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Goodbye, Ozempic

theatlantic.com

61–70 of 89 posts

Re: Goodbye, Ozempic

#61
post #43

Earlier quoted context omitted.

I personally take ozempic and have also prescribed it to ~150+ patients for diabetes. I've maybe had to stop it in ~8 patients for tolerability issues. We unfortunately usually dont get to hear many chiming in to say that they tolerated it just fine. I do (2mg/week), down 45lbs. Being heavy is really bad for you. Don't be so quick to write it off d/t the possibility of vomiting.

How long does the vomiting last if you have a bad reaction? More than a day?

Speaking for myself, the pattern has been like this on the occasions that I've had a really severe case of vomiting:

At some point I start noticing an intense "bloat" / gas feeling - with lots of burping and farting - as well as possibly some nausea and diarrhea. This will last for a few hours. Maybe 3 or 4? I wasn't keeping notes unfortunately. Then, at some point I'll just have a sudden urge to vomit (it comes on fast) where I'm lucky to make it to the bathroom to expel everything into the toilet. The actual vomiting last 2-3 minutes, after which I go back to feeling relatively normal, other than slightly drained feeling, and that slightly acid-scarred feeling in my throat.

The worst part, in many ways, is cleaning up afterwards. Even though I've made it to the bathroom both times this has happened, the stream of vomit is so intense that I can't necessarily keep it all in the toilet. When I said "power vomiting" that was no joke. So inevitably some winds up on the floor, the wall beside the toilet, my clothes (if I'm wearing any), etc. Getting the bathroom clean and back to smelling normal is... not fun.

Re: Goodbye, Ozempic

#62
post #7

An alternative / replacement without the side-effects would be huge. Since I started 1mg / week of Ozempic, the phrase "power vomiting" has become part of my vernacular where it never was before. Just last night I was overcome by a round of puking that rivals stuff you'd see in a horror movie. :-( It doesn't happen often (2 times this year so far) but when it's bad, it's BAD.

I’ve been debating whether to ask my doctor about trying it. My whole adult life I’ve been struggling with my weight and tried nutritionist, apps, you name it and can’t keep the weight off for more than a year. I hate vomiting so this is making me rethink. Thanks for sharing very helpful.

I take 2mg ozempic, worst thing was starting (lower dose) and with any stomach upset, I get nasty sulphur smelling burps.

It’s gross, but didn’t last.

Re: Goodbye, Ozempic

#63

From what I understand, Ozempic works by slowing down digestion and thus reducing appetite. If that is the case then wouldn't this be precisely evidence that caloric restriction is all you need to reduce obesity?

Yes, and …

“Calories in” is half. “Calories out” (the amount you burn) is the other half.

Having been on the “nothing but diet” train for long windows of my life I can confidently say that if you don’t pair the former and latter, you’ll end up in the yo-yo cycle. Over and over again. Took a long time for me to understand that and I STILL struggle.

Re: Goodbye, Ozempic

#64

Earlier quoted context omitted.

> that these so-called common sense ideas are so deeply held in our society that few have really questioned them Yes, these issues have been studied and questioned. In traditional hunter-gatherer societies (people whose diet and lifestyle matches what humans evolved for), obesity is almost unheard of, as are diabetes and other metabolic diseases. But when these same hunter-gatherers adopt a modern lifestyle and diet,…

> these issues have been studied and questioned Do you actually have studies you can link to that can show this? With a quick search I see a study [1] that both acknowledges that data on hunter-gatherers is light and also finds that total energy expenditure (which I assume is what you mean by the "lifestyle" part of "lifestyle and diet") is roughly the same between this hunter-gatherer society and western cultures: "…

I’d have to do some digging, but these observations are largely moot. The “differences in lifestyle” meme is accurate but incredibly imprecise; hunter-gatherer societies are vastly different than say present-day America, so there’s little practical information to glean from studying these differences. Unless, of course, we want to change to those lifestyles wholesale.

Re: Goodbye, Ozempic

#65
post #27
post #5

We need to push lifestyle change to treat obesity - diet, exercise, sleep - vs. pharmaceuticals. Big pharma just keeps rolling out v2.0, 3.0, etc. for the customers they've built through advertising and having doctor's marketed to push them on their patients along with government lobbying. He'll, how many COVID boosters did Big Pharma try to push at $30bn a round going into their purses?

I took Ozempic for the first time three months ago. I'm 45 years old. Three months ago was the first day that I can remember when I wasn't hungry. Really, now I understand people when they say that "I don't want more food". Because I always wanted more food. Of course, I realized that it's important to not over-eat, and with effort it was possible. But that's exactly the point. It's always a struggle against one of t…

I see you. I see you 100%

Re: Goodbye, Ozempic

#66

Earlier quoted context omitted.

> that these so-called common sense ideas are so deeply held in our society that few have really questioned them Yes, these issues have been studied and questioned. In traditional hunter-gatherer societies (people whose diet and lifestyle matches what humans evolved for), obesity is almost unheard of, as are diabetes and other metabolic diseases. But when these same hunter-gatherers adopt a modern lifestyle and diet,…

> these issues have been studied and questioned Do you actually have studies you can link to that can show this? With a quick search I see a study [1] that both acknowledges that data on hunter-gatherers is light and also finds that total energy expenditure (which I assume is what you mean by the "lifestyle" part of "lifestyle and diet") is roughly the same between this hunter-gatherer society and western cultures: "…

That hunter-gatherer tend to have very low rates of obesity and metabolic disorders is well documeted, for example https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12785 .

It's also well documented that obesity rates have skyrocketed in recent decades (for example https://ourworldindata.org/grapher/share-of-adults-defined-a... ).

