How, exactly, does Ozempic work?

[Anonymous]

I've been on Tirzeptide for 8 weeks to lose 20-30 pounds I've gained from a combo of Perimenopause and a new thyroid diagnosis. I've intentionally kept my dose low to avoid full appetite suppression as that isn't sustainable long term. So, I still have an appetite, it's just less than it has been the last couple of years. I've lost 14 pounds so far which has been great but honestly, the biggest benefit has been the decreased inflammation. My body was in constant pain prior to going on the GLP1. Apparently, decreased estrogen does a number on our bodies, including increasing cortisol and inflammation. I'm prepared to supplement with estrogen but my doctor would like me to wait until I'm no longer menstruating. My plan is to titrate down once I'm at goal weight and then only do a microdose 1x a month or so. I work in health care and these meds are FASCINATING from a precision medicine perspective. I'm also motivated to microdose longterm because GLP1s may reduce dementia risks, which my genetics make me more susceptible to.

[Anonymous]

I've been on tirzepatide for 13 months, during which time I've lost almost 80 pounds, which is close to 1/3rd of my body weight.

I never went to a high dose, I never totally lost my appetite. I enjoy food, eat whatever I want, and have managed steady weight loss without significant negative side effects.

I can absolutely see how someone could take a high enough dose that they have zero appetite, and/or have ground their digestive system to such a halt that they can't really eat. Obviously that isn't healthy.

[Anonymous]

Anonymous wrote:Also, I am a foodie. New recipes and special meals are something that bring me pleasure.

Why take a drug that tamps down your enjoyment of a whole category of experiences?

Because you are obese? Which is a chronic health condition that can kill you if you don't get treatment?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also, I am a foodie. New recipes and special meals are something that bring me pleasure.

Why take a drug that tamps down your enjoyment of a whole category of experiences?

Because for some of us, food and all it involves comes with a mental torture that far outweighs the enjoyment you experience. Cocaine addicts also enjoy the high, but it's not something you'd support, is it?

Addiction is addiction and food noise isn’t “normal”. Therapy helps in permanent ways miracle meds never will.

Wait, so if I just get therapy, the food noises that I’ve been battling for years will go away? Say more about that.

If you’re willing to be open and explore why you crave the dopamine hit you get from anticipating food (similar to a sex accident with sex, a gambler with gambling, a drug addict with drugs, a shopping addict with shopping…) then yes, it could potentially help you. I’m willing to bet you likely feel awful after giving in to these cravings, and like you have no control over them (like a sex addict with sex, gambler with gambling, drug addict from drugs, shopping addiction from shopping…) All addictions start with trauma.

OMG, the sanctimonious judgment is just oozing from this post. If I just had some therapy for the nonexistent trauma in my life (grew up in a healthy, stable home with parents who still love one another, in my own positive marriage raising two kids, again no trauma), then my food noises would go away! I just need some more WILLPOWER! I guess it has nothing to do with brain chemistry that is different for different people. Do you think this therapy would work on things like lowering cholesterol and blood pressure?

Taking GLP-1 has been a game changer for me. I still enjoy food, but I’m not thinking about it all the time. I can enjoy the taste and be satisfied. It’s a feeling I haven’t known in decades. I’m just much more relaxed. Yes, I attribute it to Ozempic.

There’s a lot of promise that GLP-1s can help with other addictions you mentioned. Again, it’s about brain chemistry, not just “being stronger.” Your judgment of people who are dealing with any kind of addiction is gross. Therapy is wonderful for so many people for so many reasons. To prescribe it as the truest way to deal with addiction denies the real science that acknowledges there is an actual physiological basis to some people being overweight and struggling to lose it.

It’s not a good look when you’re telling people that being overweight is unhealthy, but if you don’t work to lose the weight in the way that I think is best, then you’re also unhealthy and even worse, you’re just a damaged person because you don’t have the will power to manage this supposed trauma.

Please describe the testing that showed that you have “brain chemistry that is different for different people”?

Oh that’s right, you just made that up because it sounds good.

[Anonymous]

How are you all finding doctors who know enough about these drugs to precisely dose them for you and your goals? My GP seems to know as much or really as little as I do about them.

If anyone has a dmv doctor rec, I’ll take it.

[Anonymous]

Anonymous wrote:How are you all finding doctors who know enough about these drugs to precisely dose them for you and your goals? My GP seems to know as much or really as little as I do about them.

If anyone has a dmv doctor rec, I’ll take it.

