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Ozempic | Weight Loss

21,651 Views | 95 Replies | Last: 1 mo ago by BassCowboy33
fulshearAg96
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Anyone have experience w Ozempic for weight loss?
FIDO*98*
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Wegovy is the brand name of the Semiglutide based drug that ls indicated for weight loss. It's a higher dose than Ozempic and yes you'll lose weight. They have a coupon code right now that makes it $25/mo. You'll likely experience some nausea early on
FitzChivalry
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Been taking Ozempic off label for about 4 months now to help with type 1 diabetes management.

I have lost close to 20-25 lbs with it. No change in exercise habit. It will change your diet habits.

Before fine tuning I did experience some pretty severe nausea and GERD from the Ozempic.
fulshearAg96
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Thxs for the responses. Was this something you were able to get from a general/family physician? Or did you have to go route of specialist? thanks, aaron
FIDO*98*
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Now that Wegovy is indicated for weight loss in non-diabetic patients it shouldn't be a problem getting it from your PCP.

Word of advice. Change your eating habits while losing the weight. I've seen several friends gain the weight back when they stopped the Ozympic.
FitzChivalry
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Definitely go the Wegovy/PCP route. Most prescribers will be hesitant to rx off label ozempic (I've seen this a lot with my T1D friends and patients).

Very solid advice from Fido. Change your eating habits and portions. Implement a little exercise in as well and you will see some awesome changes. I wish I knew this before.

I would recommend testing dosages out in two week intervals. If the dosage is too high you will know from physical symptoms (nausea, fatigue, constipation, acid reflux etc.)
fulshearAg96
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Appreciate the feedback!
KidDoc
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Thanks for the feedback, I haven't kept up with this much as most weight loss drugs, as mentioned, are transient and you just bump back up. I've struggled with weight as a child then after med school/residency. I exercise and watch my diet with IF as well but still plateau badly and have to cut calories to 1200 or less to actually drop weight but I cannot sustain that over time as it is pretty miserable.

I'm going to get in touch with my PCP see if he has any experience with this one, the mechanism seems interesting.

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Semaglutide is a selective glucagon-like peptide-1 (GLP-1) receptor agonist that increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, slows gastric emptying; also acts in the areas of the brain involved in regulation of appetite and caloric intake.
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Discovery77
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I started Ozempic in NOV 2020. I had to see a Diabetes and Metabolism specialist b/c my A1C 1 was over 7.

I started out on the 0.5 mg and in march moved up to 1 mg. It def has curbed my appetite and working from home I have changed my eating habits and exercise at least 4-5 days a week.

My starting weight was 326 lbs (I am 5'9) and as of last week I weighed in at 249 lbs. My A1C was 5.0 as well.

I would say start out at the 0,5 mg, and ease into the 1 mg. I did not experience any nausea, but I did have to begin to understand how to stop eating so much (portion control, no tortillas (live in SA) etc.b/c you definitely feel much fuller faster.

And if you begin taking it, sign up for that discount thru the website, it was costing me over $200 the first few months I was using it, and naturally I found out and now it's like $25 a month.

Happy to discuss this more, good luck!
KidDoc
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Nice outcome!

I'm still waiting for my PCP to call back but it isn't urgent and so I get it taking a bit of time.

I'm 5'10" peak weight way back in 2004 or so was 285, dropped down to 195 about 8 years ago with 1200 or less calories per day and lots of jogging. That resulted in fatigue, the blahs, severe morning back stiffness, and Morton's neuroma of the foot so I had to cut the jogging and caloric restriction. Drifted back up to 245 and stuck there for years with just IF and eating salad with protein most every lunch, dropped to 235 by adding Supernatural VR 3-5 days a week and once again stuck for about a year.

Blood sugars and BP still fine thankfully, dyslipidemia responded well to Atorvastatin with no side effects-- I'm just inching up on 50 and this looks like an actually decent treatment with pretty nice outcomes so figure I would like to give it a go if my doc thinks it is worth the hassle and cost.
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Discovery77
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Thanks Doc.

Yes, I was also put on BP meds, and have been back in a normal range from my last two labs. The specialist I see also said Ozempic offered cardiovascular benefits. I still need to review that as well.

I am curious to see what they say when I reach my target weight (200 lbs) and if they dial me back, or keep me on Ozempic. If it is up to me, I do not see any reason to stop, unless instructed by my doc.

BBQAG92
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I started Ozempic back in April of this year. I was considered pre-diabetic, so asked my pcp if he could prescribe this for weight loss. He did, and I started off at .25mg for a month, then went up to .50 mg and am now at 1 mg weekly. I agree with others - it will definitely cause some gastric distress and force you to change your eating habits. BUT! I went from 300 lbs to 270 in about 6 months. Unfortunately, I've plateaued for the past few months. I'm going to talk to my pcp and see if I can switch over to wygove which has increments up to 2.4 mgs. Good luck!!
KidDoc
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I'm still waiting on the Prior authorization process with my insurance. Not a surprise.
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Stringfellow Hawke
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KidDoc said:

I'm still waiting on the Prior authorization process with my insurance. Not a surprise.