From this evidence, we can conclude that obesity isn't a purely natural phenomenon, it's cause by modern lifestyles. But what part of said lifestyles?

We need to look for a culprit(s) that:

a) hunter-gathers are insulated from, and

b) has greatly increased in just the past few decades, following the trend in rising obesity rates.

As you note, there seems to be big change in energy expenditure between hunter-gatherers and us, so that can be ruled out. That would seem to leave us diet changes and environmental contaminants.

Sugar is commonly cited as a cause of obesity, but recent increases in obesity rates have been much higher than those in sugar consumption (https://onlinestatbook.com/2/case_studies/sugar.html ). Also, there are hunter-gatherers who eat lots of honey (https://journals.plos.org/plosone/article?id=10.1371%2Fjourn...) and they are not obese.

So what could it be? I don't claim to know the answer, but there are two possibilities that seem plausible to me, that satisfy conditions (a) and (b) above:

- Environmental contaminants: http://achemicalhunger.com/

- Vegetable oils: https://www.jeffnobbs.com/posts/what-causes-chronic-disease

Re: Goodbye, Ozempic

#67

An alternative / replacement without the side-effects would be huge. Since I started 1mg / week of Ozempic, the phrase "power vomiting" has become part of my vernacular where it never was before. Just last night I was overcome by a round of puking that rivals stuff you'd see in a horror movie. :-( It doesn't happen often (2 times this year so far) but when it's bad, it's BAD.

I’ve got a hiatus hernia (the oesophagus doesn’t shut so acid flows up) - I’ve been sick every night for years, since taking semaglutide I’ve stopped being sick every night so for me it is better and the opposite.

Wow I have the same problem. Did it get better you think due to weight loss?

Re: Goodbye, Ozempic

#68

Earlier quoted context omitted.

> these issues have been studied and questioned Do you actually have studies you can link to that can show this? With a quick search I see a study [1] that both acknowledges that data on hunter-gatherers is light and also finds that total energy expenditure (which I assume is what you mean by the "lifestyle" part of "lifestyle and diet") is roughly the same between this hunter-gatherer society and western cultures: "…

That hunter-gatherer tend to have very low rates of obesity and metabolic disorders is well documeted, for example https://onlinelibrary.wiley.com/doi/full/10.1111/obr.12785 . It's also well documented that obesity rates have skyrocketed in recent decades (for example https://ourworldindata.org/grapher/share-of-adults-defined-a... ). From this evidence, we can conclude that obesity isn't a purely natural phenomenon,…

I appreciate the detailed reply.

I feel as though your comment here only serves to underscore my original point. We can speak at the population level about fatness overall, but we still do not have any definitive answers for why we see rates increasing or what fat individuals could do to lose weight. Aubrey Gordon has extensively studied diet and weight loss trends that suggest fat people can become skinny people, and has done an incredible job documenting the ways in which these schemes fail to achieve results for most people. If what fat people really want is to be healthy and feel good about themselves, focusing on weight loss may be entirely the wrong objective. If you are eating a healthy diet and getting moderate exercise, you can be healthy even if you are not losing weight. Conversely, people who are naturally skinny can eat a horrible diet and be very unhealthy without being chastised as "unhealthy" by the casual observer. The focus on fatness and weight loss leaves people who struggle to lose weight feeling horrible about themselves, and helps perpetuate anti-fatness in our society which only serves to make fat people's lives even worse.

It can simultaneously be true that we are getting fatter as a population and also that common weight loss beliefs are incorrect. Aubrey Gordon's work is crucial in helping us understand how our society mistreats fat people and how common misconceptions about health, weight loss, and what it means to be fat perpetuate harm against fat people.

Re: Goodbye, Ozempic

#69

Earlier quoted context omitted.

At the end of the day, isn't it just burning more calories than you take in every day to lose weight? If you can't exercise and are gaining weight, shouldn't you be able to reduce calorie intake until you start losing weight. I think we are organic machines, there isn't any magic involved.

I agree and I'm not understanding the seemingly dissenting opinions in the larger comments. This is basic thermodynamics.

There's more to digestion and metabolism than basic thermo. I mean sure, supply your body with inadequate calories and it will make up the difference by pulling by storage. But that's like saying the steam train and diesel turbine train work the same way: just heat up a fluid to move some metal to turn a crankshaft.

The food labels on your food packages are determined by calorimetry. But your body digests some food more readily than other foods, also affected by what else you eat with it, how you prepare it, etc. Also your body encourages you to eat certain things to get various nutrients: you rarely eat those nutrients alone; typically they come along with a bunch of other stuff. Then peoples' feedback systems are heavily influenced by all sorts of things: signals from your gut biome, your emotions and response to social signals and learning, various kinds of signalling reflecting what you eat (and those signals are empirically hacked by food engineers), and random brain bugs, among others.

Exercise is hardly scientifically measurable either. It's not like that "calories burned" reading on your bike, is comparable to a bike from a different manufacturer, much less a different kind of exercise.

Re: Goodbye, Ozempic

#70
post #9

I’m delighted that there are all these new alternatives. Not only because I believe they will help people. But selfishly because I take .75 mg a week to help manage my glucose level and the weight loss users have made the drug hard to get (even though a dose as small as mine doesn’t help weight loss — in fact I’ve been gaining weight, something I have struggled to do). A couple of months go the drug stopped being bac…

You sure thats Ozempic? Sounds like Trulicity based on the dose.

It is indeed a blue ozempic cylinder. There is one with selectable dosages for ramping up and acclimitizing and a 1.0 mg only for prolonged use, but I got good results before I got to 1.0, so went back down because why not take less.

I believe the weight loss dosage of semaglutide is well over 2 mg.

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