We may earn money or products from the companies mentioned in this post.
Content Warning: This post contains my candid thoughts about my experience taking Ozempic and Mounjaro, two GLP-1 receptor agonists. It goes into detail about my body image, my conditions, my weight, and my experience with taking medication to improve my health and to lose weight. I am not a medical professional. Ozempic and Mounjaro are prescription medications and all medications should be discussed with your health care provider.As a note, this post is not sponsored by the manufacturers of Ozempic, Wegovy, or Mounjaro and it is certainly not sponsored by “Big Pharma.” This post is not sponsored by any entity or any person.
Foreward
I have started and stopped writing this post at least ten times. How should one go about discussing such an emotional and personal topic like weight loss on the internet, today? Is it okay to be happy in my new body? Is it okay that I was happy in my old body? Should this be more of an educational post about what Ozempic, semaglutide, and Mounjaro even are? Should this be a viewpoint on body positivity vs. body neutrality? Or, should this be a post about how important it is medically advocate for your health and the health of your loved ones? Does anyone even care about this subject? Is it ironic that I, in fact, did make my sister “buy” (read: try) this class of medications? Should this be a series? (yes!)
Ten false starts later; this ended up a stream of consciousness view of the last 18 months on GLP-1 medications. I hope it’s helpful.
Some backstory
Both of my parents are dead. And since you’re probably not new here; you likely already knew that. 66. That’s the age my parents lived to. After surviving for over 12 years on dialysis due to an autoimmune kidney disease, my dad passed away in 2020. He also had insulin-dependent diabetes. He had been sick for so long. But he was such a fighter. His ICU doctor once said “I have to be honest, I think your dad is surviving on love, alone.”
My mom passed in 2018, much more unexpectedly. A complication of her Rheumatoid Arthritis medication, a biologic infusion called Remicade. I really hate that word – complication. It is not nearly strong enough a word to describe the earth-shattering impact her death had on my family and I. It is not nearly strong enough a word to describe what it was like watching your always-formidable mom fade away in the ICU, dying from an otherwise survivable infection, if it weren’t for the complications.
A non-diagnosis diagnosis
Picture this: you are sitting in your doctor’s office 3 years after your mom died. You hear that your inflammatory markers are four times the healthy amount. And it is causing a lot of stress on your body. The downstream impacts are impacting your joints, blood pressure, vascular system, and even your lungs. It is assumed psoriatic arthritis (PsA). It is hard to diagnose PsA. It is more of an elimination game – negative for Rheumatoid arthritis, negative for lupus. “It can be treated in the long run by a class of meds that ‘may cause some immune system complications.’” Yes doc, I am familiar with the complications.
Now don’t get me wrong, Remicade changed my mom’s life. She was nearly pain-free after she started her infusions. Hell, just three weeks before she was in the ICU, my mom packed up my dad and all of his medical supplies and headed out on a cross-state road trip to visit her brother and sister-in-law in Florida- something she’d never have been able to do without medication. I should also add that, everyday, people’s lives are changed in positive ways because of autoimmune meds like Remicade. But that didn’t mean I wasn’t terrified.
I wasn’t terrified to die, but terrified to be forced to decide whether to be in pain and to be swollen all the time or to be constantly PTSD-level anxious about my own mortality. Especially a stressful decision in a world that had just experienced a pandemic that took the lives of so many with reduced immune system responses. It seemed like a lose-lose mental exercise. I know people live healthy, happy lives on these biologics everyday – but we all know anxiety doesn’t care about facts.
Have you tried losing weight?
Is there anything else I can do? “Well you could lose weight and see how that might impact that your inflammation and your symptoms,” my doctor said, unintentionally flippant as if I hadn’t spent the last twenty-two years of my life constantly thinking about losing weight. As if I hadn’t spent thousands on nutritionists, naturopathic doctors, diets, Weight Watchers, Slim Fast, supplements, exercise machines, boot camps, trainers – you name it, “trying to lose weight.” As if I hadn’t spent the previous decade unlearning everything I grew up learning to hate about my body.
In my 30s, I finally moved toward body acceptance. I was even a little delusional about my weight, in the best way. Delusion can be a good thing in this sense – regardless of my size, I have rarely strayed from a crop top or a short skirt, I have rarely let society’s view on my size control me. I have never really seen myself as anything but worthy and beautiful, and I have never let my size stop me from doing anything that I wanted – save for maybe sitting in one of those cheap, white plastic patio chairs (IYKYK.)
Realizing changing my weight could mean changing my health
But I was at a point in my health journey where I knew I needed a different kind of help. I could be neutral about my body but my body wasn’t neutral about itself. It was struggling to adapt and if I didn’t get my inflammation under control – I probably wouldn’t be around to see 66. It wasn’t about looking great, honestly I always felt pretty confident, it was about my quality of life.
