By Jean Brannum and Maja Clasen

Christopher Maestas knew he needed to drop pounds. The Denver resident was as much as 250 kilos and had been diagnosed with prediabetes. His doctor told him that the one strategy to reverse it was through weight reduction.

It wasn’t easy. Christopher began losing a few pounds originally of 2020, but pandemic stress caused him to realize it back by the top of the yr. By the point he began using semaglutide, the medication sold as the load loss and kind 2 diabetes blockbuster Ozempic, he was back as much as his heaviest weight.

Immediately, the 53-year-old noticed a difference in his appetite. For the primary few weeks, he could stomach only a single boiled egg for breakfast. Now, he has overnight oats and perhaps a banana. Even on days when he chooses heavier, fattier breakfasts, he eats only a portion of what he used to. 

How Semaglutide Works

Semaglutide is a GLP-1 receptor agonist. Based on the Mayo Clinic, drugs on this family stimulate insulin production when the body’s blood sugar is high. Though originally developed to assist manage type 2 diabetes, these drugs also help create unprecedented weight reduction in ways in which experts are still attempting to decipher.

Amanda Velazquez, MD, the director of obesity medicine on the Cedars-Sinai Center for Weight Management and Metabolic Health, said that semaglutide mimics the gut hormone that makes the body feel full. This suppresses appetite, resulting in easy weight reduction.

Three U.S. Food and Drug Administration (FDA)–approved drugs contain semaglutide:

• Ozempic, an injection that’s approved to treat type 2 diabetes
• Wegovy, an injection that’s approved to treat obesity
• Rybelsus, a less-powerful oral type of semaglutide approved to treat type 2 diabetes

Cutting Out Food Noise

Appetite suppression is just one effect of semaglutide’s effects; it also has a remarkable ability to quiet the intrusive, obsessive thoughts about food that many individuals contend with day-after-day. Constant desirous about food is usually called “food noise,” and like many others, Christopher noticed that his food noise disappeared when he began taking semaglutide. He says that he never realized how much he thought of food until the medication quieted the thoughts. 

How powerful is the change? Christopher said that he’ll completely forget to eat sometimes. Someday, Christopher put his lunch on a warming plate at 10:30 a.m. and continued working. Before he knew it, it was 1:30 p.m. and he had not even thought of his lunch. 

“The great thing about it’s, I actually have been in a position to spend quite a lot of time in my brain and in my life not desirous about what are we gonna have for dinner. ‘What do we’ve for tomorrow?’ ‘Do we’ve enough?’ ‘Do we’d like to go to the shop?’ ‘We want this.’ ‘We must always get some snacks,’ I mean, there’s quite a lot of that chatter that went on in my head I don’t think I actually realized.”

It’s also turn out to be easier to make healthy food regimen selections. At his favorite Mexican place, he orders a ceviche tostada as a substitute of a big combo meal. When he dines out along with his husband, there’s an understanding that he won’t want appetizers. Sometimes, he eats a mix of side dishes. 

“What it has done for me is form of modified my relationship with food, but it surely also taught me that I don’t need to have the large breakfast every morning to get through the day. I don’t need 20 grams of protein at breakfast. I at all times thought I did.”

Accessing Semaglutide

Christopher never consulted his primary care physician. He knew that he might need trouble getting insurance coverage for Ozempic or Wegovy — and that the drug would cost him dearly.

So, he decided to show to an internet clinic for a prescription. Experts have warned patients to be cautious about online clinics, a few of which appear to supply very meager medical oversight. After completing a questionnaire and virtual meeting, Christopher received a prescription for cheaper compounded semaglutide. It costs him about $200 monthly. 

Compounded drugs live in a regulatory gray area with the FDA. The FDA doesn’t regulate compounded medications the identical way it does the regular versions available at normal pharmacies, and lots of experts fear that they might be unsafe or ineffective. Christopher’s semaglutide is mixed with vitamin B12 and will not be equivalent to Ozempic or Wegovy.

Dr. Velazquez says that we are able to’t be confident that compounded forms are effective: “You might be spending $1,000 on water or something, perhaps something comparable to Wegovy or Ozempic, but we’ve no clue.”

For the compounded form, Christopher draws up his own dose from a vial with an insulin syringe. He used to provide B12 shots to his dog, so drawing injectables and using needles was not a scary concept for him. “There’s a couple of two-second hesitation if you’re about to stay it in since it’s just just a little weird.”

At first, the negative effects were a burden, but they weren’t unbearable and he was blissful with the initial results.

“The negative effects and the appetite suppression definitely get more intense as you titrate up in doses,” Christopher said. “But I began to drop pounds instantly.”

The commonest negative effects for semaglutide include nausea, vomiting, and indigestion. Christopher said that eating less helped quite a bit with minimizing their severity. 

The drugs has been very effective. Christopher has lost about 43 kilos since starting his weekly semaglutide shot, and his blood sugar numbers have improved too.

Seeking to the Future

Once he reaches his goal weight, he would really like to debate getting off the medication along with his primary care physician. Many who stop taking semaglutide regain weight, in keeping with Velazquez. After stopping Ozempic, the appetite normally returns and other people will eventually gain weight back. 

Through the initial questionnaire from his telehealth provider, he never discussed whether semaglutide is a long-term medication. Nonetheless, Christopher said he would really like to try getting off the drug if his doctor thinks it’s best. 

“I would really like to try because I feel like if I’ve done enough behavior modification, and if I get the outcomes that I actually need to get, I feel that’s gonna be a giant driving force for me.”