to think more negative effects will come out from Ozempic use?

[nameey]

Just read that the 30 year old singer Avery has been diagnosed with osteoporosis due to Ozempic use. Looks like this could be the start of many conditions coming out.

I know Ozempic is incredibly helpful for a lot of people but losing weight but then having osteoporosis does not seem worth it.

AIBU?

@Caffeineneedednow
Interesting to see who hasn't responded to it, isn't it?

Yes, it was very concerning that 'the pharmacist' on this thread clearly didn't trust conventional medical trials and would only accept drugs were safe to use over twenty years after they appear on the market? Does she know something we don't?

Are you saying your BMI is low 30s? Sorry, the thread has been going on for a while, not sure if you've said this before. Obviously you don't have to disclose that but it just sounded like that's what you meant as it was in response my question.

Why in consultation with "their doctor"? I don't have a personal doctor. My GP hasn't seen me in person for several years and doesn't even want to see me in person or speak to me for my high BP medication review. That's done via me doing home BP checks and a phone call with a pharmacist.

The online pharmacy is very capable of taking my medical history, informing me of the possible side effects, and then reviewing my details before deciding whether to prescribe a WLI to me or not.

Well, because having read reports from people on the frontline seeing patients with serious adverse effects, often the signs of something really ominous but treatable are put down to just another symptom to suck up while on the treatment. Whether that's bowel obstruction leading to bowel perforation, or gallbladder problems then requiring removal, or gastroparesis.

How would those side effects have been prevented by having seen a doctor before being prescribed?

I said in consultation with their doctor - which then would imply a level of monitoring as treatment progressed. By all means, just roll the dice.

Many GP’s won’t have anything to do with a privately prescribed medication and won’t supply any level of monitoring or support.

People can access additional support if they want via online pharmacies that offer a more frequent and personalised level of contact. I think requiring it to be a private doctor is unnecessary and not justified by the rate of serious side effects that currently occur. That's also the position of the MHRA.

It's not "rolling the dice" as if its some kind of unknown and untested drug. People are taking it according to the required guidance. They are told about the possible risks and the symptoms of serious side effects that shouldn't be ignored. Why is taking a prescription medication that has been correctly prescribed to you, according to the instructions "rolling the dice"?

Just to put forth another side that is often overlooked in these conversations. HCP view of weight and obesity is as skewed as the general populations. So alot of doctors view it as a failing of the individual and are as such uninclied to help outside of advising to move more and eat less. A mantra that has been entirely disproven to be sufficient to overcome obesity once an individual is obese ( it is something that makes you less likely to ever become obese). This is even more prevent towards females. Below is an exert from a paper

https://pmc.ncbi.nlm.nih.gov/articles/PMC4714720/#:~:text=Weight%20Bias%20in%20Clinical%20Care,-Unfortunately%2C%20negative%20societal&text=A%20recent%20study%20of%202%2C284,in%20their%20lives%20(21).

"The importance of addressing weight bias in clinical care is further highlighted by evidence that weight bias by HCPs can impair quality of health care for patients. Evidence suggests that HCPs spend less time in appointments (45), provide less education about health (46), and are more reluctant to perform certain screenings with patients who have obesity compared to thinner patients (47). Furthermore, some physicians view patients with obesity as less adherent to medications (28), express less desire to help these patients, and report that treating obesity is “more annoying” and a greater waste of their time compared to providing care to their thinner patients (45). In addition, perceived weight bias in the health care setting contributes to reduced health care utilization among patients with obesity, especially for women (35,48,49)."

This scares me more then potential side effects

@lettyraines 😅 That comment's 'spiteful'? Jeez
I'll try to explain but know I'm probably wasting my time. One of the problems with SM is that very few, if any, people with a different perspective ever changes their position, or allows themselves to learn anything new, or hears a story which shifts their viewpoint an iota....or admits that anyway. My point, which I'm sure you understood very well but choose to respond to in a weird, wounded way ironically, is basically that this thread is, as usual with this particular subject, a waste of time as the people who say they're looking for a polite discussion don't actually engage when someone from the opposing viewpoint tries to explain something - in this case why people get upset or cross or impatient or whatever (in a perfectly polite way too, not the first time on this thread either). They'd much prefer to trade insults and act the victim, bleating about how we're all so mean for daring to challenge what they say. That's fine if it's how they choose to pass their time and no doubt, they're getting plenty from the affirmation. It's just interesting when it's as obvious as it was in this instance. You're welcome.

Oops @lettyraines has had her comment to me deleted. Just to say, I didn't report it 😅

I'm going to be absolutely nailed to the wall for this but I don't care -

Am I allowed to talk about hunger on this thread?