“What about the GLP-1 medications that help with insulin resistance, do you think they would help me lose weight? I know with PCOS and autoimmune stuff, losing weight is hard because I’ve tried so many times, I just kind of worry if I will be successful,” I asked because I had seen something about diabetes meds, Ozempic, PCOS, and weight loss pop up in my “for you page” on TikTok (fittingly, the for me page, right?)
“No, I think you can do this on your own, or at least get started on your own. We need to document everything. You may be a candidate for gastric bypass if you’re still struggling to lose weight in a few months.”
It is time to be your own health advocate
Enter my research phase; it happened in parallel to me buckling down and trying to lose weight. TikTok MDs, health journals, clinical trials, FDA reports – you name it, I read it. As a note, one of the best TikTok doctors I found was Dr.Salas-Whalen. In the words of Love Island UK, this was “still early days” with very little PR buzz about this class of medications. It was January 2022, months before anyone was talking about Hollywood Ozempic parties, the Kardashians, or the dreaded Ozempic face {shudder, eyeroll}.
This decades-long existing class of meds – GLP-1 receptor agonists, had helped people with diabetes lose weight but could also help people without diabetes but with chronic conditions like PCOS or insulin resistance, lose weight. Color me intrigued. My notes were written out. I was a great candidate – no history of medullary thyroid cancer or tumors, no history of pancreatic or gallbladder issues. I had insulin resistance due to PCOS. I was nearly pre-diabetic with a family history of diabetes, heart failure, and kidney failure. I even found a few new studies on the anti-inflammatory response in this class of medications. It felt like the perfect tool.
Back to the doctor I went, notes in hand. It is important to note that these medications are not without side effects, but in reviewing the risk with my doctor – she agreed that I could be an ideal candidate. I left the office that day with a prescription for Wegovy, a recently FDA-approved weight loss-branded version of the scientific molecule of semaglutide, aka Ozempic. I left feeling cautiously optimistic. Maybe I could change my health and the trajectory of my health and even my life. The only thing I had to lose was my FSA.
Starting semaglutide – the good, the bad, the ugly
My employer does not cover GLP-1s (how people often refer to these meds by short name) for weight loss or for any reason besides Type II Diabetes. I paid $645/month for Wegovy, after the manufacturer coupon. Something I felt so privileged to be able to do – even if it meant emptying my FSA and delaying things like the dental implant I had stashed away money for. I knew it was worth trying this medication and adding it alongside a nutrition and personal training regimen that I had already started.
Heartburn (from both the medicine and paying $645/month), fatigue, diarrhea, constipation (oh the constipation!) I can’t believe I’m talking about my bowel movements in a post linked to my name, on Al Gore’s internet, but I have to be real with you – these are definitely very real side effects that I had. I still have them on occasion, especially if I skimp on fiber in my diet or if I have too many Sambuca shots in Italy, trust me on this one – I have done the legwork.
The side effects
The nausea and dizziness were the most life-interrupting side effects and they were also the hardest to fix. Even after I added an as-needed prescription for Zofran to combat the worsening nausea each month I experienced as I increased my dosage, I still felt pretty gross for a few days after each weekly injection. Luckily, the side effects started to wane a bit by the time I reached the 2.4mg max dosage.
For reference, this class of meds requires a slow titration. Moving up a dosage each month until you reach the strength that works best for you. The Wegovy max strength is 2.4mg and that’s where I ended up. I was a losing a slow and steady 1/2 – 1 lb a week, which was healthy but still felt slow compared to all of the people who lost 50 lbs in 3 months. But my appetite was fairly suppressed and the constant buzz of food noise was starting to dissipate. I was hopeful – with my protein supplement shakes, fiber supplements, and weightlifting routine – I could make this work!
By late summer 2022, my doctor started to proactively lean more into learning about GLP-1s. Her practice had been reviewing studies. She even suggested I consider a switch to a brand new med that was a combination of a GLP-1 receptor agonist + GIP receptor agonist.
Making the switch to Mounjaro
“Clinical trials show it may be even more effective than semaglutide but it is only approved for diabetes right now. I can still prescribe it off-label for you for PCOS and pre-diabetes.” She also had some samples and a discount program from the manufacturer that made it $25 a month for a year, even if my insurance didn’t cover it. Sold!
I started the new med, called Mounjaro (scientific name tirzepatide,) in August 2022 – 6 months after starting Wegovy. After my first injection, I immediately experienced significantly less side effects than I had experienced on Wegovy. My appetite had significantly decreased. I was still able to eat whole meals and enjoy life and food, but food had become an afterthought. The best part – two weeks in (even without losing a significant amount of weight,) my psoriasis cleared, my lactose intolerance and IBS disappeared, and even my asthma improved. I saw my ankles and knees without pitting edema for the first time in years. I didn’t have constant food noise or think about food – outside of when I knew I needed it to fuel my body. My knees, my ankles, my hands – not even a slight twinge of pain or swelling. I wasn’t expecting that it would have this big of an impact on my inflammation right away. What the hell was in this stuff?
