Standard Weight Loss Medication Can Carry Some Gnarly Aspect Results


June 12, 2023 – Johnna Mendenall had by no means been “the thin pal,” she mentioned, however the calls for of motherhood – together with a sedentary desk job – made weight administration much more tough. Anxious that household kind 2 diabetes would meet up with her, she determined to begin Wegovy photographs for weight reduction.

She was nervous about potential unwanted side effects. It took 5 days of staring on the Wegovy pen earlier than she labored up the nerve for her first .25-milligram shot. And positive sufficient, the unwanted side effects got here on sturdy.

“The nausea kicked in,” she mentioned. “After I elevated my dose to 1 milligram, I spent all the night time from 10 p.m. to five a.m. vomiting. I virtually give up that day.”

Mendenall is amongst a rising variety of individuals sharing private tales on-line in regards to the weight reduction medicine Wegovy – and related medication – delving into their typically disagreeable, and doubtlessly gut-wrenching, unwanted side effects. 

Whereas gastrointestinal (GI) signs appear to be the most typical, a laundry checklist of others have been mentioned within the information, on TikTok, and throughout on-line boards. These embody “Ozempic face,” or the gaunt look some get after taking the medicine, together with hair loss, nervousness, despair, and debilitating fatigue. 

Mendenall’s major unwanted side effects have been vomiting, fatigue, and extreme constipation, however she has additionally seen some constructive adjustments: the “meals noise,” or the urge to eat when she isn’t hungry, is gone. Since her first dose 12 weeks in the past, she has gone from 236 kilos to 215. 

Warning Label

Wegovy’s energetic ingredient, semaglutide, mimics the position of a pure hormone referred to as glucagon-like peptide, or GLP-1, which helps you are feeling well-fed. Semaglutide is used at a decrease dose below the model identify Ozempic, which is permitted for kind 2 diabetes and used off-label for weight reduction.  

Each Ozempic and Wegovy include a warning label for potential unwanted side effects, the most typical ones being nausea, diarrhea, abdomen ache, and vomiting.

With the surging recognition of semaglutide, extra individuals are getting prescriptions by means of telemedicine corporations, forgoing

 extra in-depth consultations, resulting in extra unwanted side effects, mentioned Caroline Apovian, MD, a professor of medication at Harvard Medical Faculty and co-director of the Heart for Weight Administration and Wellness at Brigham and Girls’s Hospital.

Specialists say beginning with low doses and regularly growing over time helps keep away from unwanted side effects, however insurance coverage corporations usually require a quicker timeline to proceed overlaying the medicine, Apovian mentioned. 

“Insurance coverage corporations are working towards drugs for us by demanding the affected person go up in dosage [too quickly],” she defined. 

Mendenall’s insurance coverage has paid for her Wegovy photographs, however with out that protection, she mentioned it might price her $1,200 monthly. 

There are related medicines in the marketplace, like liraglutide, offered below the identify Saxenda. However it’s a day by day, relatively than a weekly, shot and in addition comes with unwanted side effects and has been proven to be much less efficient. In one scientific trial, the individuals being studied noticed their common physique weight over 68 weeks drop by 15.8% with semaglutide, and by 6.4% with liraglutide.

Tirzepatide, branded Mounjaro – a kind 2 diabetes drug made by Eli Lilly which will quickly achieve FDA approval for weight reduction – may have fewer unwanted side effects. In scientific trials, 44% of these taking semaglutide had nausea and 31% reported diarrhea, in comparison with 33% and 23% of these taking tirzepatide, though no trial has instantly in contrast the 2 brokers. 

Lack of Bowel Management 

For now, Wegovy and Saxenda are the one GLP-1 agonist photographs licensed for weight reduction, and their maker, Danish drug firm Novo Nordisk, is dealing with its second scarcity of Wegovy amid rising demand. 

Private tales on-line about semaglutide vary from overwhelmingly constructive – simply what some have to win a lifelong battle with weight problems – to harsh situations with doubtlessly long-term well being penalties, and the whole lot in between. 

One non-public group on Reddit is devoted to a very disagreeable facet impact: lack of bowel management whereas sleeping. Others have reported uncontrollable vomiting.

