Getting less fat in 2017... With technology!

Yep if it’s a problem just drop back down.

Yeah, I hope to take it with a 1.7 still left in “reserve”

2.4 approved and on the way. I have 2 1.7 pens left, I might leave the 2 in reserve to feather back onto if 2.4 is too intense.

So when you up the dosage does that result in eating even fewer calories? Or does is jumpstart weight loss in some other manner?

You have less appetite, yes. Helps get past a plateau.

Yeah, I am still losing on the 1.7 but maybe at 2-3 lbs a month, so time to up.

Plus the side effects have stabilized a bit.

My feeling is eventually everybody plateaus, but at a different spot as everybody responds differently. I may have been lucky dropping as much as I did and hitting my “ideal” BMI. Then again I’ve been stuck on semaglutide for a couple months due to tirzepatide being unavailable, and I did find it to be substantially more effective.

Yeah, we will see where I get to on the 2.4

Welp, couple annoying roadblocks.

CVS Caremark just sent me a letter saying they can no longer fill 2.4 mg prescription through mail order due to “shortages”

Calling around, the 2.4 is one of the few doses that currently isn’t on shortage, multiple local pharmacies had it in stock, so … odd. I have a feeling they just don’t want to pay to ship it anymore, because it requires so much packaging. Even though they are my insurances’ “preferred” provider they suggest to use. I have other in network options.

Gonna have to find a new place to get my prescription filled, just going to go with my local clinic pharmacy. Glad I have 2 1.7 pens in reserve to get me through this fuckery.

Also, the 2.4 is just absolutely wrecking my body. Just complete intestinal evacuation the first 2 weeks using it, (though week 2 was better) and now on week 3 the exact opposite happened, completely stopped up for 72 hours, I had to push the panic button and utilize the demon elixir combo that is Bisacodyl/PEG (I was already on day 2 of miralax). That worked. I looked up some advice and the suggestion was to use Colace with Senna root, so I picked up some of that, it is supposed to be gentler than Bisacodyl.

The side effects appear to have no rhyme or reason as to what happens or why. They are manageable (read: tolerable) but boy does this stuff pack a punch. Either I am completely stopped up or the opposite, and then some weeks, no side effects at all.

Huge tip for those on the drug, Simethicone (gas-x) is so amazing. One of the worst side effects (even more than the intestinal trauma) is the unbelievable amount of gas this causes, some days I am just constantly burping (look up ozempic burps, or sulfur burps) and they are incredibly unpleasant. Simethicone has been awesome though, it really cuts things down to where I don’t wake up in the middle of the night so bloated I can’t sleep until I burp for 10 seconds straight. (This is exacerbated by my bipap use, which introduces a little gas that leaks into the digestive tract as well)

Anyway, going to stick on the 2.4 for another round of doses, but I do hope the side effects lessen, otherwise I might drop back to the 1.7 for loss. It will be slower, but more tolerable.

Edit: I was correct. Had to get on the phone with the CVS people to sort out moving the prior auth to a new pharmacy. They said they are discontinuing the GLP-1 drugs from all mail service (except in rare cases) and moving all distribution to retail locations. Which would make sense, they have to ship wegovy cold, and that has to eat into costs quite a bit.

Also, wanted to share this youtube account about weight loss, some great stuff

On weight loss “Plateaus”

Your body does not want you to lose weight, it will actively fight this, because it doesn’t care about you being overweight, your metabolism is built around maintaining your current weight, losing weight = dying.

He gives some pretty good examples about how this works, that your body will expect the same calories in each day, despite your weight loss reducing your base calories burned daily.

If you want to breakthrough the plateau, you need to change up things (or wait), increase calorie deficit through exercise, better track calories in, or up your dose (or change drugs)

Great info.

More info on the insurance situation.

My insurance is requiring I come in for a “weight check” to verify that I am losing weight on the drugs. Why you would take these and endure the side effects if they aren’t working, is beyond me, but it is clear they are trying to cut people off.

Luckily for me, I am down nearly 50lbs, and they are working. Funny thing is, I had a physical just about a month an a half ago, where they weighed me, and my doctor and I high fived over my BMI dropping 5 points, but this appt needs to be done within 30 days of the pre-auth.

JFC.

Insurance sucks, Novo Nordisk sucks, the healthcare system sucks. I just want to be healthy.

Yeah, they all make it very annoying. I’ve gone through dozens of phonecalls in the past 3 months to find mounjaro 15mg in stock, get my prescription changed, etc. Literally dozens.

The drugs are very expensive, so annoying people into giving up is a rewarding strategy.

Maybe too make sure you are taking them? Wouldn’t surprise me if some people were selling the stuff.

I doubt that. If you can’t afford legitimate semaglutide/tirzepatide you take a road trip to Canada or Mexico, perhaps, for around $300/month. Or if you’re really out of your frickin’ mind you order from a compounding pharmacy and cook it up yourself. (Don’t do this.)

Yeah, reselling the legit stuff is a weird game to be playing, but I am sure there are people doing it.

Anyway, I got a 15 min appt with the doctor to come in, take a weight and leave.

I fucking ENVY the folks that are getting multiple month supply shipped to them. Hearing a lot of people getting a 90 day supply.

Upside for me is, that pre-auth I got for 1 year of 2.4 was just like 45 days ago, I have lost more weight since then, so this pre-auth will cruise through and I won’t have to worry about coverage for at least 12 months.

Getting the drug in my hands however… I called 2 pharmacies and they both had it in stock.

At least the 2.4 is fairly easy to get, it is the starter doses that are impossible to get.

I am also lucky, because due to weird timing issues, i have 2 extra doses of 1.7mg that I can keep in the fridge as backup for when I get fucked over by supply issues. You can stretch out dosing too, by taking every other week as well, so in an absolute worst-case scenario I got about a month of breathing room.

Yeah I get 3 pens at a time for $90. WHAT A TIME TO BE ALIVE!

I get 4 pens in a box (1 month) for 125$. And then every month I have to worry if I am going to have to fucking call around to multiple places just to get my doses.

As time moves on, however, the shortages will ease as supply will catch up to demand.

Also, some great preliminary research on how that stopping these drugs might not mean an immediate weight gain

Not much data on the new drugs, but for Saxenda, which is a related drug, the weight loss appears to stick even after stopping the drug, for a significant number of patients.

Also starting to get long term data on the drug’s efficacy

The Danish study also showed promise that those who do a “step down” treatment to slowly wean themselves off of the drug, tended to keep weight off more easily after completely stopping.

I think we have some really exciting things in the future, and I really do think that we have some knowledge on how this Obesity epidemic can be fought.

I am just so happy at how much healthier I have felt, and I am excited to see where I am by the end of the summer. My goal is to lose 100 lbs (to start) and I am nearly halfway there. To be able to remove the word “morbidly” from obese would be such a huge accomplishment.

Oh my Ozempic pens are 4 doses per pen. It comes with 4 needles that you attach each time though. Weird.

Yeah, WeGovy is 1 dose/pen.

Also, I tried on my old pair of jeans this morning. I can fit a fist in the waistband, and I need my stretchy belt to keep them from falling. These were, by far, my largest pair of jeans I ever bought, and I have some older ones that are still a bit snug, but progress is progress.

I am leery of buying a new pair just yet, because I don’t want to buy something that will be too big in a few more months.

Not immediate, but the general consensus is most people do gain the weight back.

My guess is US insurers are trying to follow the UK NIH on weight loss in that once you lose the weight, they stop paying for the meds. This will be disastrous of course but they will try to do it.