Dr. Ali at VHC is wonderful. He really takes time to listen. He does not prescribe to compounding pharmacies FWIW. In my case, there was an expectation that I would see a nutritionist and a psychologist in the office as well, but I have binge eating disorder.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also, I am a foodie. New recipes and special meals are something that bring me pleasure.

Why take a drug that tamps down your enjoyment of a whole category of experiences?

Because for some of us, food and all it involves comes with a mental torture that far outweighs the enjoyment you experience. Cocaine addicts also enjoy the high, but it's not something you'd support, is it?

Addiction is addiction and food noise isn’t “normal”. Therapy helps in permanent ways miracle meds never will.

Wait, so if I just get therapy, the food noises that I’ve been battling for years will go away? Say more about that.

If you’re willing to be open and explore why you crave the dopamine hit you get from anticipating food (similar to a sex accident with sex, a gambler with gambling, a drug addict with drugs, a shopping addict with shopping…) then yes, it could potentially help you. I’m willing to bet you likely feel awful after giving in to these cravings, and like you have no control over them (like a sex addict with sex, gambler with gambling, drug addict from drugs, shopping addiction from shopping…) All addictions start with trauma.

OMG, the sanctimonious judgment is just oozing from this post. If I just had some therapy for the nonexistent trauma in my life (grew up in a healthy, stable home with parents who still love one another, in my own positive marriage raising two kids, again no trauma), then my food noises would go away! I just need some more WILLPOWER! I guess it has nothing to do with brain chemistry that is different for different people. Do you think this therapy would work on things like lowering cholesterol and blood pressure?

Taking GLP-1 has been a game changer for me. I still enjoy food, but I’m not thinking about it all the time. I can enjoy the taste and be satisfied. It’s a feeling I haven’t known in decades. I’m just much more relaxed. Yes, I attribute it to Ozempic.

There’s a lot of promise that GLP-1s can help with other addictions you mentioned. Again, it’s about brain chemistry, not just “being stronger.” Your judgment of people who are dealing with any kind of addiction is gross. Therapy is wonderful for so many people for so many reasons. To prescribe it as the truest way to deal with addiction denies the real science that acknowledges there is an actual physiological basis to some people being overweight and struggling to lose it.

It’s not a good look when you’re telling people that being overweight is unhealthy, but if you don’t work to lose the weight in the way that I think is best, then you’re also unhealthy and even worse, you’re just a damaged person because you don’t have the will power to manage this supposed trauma.

Please describe the testing that showed that you have “brain chemistry that is different for different people”?

Oh that’s right, you just made that up because it sounds good.

Here’s one example
https://d1wqtxts1xzle7.cloudfront.net/74732494/s0140-6736_2800_2903643-620211116-16329-1keojzc-libre.pdf?1637076701=&response-content-disposition=inline%3B+filename%3DBrain_dopamine_and_obesity.pdf&Expires=1741784556&Signature=E341fx6~0hKKnl-oxHOTxKgl7JgaUB0GH377p98Ty1QaGmEedlvDD1gotwKyZxB8qOCTXhc2ZsN6O--JoE6y2DNTcXfLnBCQw9CrTWGWrIQveiI1KI9qujVTUsfqZiZkctb5IbJSz38ugTURVeoy-k5ZDIYjgCOXhW0~JIL9txPJCZf9qhupjAx5Q4pbPCapm5Oo~jCdZolgd3mhrmTUgMO3N3ZZq3W1TOXxMU9gpuzXXjHkVmdEr~KobhVtpcQoF0yyQyBtqYQTFsiMhmIIVXmPtlwseGqgANAKoCwSNjVf2zUTLEVrzzR0F7sOK1i-l3KDu7TZCS6pU30D~UYU7Q__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA

[Anonymous]

Anonymous wrote:Also, I am a foodie. New recipes and special meals are something that bring me pleasure.

Why take a drug that tamps down your enjoyment of a whole category of experiences?

That’s a faulty premise for many of us on these drugs. I enjoy food so much more now that there isn’t a lot of anxiety or food noise around it. I can actually slow down when I’m eating and taste of the food. Things actually taste better. I have zero food aversions on Zepbound and I have been able to eat everything I was able before, in fact, I can actually eat more because it has put my IBS into remission.

[Anonymous]

She needs to lower her dose. My doctor is adamant that it shouldn’t cause discomfort, starvation, or lethargy.

[Anonymous]

Anonymous wrote:She needs to lower her dose. My doctor is adamant that it shouldn’t cause discomfort, starvation, or lethargy.

I think this is a real risk of using telehealth providers for this specific medication. I think a lot of the people who aren't doing well with it are not seeing doctors regularly