, like Carew, they’re insupportable.
Carew stated she stopped the remedy after about 7 months, and progressively labored as much as consuming strong meals once more.
“It’s the American means, we have all received to be skinny and delightful,” she stated. “However I really feel prefer it’s very unsafe as a result of we simply don’t know the way significantly our our bodies will react to those issues in the long run. Individuals see it as a fast repair, nevertheless it comes with dangers.”