The information in the graphic above was pulled from a New York Times review of the Mounjaro Phase III clinical trial information.
A win is a win – even on the outdated BMI chart
Fast forward to December 2022, I was down 35 lbs from August -a total of 60 lbs since I had first started my GLP and fitness journey in February, 2022. I had moved from the “morbidly obese” category to “obese” according to the very outdated BMI chart I still cringe at.
The most important news of all was that my inflammatory markers were in normal range – from even as early as September, when I had transitioned to Mounjaro, before I had even lost a significant amount of weight. I had started my year of yes (my resolution to spend a year saying yes to more adventure and fun) back on New Year’s Eve 2021 – 2022, pre-medication, but I knew I was going into another new year with less pain, more muscle, and even more hope for the future of my health. It was much easier to to say yes to go to the gym regularly without pain. It was easier to make food decisions when I wasn’t constantly thinking about making food decisions. It seems cliche to say, but I knew then that this medication had changed my life.
Where I am today
Today, I write this 1 pound away from being 100 lbs down from where I started. According to my doctor, I’m now just “overweight.” The training and weightlifting that I started before GLP-1s has helped me continue to feel strong and powerful. I feel pain-free. I feel free, in general.
And yet, I’m still struggling with how to talk about my journey. It has been the biggest barrier to me sharing more about it. I’m not a medical professional, I can’t give anybody any advice. Will anyone think less of me? Will they assume I am lazy? Does anyone even care about my experience?
I struggle even feeling like I can give advice about body confidence anymore because I’m stuck. Can I be body positive while actively losing weight? Maybe I’m now transitioning to being body neutral – I just don’t want to be judged for or constantly think about my body. I want myself and everyone else to get up, get dressed, and to live our lives without thinking about what our bodies look like all the time. Comfortable in our own skin – isn’t that what we all want?
The paradigm of body confidence
I still feel torn because I don’t want to abandon my principles on body confidence and I cannot abandon the anger I have for how this world treats people in bigger bodies – but am I now disingenuous for saying that while living in a more traditionally “mid-sized” body? I don’t know.
Even if I wanted to abandon principles and move on, I couldn’t, because the change I see everyday in the way people treat me with less weight is startling. Men hold doors for me more now, women compliment me more, men listen to me more intently and look me in the eyes – It’s shocking and it’s a real thing. It’s devastating because everyone, at every size and every physical ability, should be treated with care and respect.
So how do I bundle all of these mixed emotions in a post that accurately describes how these medications have changed my life? It’s not like I’m trying to hide that I use them, if you ask me in person or in our DMs what I have been doing I constantly talk about Mounjaro. I tell my hairstylist, my gardener (if I had one,) my trainer, my colleagues, my friends, and my family how different I feel and why.
I struggle because while it’s important to talk about how this medication changed my life, it is just as important to tell people all the ways this medication – and losing weight in general – didn’t change my life.
Losing weight did not fix my problems
Being thinner didn’t solve my mental health problems. Being thinner didn’t make me smarter. It certainly didn’t make my house cleaner. It didn’t make me a more punctual person. Being thinner didn’t make me richer. It didn’t make me love myself more. It didn’t solve my self consciousness about certain parts of my body, like my arms (btw, free the arms is a movement I fully support and have been embracing!) Being thinner didn’t fix how society treats people living in larger bodies. Being thinner didn’t make me happier. Being thinner definitely didn’t solve the media’s fascination with judging people who take these medications or the media’s fascination with straddling the line of being too fat or being too thin.
So I sit here now, realizing maybe I didn’t need to frame this story at all, I just needed to tell it. Will I be on these medications forever? I don’t know. But even if I am, I don’t care. If I ended up being diagnosed as diabetic wouldn’t I be on those medications forever? If my inflammatory markers were still not budging wouldn’t I be on biologics for the rest of my life? As I inch closer toward my “medical” goal weight, I have even started to lower my dosage. I have been spacing out my injections by ten days, as opposed to seven, to account for supply issues and also to account for the coupon expiring ($$$) and guess what? I still feel pretty great.
So there you have it – that’s the full, honest, and true story of why my [Ozempic] face looks a little different these days.
You can read about Sarah’s experience with Ozempic here. Sarah and I will be working on creating a series of posts on our experiences GLP-1s and weight. If you feel it’s right for you, we highly encourage you to talk to your doctor.