You know. The H word that is never, ever spoken about in an objective way when we talk about dieting.

The reason I am mentioning it is because I think (and yeah it's just my opinion) that a lot of people in the Global North have completely forgotten what hunger is, and why it is a necessary part of our day.

We snack constantly. We say we "need wine" at the end of our days. We 'reward' ourselves with 'treats'.

It all leads to a world where a vast majority of people act on hunger instantly rather than allow themselves to be hungry for an hour or two before a mealtime.

For me there's so much psychology in this.

Am I allowed to actually talk about this?

Because Mountjaro for example has the effect of suppressing hunger by "making you feel fuller for longer".

Which is fascinating to me, because I don't actually understand or endorse that whole concept.

The whole idea of "I must feel full at all times" just makes my head spin...

Is anyone going to ever talk about this honestly on Mumsnet, or will it just be shouting folk down about thin privilege or whatever I get lobbed at me usually?

I don't feel full all the time on Mounjaro. I just don't feel extremely hungry and I can take or leave snacks, so I choose to leave them. I still eat three meals a day, although smaller portions than before. Which makes sense because I'm trying to be in a constant calorie deficit.

I dont know if that's what you're after @JacquesHarlow but that's my personal experience.

I think what you're saying is that GLP-1 medications are unhelpful because they totally remove any feelings of hunger. I don't think that's true for the majority of people on them. I think it reduces the feelings of hunger or the mental obsession about food to a manageable level. Not to nothing.

Also, I was morbidly obese before I started. Now I'm not and I'm approaching a BMI of under 30. That's better for my health and long term wellbeing, even if it's morally or psychologically wrong to suppress hunger to some degree.

Mounjaro doesn't remove hunger. It does in a small number of people but that's not how it's supposed to work. It reduces hunger so it's manageable. I get hungry at mealtimes, I just don't get chew my own arm off hungry, or hungry when I've just eaten an hour ago, or still hungry even after eating a meal hungry. If you've not experienced what it feels like to have a large appetite driven by hormonal issues then you really can't comprehend why it's so difficult to just ignore being hungry. I don't want any drug to remove hunger from me! But to feel a normal slim person's level of hunger is fucking revelatory I can assure you. I'm not a weak person, I am a person who has an abnormal hunger level when I'm not on this medication.

I had some pretty spectacular suppression on the early doses of mounjaro. I don’t get that now on a higher dose. I had my lunch an hour and half ago and am now feeling a slightly rumbly stomach. I’ll not eat now until dinner.
Being hungry has never really been an issue for for me - I’ve quite happily only eaten 2 meals a day for most of my adult life and not snacked in between. My problem has always been eating meals that are far too big and far too caloric. What the medication has done for me is allow me time to get to grips with what I should be eating, portion wise, and understand how many calories I should be eating to be in a deficit.

@JacquesHarlow
Not sure where you've tried to discuss this before and experienced such extreme reactions but hunger is something that gets discussed a lot on WLI threads. And I think you're partly right; some people may chase complete hunger suppression whereas others recognise that hunger is a normal physiological response that we need to recognise and manage in a healthy way.

I don't actually agree that 'making you feel full for longer' is about hunger though - that's about satiety, after a meal, which MJ helps with by increasing the leptin peptide. Simultaneously, ghrelin peptide is reduced - this reduces hunger somewhat. But it's not intended that you literally starve yourself, new users are constantly advised that they need to eat, at least something even if they're not really hungry which you might not be in the early days of taking the drug - believe me, I still feel hungry at least once a day.

I’m not going to nail you to the wall, it’s a good point.

All I can say is for me yes I do still get hungry but I can manage the hunger now. Likes of Sunday morning I was going swimming. I felt hungry but didn’t want to swim on a full stomach so I swam and then had some food after. Whereas before MJ the hunger was unmanageable I couldn’t just get on with what I was doing whilst I felt hungry. It was like a physical pain combined with a voice inside screaming at me to eat.

Likes of today I’ve had my lunch and won’t need to eat again till dinner. Yes I’ll feel hungry for it when it comes but I don’t need to damp down the hunger with food meantime.

I am going to just mimick what other user have said, it doesn't remove hunger but makes it manageable.

I now realise how normal people feel hunger. Not an overwhelming need to eat but just a normal level of hunger. So I am getting hungry right now. Our dinner time is 6 so I will have low level hunger for the next couple of hours and then ill eat without a problem.

