No No No Ozempic!
A cautionary tale.
I'm old and I make no bones about it.
One of the many downsides of aging is the concomitant decrease in metabolism. Whereas ten or fifteen years ago I could drop thirty pounds by simply drinking one less Pepsi per day, I now find myself in a constant grudge match with my waistline, a match wherein the waistline usually prevails. I've always said. “A waist is a terrible thing to mind,” a pun that is sadly all too true these days.
Tall, dark, and handsome? Well, two out of three ain't bad. My older sister, who also fights the battle of the bulge, is fond of likening our genetic forebears to “bricks with legs.” Dark-haired and olive complected, most of our maternal family has always been what used to be called “stocky.”
So, as I recently watched the readout on the scale inch inexorably upward despite my best efforts, I decided to try a shortcut. I decided to try Ozempic.
Unless you've been living in a retreat with some Tibetan monks or something, you've heard of the latest celebrity weight loss fad. Everybody and their third cousins twice removed have been losing massive amounts of weight by injecting themselves weekly with the Type 2 diabetes drug semaglutide, aka Ozempic.
Ozempic is a glucagon-like peptide-1 (GLP-1) agonist medication that aids in lowering blood sugar by helping the pancreas make more insulin. It mimics a naturally occurring hormone, and as those hormone levels rise, they go to your brain, tricking it into thinking you're full. Ozempic also slows digestion by increasing the time it takes for food to leave the body. It's kind of the chemical equivalent of bariatric surgery.
The light and fluffy commercial that co-opts Pilot's 1970s hit “Magic” has firmly planted the refrain “Oh oh oh Ozempic” in consumer's minds like an annoying earworm. It shows happy, smiling people going about their happy daily activities, all while the happily upbeat narrator warns of pancreatitis, vision problems, severe stomach pain, low blood sugar risks, or myriad allergic reactions such as swelling of your face, lips, tongue, or throat, or problems breathing or swallowing. Severe rash or itching, fainting or feeling dizzy, or having a very rapid heartbeat are also mentioned, although obviously not manifested by any of the chipper actors cavorting around the screen. In a supreme example of “duh”-ness, the announcer advises you not to take the crap if you're allergic to it. And as a happy little girl bikes down a suburban street on her newspaper route, a brief disclaimer flashes: “Common side effects are nausea, vomiting, diarrhea, stomach pain, and constipation. Drinking plenty of fluids may reduce your chances of dehydration.” “Which,” the announcer intones, “may worsen kidney problems.”
Hey! Sounds like a no-brainer to me. Where can I get some?
Well, Ozempic is not actually approved for weight loss, so your doctor has to prescribe it “off label,” meaning you'll have to mortgage your house in order to obtain a couple of months' worth. Unless, of course, you are “lucky” enough to actually have Type 2 diabetes, in which case most insurances cover it to the tune of $25 to $50 per month.
While I am not a raging, insulin-dependent diabetic, I have in recent years – as my gross tonnage has increased – become prediabetic.
A normal A1C level is below 5.7. Levels of 5.7 to 6.4 indicate prediabetes, and anything over 6.4 is full-blown diabetes. I consistently bounce around between 5.6 and 6.2, maybe spiking a 7.0 if I've been particularly neglectful. When that happens, I drop that extra Pepsi I referred to earlier and, while I no longer lose thirty pounds, I do usually manage to drop a couple of A1C points.
That said, my primary doc agreed to put me on Ozempic, not so much for diabetic control but to see if I could lose a few pounds. Which, in and of itself, would likely keep my blood sugar levels level. Win-win, right?
Now, one of my nieces got herself on the stuff and had remarkable success. Dropped something like forty pounds in just a couple of months. Even got herself a case of “Ozempic butt,” a frequent complaint caused by the sagging that results from losing too much too fast. But she had gotten some sort of promotional deal from Novo Nordisk. When it ran out and she was faced with $1,300 a month to continue, well......
Another niece, however, had an entirely different experience. She lasted three weeks before the bloating, gassy, nauseous, stomach-lurching effects she was living with three-and-a-half days out of seven finally got to her and she said, “basta!” Well, since she doesn't actually speak Italian, she just said, “enough.” She quit and never looked back.
I figured I'd chance it because I'm one of those odd ducks that never seems to really get side effects from medications and such. Just lucky, I guess. But, boy, did my luck run out.
