If you're taking Ozempic to lose a bit of weight doesn't this make you feel guilty?

[QueenieMe]

The Weight Loss Chat board feels like it's been taken over by Ozempic threads at the moment, with everyone and their aunt spending a fortune on injections to lose weight. Yet I've just seen Diabetes UK has issued a warning saying that diabetic patients are struggling to get supplies because of the demand. For them, taking the drug is not a lifestyle choice! I do appreciate there are those on the WLC board who are clinically obese and are taking it because their weight is impacting their health, but when I see women with normal BMIs saying they're taking it to lose that last stubborn stone I do despair. Knowing patients were struggling for supplies so I could fit in a bikini make me feel so guilty that I just couldn't do it. I'd love to hear their justification.

https://inews.co.uk/news/ozempic-diabetic-weight-loss-patients-drug-demand-2342119

So many people seem to object to ozempic etc being used to aid weight loss. It's almost as if some people think there shouldn't be any help. Fat people should either suffer (as a punishment for being fat in the first place) or stay fat (so others can feel superior). Some of the posts on other threads about this have been awful, barely disguised vitriol.

I object to it being used by people with a normal BMI to get down to their holiday weight when diabetics are struggling with their supplies. I understand why it's good for the clinically and morbidly obese.

Being in ketosis gives you appetite suppression. Surely that is safer than Ozempic?

I am overweight, I carry it well (as in medically well, not a stealth boast, it's very much on my hips waist and bum which is apparently less of a health risk) but my BMI is technically high enough to look into weight loss surgery.

I've been desperate for help but I've come to the conclusion that I won't take any Semaglutide products, whether prescribed or privately paid for. It has some quite serious health risks, as said in the OP it's an actual medication for certain conditions, and I don't believe medications will be a sustainable solution for most people - either you take it for the rest of your life (which increases the chance of you developing the associated health risks) or you come off it and realise you haven't addressed any of your issues with food and you put it all back on again.

It's better to find a way to sustainably lose weight yourself, even if it's at a much slower pace, than rely on something that you are unlikely to be able to take forever.

People should not be being prescribed ozempic if they are only slightly overweight. They need a BMI of 27 AND related health issues OR a BMI of over 30. If they're getting a prescription when they don't fit that criteria they are either lying in the consultation or the prescriber is acting unlawfully. This shouldn't happen.

I think it's very clear from reading the threads on WLC that this is happening a lot.

I am on month 10 of a calorie deficit (1400 calories) and increasing my movement regime - my measurements were 38 bust, 34 waist and 46 hips and I was 72kg (11 stone 3) in July 2022 when I was put on the list for a hysterectomy, my surgeon said to get my BMI down, I am 5 foot 4. Had my surgery in Jan but carried on with my regime for my wedding in 4 weeks, and it was helping me walk up mountains better. I am now 34 bust, 29 waist and 40 hips. I think I will be around 60 - 62kg now. I don't know my weight though as I have previously had an eating disorder so weighing myself becomes obsessive so was avoiding that. Would Ozempic have got me there in a quicker timeframe? Is that why people are going on it? I don't really get the functionality of the drug? Why is it so effective and how does it work in the brain to suppress the appetite?

My GP told me that once I have managed to get my BMI down a lot and also changed lifestyle and eating habits I will possibly need a low dose 0.25 to help me not to put weight back on. I'm fine with that. That should just take the edge off my appetite.

For weightloss it's recommended 6 months to 2years, but you can take it indefinitely if needed, you titrate up to the therapeutic dose (currently 1mg, though once available on label for weightloss it'll be 2.4mg) and you can titrate back down to remain on the lowest effective dose or come off completely. It's a very safe drug in the scheme of things. There's significant evidence that's it's cardio protective and they are starting trials (or have recently started) testing it's usefulness in preventing dementia.

To the person who said that type 2 diabetes can be reversed with lifestyle changes, that's only in a certain percentage of people. Some people (around 60% I think) will need to be medicated for life.

Surely the sensible and sane approach to this would be for your doctor to increase your thyroid medication and get you euthyroid with the ability to lose the excess weight that way?

Am staggered at how casually people will take new drugs with no real long term date to lose weight that could be achieved by eating healthier and moving more.

I don't believe it's not a nuanced issue though, to be clear. As someone who has struggled with weight since having a baby at 21, I completely get how hellish it is to be gaining weight and seeming to not have control over it despite what a constant goal weight loss has been. There are so many bad actors involved, diet culture, fatphobia, the processed foods literally designed to be as appealing as possible, the list goes on. I completely empathise with people who have struggled with their weight their whole lives, might be approaching the stage in life where the health impacts of obesity are becoming apparent, and want to do whatever they can to fix it, and also understand why advice along the lines of "just eat less move more/get some self control" is completely ignorant and unhelpful.

I also think the addictive power of processed food needs to be more recognised. I do think this will likely never happen because acknowledging it will come at huge cost to some pretty powerful industries, but I know personally how different I feel not eating processed food (and not overeating in general) feels, it's like a veil lifting. It doesn't mean it's not difficult to stay on that path though. I'm turning 30 this year and hoping my years of trials and reading will finally click for me this time. Medication or surgery is just not something I want to have to turn to.