Can you not just write yourself a prescription? Not like it is Oxy…
KidDoc
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Stringfellow Hawke said:

KidDoc said:

I'm still waiting on the Prior authorization process with my insurance. Not a surprise.


Can you not just write yourself a prescription? Not like it is Oxy…
No, that is a good way to get in trouble with the TMB(Texas Medical Board). There was a surgeon out of Madisonville recently who got on probation for writing for Bactroban(a topical antibiotic) for family without charting it.
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Stringfellow Hawke
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KidDoc said:

Stringfellow Hawke said:

KidDoc said:

I'm still waiting on the Prior authorization process with my insurance. Not a surprise.


Can you not just write yourself a prescription? Not like it is Oxy…
No, that is a good way to get in trouble with the TMB(Texas Medical Board). There was a surgeon out of Madisonville recently who got on probation for writing for Bactroban(a topical antibiotic) for family without charting it.


That is interesting. I just thought Doc's would be able to write prescriptions in a manner consistent with the goal of taking care of themselves and loved ones.
KidDoc
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I got a robocall that my PA was approved (BMI 33 body fat %27 with dyslipidemia that is controlled with atorvastatin 10mg). I plan to start at the end of the month as I'm heading to Cancun in a week and don't want to worry about side effects with a new medicine in Mexico.
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Stringfellow Hawke
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KidDoc said:

I got a robocall that my PA was approved (BMI 33 body fat %27 with dyslipidemia that is controlled with atorvastatin 10mg). I plan to start at the end of the month as I'm heading to Cancun in a week and don't want to worry about side effects with a new medicine in Mexico.


Hell, pick up a year's supply in Mexico. South of the border you can probably write a prescription for whatever you want…
KidDoc
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Finally got approved through insurance but I have a Cancun trip next week and I don't want to start a new med and deal with possible side effects in Mexico so I'll start it 11/2021. Should be interesting to see if this is a valid tool in the chronic battle of the bulge.
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fulshearAg96
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I got denied wegovy because my BMI is not high enough. My buddy gets Ozempic thru a wellness clinic. Unfortunately they are not taking new patients.

I'm in Houston... If anyone has options to get a hold of either please let me know.
KidDoc
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fulshearAg96 said:

I got denied wegovy because my BMI is not high enough. My buddy gets Ozempic thru a wellness clinic. Unfortunately they are not taking new patients.

I'm in Houston... If anyone has options to get a hold of either please let me know.
The FDA indication is BMI > 27 with any complication (HTN, dyslipidemia, DM) or BMI > 30.

If you don't fit that then it makes sense, if you do fit any of those parameters it is possible they didn't fill out the prior authorization paperwork properly.
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FitzChivalry
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Did the pharmacy deny it or your HCP?

If pharmacy then I would definitely try the PA route mentioned above. Contact your pharmacy to start this.

If the HCP denied it there may be good reason. I would talk with your HCP and see why they denied it and go from there.

You can always check to see if there are clinical trials going on as well. Might be difficult to locate but if you are the right patient it is generally smooth sailing.
fulshearAg96
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OK. Good news. I spoke to the Dr's office and got my prescription approved. I use Cigna for health insurance. Bad news is my out of pocket is 1,537.88 for 4 pins. Is this what others are experiencing as far as out of cost expense for Wegovy?
KidDoc
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fulshearAg96 said:

OK. Good news. I spoke to the Dr's office and got my prescription approved. I use Cigna for health insurance. Bad news is my out of pocket is 1,537.88 for 4 pins. Is this what others are experiencing as far as out of cost expense for Wegovy?
Mine was $50 for the first month, $25 after the online coupon after the PA went through (took about a week).

You may have a pharmacy deductible you haven't met?

That sounds like the cash price and just not covered. Most likely the doc has to do a prior authorization (PA) to prove you meet criteria for insurance to cover it.
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permabull
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If I were to try a diabetes medication for weight loss I would ask my doctor for Metformin. It is available as a generic and cheaply available if your insurance won't cover it for off label use.

https://pubmed.ncbi.nlm.nih.gov/23147210/

I'm not a doctor nor have I taken this medication, but I have struggled with weight and gotten control of it by controlling my insulin via diet and fasting. I believe the reason these diabetes drugs are effective for losing weight is because they decrease your insulin resistance, which is exactly what metformin does for a lot less money.
KidDoc
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The Wegovy dose is specifically FDA approved for weight loss. Metformin is not.