Prior to MJ I would be insatiable hungry. I have done fasts and the closest thing I can describe is that insatiable hunger is having not eaten in a day. When I ignore it I would end up shaking and lightheaded ( more so if I skip a meal or had somethign like just a small salad for lunch) and so irritable that I would scream or cry at the drop of a hat.

Did you know that in obesity calorie restrictions leads to a drop in dopamine (this is the key component in our reward centre)

Being on MJ I see how normal people experience hunger and for the first time in my life I see a way to be like everyone else. This is why we are so defensive of the drug. It gives that reset and allows up to control our lives.

I also still feel hungry on WLIs. A few times I've experienced full suppression, seems to be when I've moved up doses, but it goes within a few days and then, yes, I do feel hungry. Mostly before lunch and before dinner, but not always. My stomach rumbles and I think about food more. If someone put food in front of me it would be extremely tempting, but not impossible to decline.

The difference between this hunger and THAT hunger, is that this one is manageable. I can snack on fruit if I really want to, and that helps. Or I can just wait until it's time to eat.

THAT hunger, the one I had pre-WLIs, was a totally different beast. With that one I'd have cold sweats, my hands would shake, I'd feel dizzy and sick, my vision was affected, I'd feel confused. The idea of being able to, say, focus on work or just do something else was unrealistic. If someone put food in front of me it would be impossible to decline, and I would go out of my way to find something to eat if I didn't have anything with me.

During one of the many many many diet and lifestyle changes I tried, I took part in the Zoe programme and had a blood sugar monitor for a while. For the first time I could see that, when I get those feelings, my blood sugars dip into the hypoglycemic range. When my blood sugars hit that level I'd get an alert to tell me it wasn't normal. I assume this isn't everyone's experience, but this is something I would experience daily if I didn't make sure I ate when I was hungry. It is also something I've had for as long as I can remember (ie pre-teen and significantly pre-dating any overweight) therefore it's not a result of a metabolism broken by obesity.

From experiencing this daily, I haven't had hypoglycemia since I started on WLIs. This struck me as odd because hypoglycemia is listed as a possible side effect, and I definitely eat less than I did when I wasn't on WLIs, but there you have it. Why this should be, I have no idea.

So - unless this level of of hunger is a normal experience for everyone (and I'm happy to stand corrected if it is) - perhaps some people have different hormone levels, different responses to those hormone levels, and perhaps the WLIs have done something to help correct this.

Incidentally @KrankyKumquat I can relate to everything you've said on this thread.

@JacquesHarlow
Just thought I'd also respond to your comment re being accused of having thin privilege. Not nice I'm sure. However, discussions about hunger and fat people can very easily slip into fat-shaming ie. that fat people can't live with normal feelings of hunger and just wait it out for their tea.

Obese people are well-used to being seen as greedy - they experience hunger and because they're greedy, they respond by eating a doughnut or something. And then another as they're still hungry.

But it's been shown that most obese people experience hunger to a very high level (see above re levels of ghrelin and leptin) and are rarely satiated after eating or at least, not for long. Feeling like this all the time is miserable, as I'm sure you can imagine, and it's why traditional diets, which restrict calories, fail for many as they just exacerbate this feeling.

Believe me, if you are and have always been thin, you won't be living with this level of hunger, all day and night. So rather than thin-priveledge, I think you could be more accurately described as fortunate to be metabolically healthy. You experience normal, healthy, manageable levels of hunger and satiety, as do we when we take WLIs.

And two hours later, the oh-so brave, fighter for free speech @JacquesHarlow , who really wanted to discuss an important issue about obese people on WLIs that she's never been allowed to discuss before (due to the aggression and dishonesty of obese people on WLIs apparently) is nowhere to be seen 🙄.

"But it's been shown that most obese people experience hunger to a very high level (see above re levels of ghrelin and leptin) and are rarely satiated after eating or at least, not for long. Feeling like this all the time is miserable, as I'm sure you can imagine, and it's why traditional diets, which restrict calories, fail for many as they just exacerbate this feeling."

I don't mean to de-rail the thread, but that just reminded me of this: https://www.cam.ac.uk/research/news/genetic-mutation-in-a-quarter-of-all-labradors-hard-wires-them-for-obesity. Now wondering if all I really needed to do was to scatter my dinner round the garden before eating it.

I don’t know why you think you will be nailed to the wall for this. It’s true that part of getting overweight is the reluctance to feel hungry even for a short while. Speaking for myself I put on weight mainly through too much snacking rather than big portions. So yes the psychology of why we eat too much is relevant to any debate about weight problems. If I could cut out snacking I would be a size 10 again but it’s not that easy & we’re constantly bombarded with temptation.