I’ve never tried being in ketosis so cannot judge whether that is safe or not. I know Ozempic has health risks which I was prepared to accept as being obese also has health risks.
I only ever intended to take it for a few months to get my BMI below 30. But as it turns out, I suffered bad side effects so only took it for about 6 weeks. The appetite suppression part worked very well.

Honestly, if they're disclosing where they are getting it from, I would be reporting the pharmacy. But ultimately, unless we're going to insist on in person consultations prior to prescription, it's limited as to what safeguards can be put in place.

I've been on liraglutide or semaglutide in some form since 2016 and there is a wealth of bad information on this thread.

Some things I'd add:

• I went off of it during pregnancy in 2019. I didn't gain anything. So those who spout the "but you gain all the weight back when you stop!" line, that's not a given.
• I probably did have side effects, but they were way, WAY less pronounced than the alternatives, which is why I was prescribed this in the first place.
• It's not a miracle drug. You can absolutely stay overweight while on it.
• I've been prescribed it for A1c issues. I don't resent other people for taking it for obesity, even though yes, I've had months where getting my prescription filled has been a joy. If it helps you, I am happy for you.

It helps suppress appetite by mimicking a peptide naturally produced in the body which signals fullness to the brain, so people who really struggle to stop overeating have a better chance of sticking to a healthy diet.

It's not a magic bullet and doesn't work to the same degree for everyone.

Well done on your weight loss!! Sounds fantastic!

Exactly. It is easy to say that poor people can make food from scratch, but that's ignorant at best. Most poor people are working so much they can't afford to sit and cook for hours. Healthy convenience food is so expensive. Outdoor activities are often reserved for the rich. Lack of bike storage, parks filled with druggies or rubbish, no local affordable leisure facilities. I could go on and on.
The poor people who are managing to live a healthy lifestyle, have to put in double the effort. In the meantime, food companies are getting away with feeding people UPF that's been proven to literally altern the wiring of your brain.
I am not shocked at all that things like these injections are now so common. It is a failure on a massive scale.

• I went off of it during pregnancy in 2019. I didn't gain anything. So those who spout the "but you gain all the weight back when you stop!" line, that's not a given

I think what people mean is that if people are solely relying on the appetite suppressing effects of Ozempic, it is completely plausible that if they don't actively work to change their habits and monitor their diet/weight, the weight can come back on as your appetite will obviously increase after ceasing to take an appetite suppression.

It's great that you didn't regain weight and you're right that it's not a given, but it is an absolutely real possibility for people who are overweight and have previously struggled with food intake regulation and more general healthy lifestyle choices.

Thar's fair - I also didn't LOSE weight on it as a given, either. It absolutely brought my A1c into a normal range, but I was still overweight until I also addressed the boring thermodynamics part.

appetite suppressant*

I know 3 people who lied to get it . Taking s photo of the scales while holding something heavy!

Being in ketosis gives you appetite suppression. Surely that is safer than Ozempic?

Of course ketosis can do exactly what Ozempic does, but there is no money in people doing that on their own.

I would suggest that most people on Ozempic have no clue about how to do what it does naturally, which is a failure of public health and a triumph of the power of pharmaceuticals

Being in ketosis has side effects - thirst, bad breath, low blood pressure, higher risk of kidney stones, potential heart disease. It's also difficult to maintain such a restrictive diet. You CAN'T have carbs, cake, biscuits etc not even occasionally, as you'll come out of ketosis and increase the risk of binging, any appetite suppression will be lost etc. It's makes eating out more difficult and drinking alcohol in ketosis is very risky. For some people, a ketosis inducing lifestyle works really well, but for many, it's unsustainable long term.

Like with all efforts to get to or maintain a healthy weight, most people have to pick a downside: some are more acceptable than others and it's very much personal choice, dependent on other lifestyle factors and the cause of the person's obesity.

Yes I would use those words to someone's face. I will admit I have been overweight myself on several occasions on life, yet I've managed to shed the weight using the common sense approach of healthier balanced diet, exercise and reducing calories to shed it. And I can assure you, I am not blessed with genetics. I have several serious genetic conditions running through my family, I have a child with additional needs and I most certainly am not the only family member who has been overweight and struggled to shift it. But it's entirely possible to do so.

I'm obese and took it for 4 months. The side effects were horrific and it's also given me (a lot!) of gallstones. I also barely lost any weight anyway. It's not a magic fix at all.

@CandlelightGlow ah brilliant, thanks, I understand now. So it doesn't directly target the ventromedial hypothalamus, just creates the mimic of the peptide signal. Interesting!

I am curious where the education about portion sizes, calorie content of food and drink and the calorie input/output ratio is. The NHS weightloss app was amazing in teaching me these basics - it would be good if the people being prescribed this medication were asked to follow the app too to try put the lifelong lifestyle changes into practice whilst having this appetite suppression helping hand. Some people won't be able to sustain medication for life so a two pronged approach seems sensible.

Ouch! Gallstones are really painful. Are you absolutely sure the drug was the cause? I do agree it doesn't seem like a magic fix at all – there was another poster on a thread I read who has pancreatitis after injecting it.

They are exactly the people I started this thread about. As I've said repeatedly, I do understand why clinically and morbidly obese people are drawn to it. But those with a normal BMI blatantly lying to get their hands on it should be ashamed that diabetics are struggling.