I got my little blue pen and was ready for the long haul. I even went out and bought a sharps disposal container for the used needles. It's a tiny little needle for a subcutaneous injection. Since the five thumbs I have on each hand sometimes limit my manual dexterity, I got my wife to handle the first injection into my upper outer thigh.
The starting dose is 0.25 mg, which you maintain for four weeks before doubling to 0.5 mg. The starting dose doesn't really affect your blood sugar; it's just supposed to help your body adjust to the oncoming digestive-related issues.
Well, I got shot in the leg on a Sunday afternoon. I knew the stuff was low-dose and slow acting, so I wasn't really expecting anything to happen immediately or even for the next day or two. And I was right. Nothing happened for a couple of days. Then, along about bedtime on Tuesday, I started feeling “off,” for lack of a better term. Not sick, per se, but feeling like it wouldn't take much to tip the balance. I woke up Wednesday morning full-on nauseated. An actual breakfast was out of the question, but I risked a couple of slices of toast. Bad move. Within an hour, the trips to the bathroom began. And they didn't stop for the next eight hours. This morning's toast, last night's dinner, yesterday's lunch – it all came out one end or the other. There might even have been some toenails in there towards the last.
Then came the diaphoresis. Also known in medical parlance as secondary hyperhidrosis, in everyday language it means the cold sweats. Followed by the dizziness and light-headedness, dry mouth, and a degree of disorientation. Having had medical training in a previous existence, I knew I was dehydrated. And I also knew there wasn't a damn thing I could do about it, because ginger ale, Gatorade, water – whatever I tried to use to hydrate – came barreling right back out. So when the wife got home from work, I said, “Honey, we're going for a ride.” And off to the ER I went.
Phenergan is wonderful stuff and once I got some – and a couple of bags of I.V. fluids – I was right as rain within a couple of hours. Well....sort of. I managed to move out of the bathroom Wednesday night but I remained in residence in the bedroom for most of Thursday. I was absolutely wiped out.
Friday was better and Saturday was okay and thus ended Ozempic week one.
Week two started again on Sunday. And it was Wednesday afternoon before the gassy, bloated, slightly nauseous feeling started to gain traction. This time I headed it of with Pepto-Bismol. I was still sick for two days, living on mashed potatoes, pudding, and crackers, but at least I stayed out of the hospital.
I thought week three was going to be the beginning of my success story. I was still sick by midweek, but not as bad as the previous week and nowhere near the way I had been the week before that. Of course, my toothbrush had to vie for space on the bathroom vanity with the Pepto and the GasX and all the other OTC concoctions I was using to stave off the symptoms.
Oh, and I had lost ten pounds. Being nauseated by the thought of food will do that to you.
Another Sunday rolled around and, with high hopes for the coming week, my wife gave me another jab. This time, it didn't wait until Wednesday. I was back in the ER by late Tuesday night. More fluids, more phenergan......and no more Ozempic. I went from “oh oh oh Ozempic” to “no no no Ozempic” in four weeks. I informed my doctor and told him we were going to go back to the old way of doing things. No more shortcuts.
When I mentioned this to my pharmacist – while filling a prescription to help me deal with the after effects of this crap – she said, “Oh, yeah. There are lawsuits being filed as we speak.”
Seems that in addition to the delightful gastro side effects I experienced, there's one more little disclaimer they need to add to their toxically upbeat and positive ad campaign: gastroparesis. Basically, it's a matter of Ozempic doing its job a little too well. Food moves so slowly through the stomach to the small intestine that it may stop moving altogether, resulting in a paralyzed stomach. Resulting in more nausea, vomiting, abdominal bloating, abdominal pain, severe dehydration, acid reflux, and malnutrition. Undigested food may remain in the stomach and harden. Doesn't that sound like fun? They ought to make a commercial about that. On the upside, you'll lose lots of weight.
Look, your mileage may vary. The niece who had a modicum of success with Ozempic admitted to having “some discomfort at first.” One of my numerous attendants in the ER said she had had no trouble with it at all. (Even in my weakened and semi-delirious state, I managed to give her a raspberry.) I'm just saying, don't jump in with both feet. Stock up on clear liquids, OTC medications, and toilet paper and hope for the best. Everything may be just peachy for you.
I wish it had been for me.