Kimberly Carew of Clearwater, FL, began on .5 milligrams of Ozempic final yr after her rheumatologist and endocrinologist advised it to deal with her kind 2 diabetes. She was instructed it got here with the bonus of weight reduction, which she hoped would assist together with her joint and again ache. 

However after she elevated the dose to 1 milligram, her GI signs, which began out gentle, grew to become insufferable. She couldn’t hold meals down, and when she vomited, the meals would usually come up entire, she mentioned. 

“One night time I ate ramen earlier than mattress. And the following morning, it got here out simply because it went down,” mentioned Carew, 42, a registered psychological well being counseling intern. “I used to be getting extreme heartburn and couldn’t take a pair bites of meals with out getting nauseous.”

She additionally had “sulfur burps,” a facet impact mentioned by some Ozempic customers, inflicting her to style rotten egg typically.

She was recognized with gastroparesis, the weakening and paralysis of abdomen muscle contractions that make it more durable to digest meals. Some forms of gastroparesis will be resolved by discontinuing GLP-1 medicines, as referenced in two case reviews within the Journal of Investigative Drugs. 

Intestine Hormone

GI signs are commonest with semaglutide as a result of the hormone it imitates, GLP-1, is secreted by cells within the abdomen, small intestines, and pancreas, mentioned Anne Peters, MD, director of the USC Scientific Diabetes Packages.

“That is the deal: The unwanted side effects are actual as a result of it is a intestine hormone. It is growing the extent of one thing your physique already has,” she mentioned. 

However, like Apovian, Peters mentioned these unwanted side effects can probably be averted if photographs are began on the lowest doses and regularly adjusted up. 

Whereas the common beginning dose is .25 milligrams, Peters mentioned she usually begins her sufferers on about an eighth of that – simply “a whiff of a dose.” 

“It’s going to take them months to rise up to the beginning dose, however what is the rush?” 

Peters mentioned she additionally avoids giving diabetes sufferers the utmost dose, which is 2 milligrams per week for Ozempic (and a pair of.4 milligrams for Wegovy for weight reduction). 

When requested in regards to the medication’ unwanted side effects, Novo Nordisk responded that “GLP-1 receptor agonists are a well-established class of medicines, which have demonstrated long-term security in scientific trials. The commonest hostile reactions, as with all GLP-1 [agonists], are gastrointestinal associated.”

Is It the Drug or the Weight Loss?

Nonetheless, non-gastrointestinal unwanted side effects like hair loss, temper adjustments, and sunken facial options are reported amongst semaglutide customers throughout the web. Whereas these circumstances are sometimes what’s recognized within the medical world as “anecdotal,” that are private, however not at all times simply verified scientific experiences, they are often very heartfelt.

Celina Horvath Myers, often known as CelinaSpookyBoo, a Canadian YouTuber who took Ozempic for kind 2 diabetes, mentioned she started having intense panic assaults and despair after beginning the medicine. 

“Who I’ve been these final couple weeks, has most likely been the scariest time of my life,” she mentioned on her YouTube channel. 

Whereas extreme despair and nervousness should not established unwanted side effects of the medicine, some individuals get anhedonia, or the “lowered potential for pleasure,” mentioned W. Scott Butsch, MD, MSc, director of weight problems drugs within the Bariatric and Metabolic Institute at Cleveland Clinic. However that could possibly be a pure consequence of decrease urge for food, he mentioned, on condition that meals offers most individuals pleasure within the second.

Many different reported adjustments come from the load loss itself, not the medicine, mentioned Butsch.

“These are medication that change the physique’s weight regulatory system,” he mentioned. “When somebody loses weight, you get the shrinking of the fats cells, in addition to the atrophy of the muscular tissues. This fast weight reduction might give the looks of 1’s face altering.”

For some individuals, like Mendenall, the unwanted side effects are value it. For others, like Carew, they’re insupportable. 

Carew mentioned she stopped the medicine after about 7 months, and regularly labored as much as consuming stable meals once more. 

“It’s the American means, we have all bought to be skinny and delightful,” she mentioned. “However I really feel prefer it’s very unsafe as a result of we simply don’t understand how critically our our bodies will react to those issues in the long run. Individuals see it as a fast repair, but it surely comes with dangers.”