Is Ozempic for life?

[filka]

I'm a 100kg/1.73m (BMI 33.4) 63yo male so I need to lose 25kg to get to the upper limit of "normal". This is about where I was 25 years ago! I work long hours, rubbish at dieting, find the gym absolutely not interesting at all even though I have a basic one at home. Not diabetic but blood pressure a little high. So I've started to explore the possibility of Ozempic.

I came across this on YouTube:

...where at about 6.10 there's the question "once you start this are you on it for life?" And the explanation that follows is basically "Yes".

And there are plenty of other reports of people saying that as soon as they stopped, the weight just piled back on.

Cost isn't an issue but I'm just a bit nervous about taking a decision that is potentially life-long.

Just wondering about other folks thinking or experience is/was about this? What is/was your plan for when you hit your target weight?

A diabetic will be on it for life.
For weight loss I believe it’s two years and you would be expected to make healthy life style changes so that, by the time you stop, you remain eating as you did whilst on Ozempic or else the weight will return.

@Gladlynot "you would be expected to make healthy life style changes so that, by the time you stop, you remain eating as you did whilst on Ozempic or else the weight will return"

This YouTube doctor considers obesity as a chronic disease just the same as diabetes. Although Ozempic is off-prescription for weight loss in the UK, it's basically the same as other semaglutides and I wonder why it is OK to be life-long for diabetics but not for obesity.

As a non-diabetic, that's really the crunch issue, whether you (I/one) can do that if the hunger comes back. Difficult to know as it's 2 years down the road. Would be good to hear of others experiences.

For diabetes it is life long due to a medical need to control their sugars. The fact that it results in weight loss is a bonus.
I’m not denying that obesity is also a medical issue that needs treatment. I’m simply pointing out that, at the moment, you can only have it purely for weight loss for a limited time so need to use it to make lifestyle changes a habit whilst you are on it.

The Zoe podcast is a good listen or you can read the transcript here.

I have been on it over a year and have lost just over three stone. It’s definitely been a game changer for me. I’ve tried every diet going over the years. I’d safely say I’m not rubbish at them. The basic fact is that diets just don’t work.

Our modern way of eating is responsible for the current obesity epidemic. Processed foods. Too many crap carbs. Etc etc.

Most of us can’t eat that way and stay at a healthy weight. We do need to change WHAT we eat.

The manufacturers of semaglutide say it’s a medication for life in the same way that a blood pressure medication would be. And as a treatment for diabetes it probably is for life. As a weight loss medication it does seem that if you stop taking it you start to want more food and therefore obviously regain weight. In some ways that is like any diet. You go back to eating how you did to gain weight it stands to reason you will put it all back on. It’s the whole business model for companies like Weight Watchers etc. (Interestingly WW have bought a company that sells Ozempic/Wegovy and feel it will work well with their programme.)

My own plan is that I’m open to having to take it long term. Hopefully at a low dose. I know I can’t eat a high carb diet. But most of us can’t anyway. Switching to a low carb diet can reverse type 2 diabetes and obesity. Have a look at Dr David Unwin on Twitter and his programme at his GP practice. There is a low carb app (free) called Freshwell which is worth a look.

at the end of the day if we want to lose weight, ward off diabetes or reverse it we need to take some personal responsibility and make some changes. Ozempic is helping me to do that but I know going forward I need to also do the work. But it doesn’t mean going on a diet. It means healthy, sustainable long term changes. That also allow for life. I’m generally pretty low carb Monday to Friday and I relax a bit at the weekends.

There are some interesting books to read on obesity - The Obesity Code by Dr Jason Fung and Why We Eat (Too Much) by Dr Andrew Jenkinson are both worth reading.

Sorry this ended up way longer than I meant and got interrupted by a dog walk so the thread may have moved on a lot since I started my reply!

@Peridot1 "Sorry this ended up way longer than I meant"

But all things that I need to consider, and useful link, many thanks

I think realistically it probably will be a case of many people staying on Ozempic or a similar brand for life, hopefully on a low dose. Unless they are one of the few who can actually maintain the lifestyle changes.
There are a lot of unknowns with it at the moment. If I was still taking it I would try to continue for the recommended 2 years then hope I could maintain the weight loss by willpower after 2 years of healthier eating. That would be the hope but who knows whether it would work out that way or not. Statistics on the subject are not very promising, which is the same as weight gain after any diet.

There's a difference between being obese and chronic obesity though. "Chronic obesity is a disease that doesn't just go away, just the same as any chronic issue Not all obese people have chronic obesity just as not everyone who has a cough has COPD. It's becoming more accepted that if you have chronic obesity you will need some kind of long-term treatment and semiglutide may very well be that treatment.

No one knows. This drug was designed to reduce pancreatic insulin resistance in D2 patients, ie to regulate their blood sugars, and weight loss resulted through supervised diet and exercise. We will have to follow long-term results to see if it helps D2. I would not pay internet providers for Ozempic and Wegovy etc to kick-start a diet or exercise programme, unless I was deep into D2.

How do you know if you have obesity or chronic obesity? I'm morbidly obese and about to go to my Dr again for help but worried they'll "prescribe" ww again 🙄

@OnionBhajis - for me chronic obesity is a person who has tried and tried and tried again to lose weight. They succeed a bit for a while but then fall off the wagon. Which is not their fault. And usually regain any lost weight sometimes with a bit more on for good measure. The book Why We Eat (Too Much) by Dr Andrew Jenkinson is really good at explaining why all this happens. Maybe read that before going to your GP so you understand a bit more yourself?

Ah peridot that sounds familiar. Will look at that.

I have been a yo-yo all my adult life, my only success has been that in the last 7 years I have managed to keep the up yo-yoing at 2 stone less than my heaviest weight, so I am improving as I get older but realistically whilst I can stick to healthy patterns and behaviours at times I cannot stick to it very long term and not convinced I ever could. So whilst I do think when I come off (saxenda rather than ozempic but so similar), I do think I would be able to stick at it for a good few months it is likely I would fall off again by about 6-9 months and then could easily see 2-3 years down the line being back where I started and needing help again, so ideally a low dose long term as maintenance would massively help but I’m not sure the cost / risk benefit will pan out that way

I have just come off it after 18 months - I'm diabetic. I couldn't take the side effects. It is awful for those with ibs. I had shocking diarrhoea that seriously impacted my life. I have come off it and now I have such awful constipation I can barely move for the pain. It has absolutely buggered my gut. And I lost NO weight.

I am getting really worried about the idea that this is a panacea for weight loss.