I'm not disagreeing with trying it but in real world data the weight loss with metformin is minimal at best. Wegovy showed 15-20% loss over 12 months vs placebo.
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fulshearAg96
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KidDoc said:

fulshearAg96 said:

OK. Good news. I spoke to the Dr's office and got my prescription approved. I use Cigna for health insurance. Bad news is my out of pocket is 1,537.88 for 4 pins. Is this what others are experiencing as far as out of cost expense for Wegovy?
Mine was $50 for the first month, $25 after the online coupon after the PA went through (took about a week).

You may have a pharmacy deductible you haven't met?

That sounds like the cash price and just not covered. Most likely the doc has to do a prior authorization (PA) to prove you meet criteria for insurance to cover it.

List price for the 4 pins - 5,900 p/pharmacy
My price - 1,500 for 4 pins
The wegogy discount card gets it down to 1,100 for the first 4 pins

I've asked my Dr to go back to my insurance provider - Cigna - and see what else can be done.
FitzChivalry
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Call your Pharmacy Benefits Manager (PBM). This is usually separate from Cigna. Look for an RX BIN on your card to determine who your PBM is. It will be 6 digits. Customer service can tell you if a PA was filed/approved and give you more reasoning for price.

Maybe check with a distributor as well? Cardinal Health, CCS, Edgepark etc.
KidDoc
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Good advice.

My pharmacy company is OptumRX and they sent a robocall once the PA went through.
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permabull
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What are your thoughts on using the injection for semaglutide rather than the tablet (Rybelsus)? Do you expect the tablet to eventually be approved for weight loss?

KidDoc
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hypeiv said:

What are your thoughts on using the injection for semaglutide rather than the tablet (Rybelsus)? Do you expect the tablet to eventually be approved for weight loss?


Great question and I'm not sure. I would assume that the drug company has tried to prove it works for weight loss and the studies have not supported it. Drug companies do not have to publish failed studies, they can pick the good ones. They would love to move more product and a pill that is proven effective for weight loss would be printing $$$.
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permabull
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Thanks for the reply... Can I also get your thoughts on why you think these medications work? My hypotheses is type 2 diabetes medications that lower insulin help your body get into ketosis which allows you to burn body fat for fuel rather than glucose. I can't help but notice that the side effects of these drugs (nausea, diarrhea, constipation, decreased appetite) are very similar to what people call the "keto flu". Like the "keto flu" these side effects usually only last for a week until your body adapts.
KidDoc
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hypeiv said:

Thanks for the reply... Can I also get your thoughts on why you think these medications work? My hypotheses is type 2 diabetes medications that lower insulin help your body get into ketosis which allows you to burn body fat for fuel rather than glucose. I can't help but notice that the side effects of these drugs (nausea, diarrhea, constipation, decreased appetite) are very similar to what people call the "keto flu". Like the "keto flu" these side effects usually only last for a week until your body adapts.
I've been thinking alot about this and I think it is multifactorial.

1) Slowed gastric emptying- if you overeat or eat a bunch of spicy stuff it is going to sit in your stomach a good while and give you heart burn or nausea. This is a negative reinforcement to overeat. It will also make you feel full much longer with smaller portions. Similar to how gastric sleeves work really but not surgical.

2) what you said- helps your insulin work better dropping sugar faster and inducing ketosis much easier and putting your fat on burn notice as an energy source

I can see why most adult docs don't want to prescribe this as it is a new FDA indication (June 2021) and historically weight loss drugs have been flops. I've been stuck for a few years in my late 40s despite exercise and a pretty lean diet (no breakfast, home cooked dinner, salad + protein for lunch, no snacks) most days so I'm happy to give it a go.

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permabull
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I don't blame you for trying... I would love to give it a try too but the price scared me away. I'd like to experiment with metformin if my PCP is okay with it, I just haven't seen him since I found out about that medication. If he says no, I won't go doctor shopping but I am going to get his input on it next time I am there for my annual.

It would be interesting if you could use the ketone urine test strips before and after you start taking the medication to see if it is indeed causing you to lose more ketones in your urine which is what leads to the weight loss.
KidDoc
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I started mine on Monday. I used the auto-injector on my right outer thigh- once it was done injecting and I removed it from the skin it squirted about 1/3 of the dose into the air. My thigh's are fairly meaty and not too flabby so I should have known better and I just need to stick it in my flabbiest part which is the stomach.

Anyway no side effects noted, appetite does seem to be a bit easier to control and I feel fuller sooner by a small bit. I have dropped a few lbs this week but I fluctuate a few lbs day to day so not really excited or anything. I've bounced 233-237 for about 4 years and now at 232- I'll be happy once it drops below my physiological plateau which seems to be 235ish.

No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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