In 2009 at 38 years old, Joan Lewis underwent chemotherapy to treat breast cancer. From that point on, she began to gain weight.
“My weight always was about the same even after having children. I think going through chemo-induced menopause in overdrive at 40, weight just piled on and it was impossible to lose,” Lewis told Healthline.
She said treatment changed her body chemistry and that the foods she used to eat her entire life became less tolerated and impacted her weight.
For the past 12 years, Lewis tried various diets and weight loss programs, including Weight Watchers, Noom, Keto, anti-inflammatory diet, Whole 30, low carb, and Ideal Protein.
“Before I had children, Weight Watchers was my go-to. I had such success. After treatment, I tried them all and I would lose a few and gain a couple back. It always seemed that my body did not want to give in and keep the weight off,” Lewis said.
Diabetes diagnosis and turning to medication
Over the past few years, Lewis’s blood sugar levels began to increase, and in September 2022, she was diagnosed with type 2 diabetes.
“Both my cardiologist and primary care doctor knew how frustrated I have been with trying to lose weight,” she said.
After her diagnosis, her doctor prescribed Metformin, a medication used to treat type 2 diabetes, that works by lowering blood sugar. Lewis also met with a dietician to develop a low-glycemic diet. However, after taking Metformin and sticking to the diet for 3 months, her A1C still went up.
“We chose to start a low dose of Ozempic to try to get my A1C down and to help kick start some weight loss,” said Lewis.
Ozempic is an injectable medication that stimulates GLP-1 receptors in the pancreas and other parts of the body, and, as a result, enhances insulin secretion in response to high blood sugar, explained Dr. Sethu Reddy, president of the American Association of Clinical Endocrinology.
“Ozempic would also tend to reduce the levels of glucagon, which is an anti-insulin hormone. In addition to improving sugar control in those with type 2 diabetes, these agents appear to reduce appetite and increase satiety, thus resulting in potential weight loss. The weight loss can also help further improve blood sugar control,” Reddy told Healthline.
Ozempic includes the active chemical compound semaglutide.
Dr. Rekha B. Kumar, associate professor of medicine at Cornell and Chief Medical Officer at Found, said semaglutide helps with weight loss by increasing feelings of fullness, delaying stomach emptying, and lowering blood sugar.
“Semaglutide, under the name Wegovy is an FDA-approved medication for obesity management. So, Ozempic can help with weight loss in patients with diabetes,” Kumar told Healthline.
Ozempic is only FDA-approved for the treatment of type 2 diabetes, however, “when patients who have diabetes also have obesity, Ozempic is a good choice medication,” Kumar said.
Using Ozempic for weight loss in the absence of type 2 diabetes is considered “off-label use” of the medication.
In 2022, the Food and Drug Administration reported shortages of Ozempic. This caused some controversy because in some cases, people were taking the medication off-label for weight loss.
“Given the recent supply issues in general, one would prioritize diabetes management,” said Reddy. “However, weight loss in those without diabetes will be an increasing indication in the future. The use of GL-1 analogs for weight loss will also depend upon insurance policies and access to these agents.”
Losing weight and experiencing side effects of Ozempic
Lewis started taking Ozempic in January 2023, and since then has lost about 4 pounds per week.
“I am not hungry at all. I get full very quickly,” she said. “I used to snack when I would get home [from work] or be so hungry at lunch. Not anymore.”
However, she does experience some side effects, including an upset stomach when she eats fatty or greasy foods like french fries.
For most people, side effects are mild and cause gastrointestinal symptoms, such as nausea, vomiting, and reflux, said Reddy.
“Since the injection is given every 7 days, the side effects may be earlier in the week,” he noted. “There have been reports of pancreatitis (inflammation in the pancreas) with use of agents like Ozempic, but no cause-effect has been demonstrated. Nevertheless, if an individual has had pancreatitis, one would be cautious about initiating a GLP-1 analog.”
Another potentially serious adverse effect could be an increased risk of tumor growth in those with a relatively rare form of thyroid cancer (medullary), said Kumar.
“Patients who have medullary thyroid cancer, genetic syndromes that include medullary thyroid cancer, pancreatitis, and severe acid reflux and gallstones would not be good candidates,” she said.
Lewis said taking the medication has forced her to change her diet.
“Sometimes foods taste very different and not in a good way. I love coffee, but sometimes the flavor is so intense that I get a little queasy,” she said.
The medication puts her in touch with her food choices, too.
“I have been very aware of what foods I am eating. I know if I do eat high fat foods, I will most likely not feel very well. Kind of a new mindset,” she said.
Ozempic needs to be taken long-term
Ozempic is only intended for long-term use to treat diabetes and when it is used off-label for weight loss, Kumar said it needs to be continued long-term to maintain the lost weight.
However, Reddy noted that people who take Ozempic should be monitored closely by their doctor “[for] worsening sugar control over time and eventually, almost all patients with type 2 diabetes will require insulin therapy,” he said.
Still, he anticipates that Ozempic and other medications like it will become more and more widely used.
“These agents have also been proven to be cardioprotective and combined with glucose and weight lowering properties, they will be increasingly popular in the medical toolbox,” Reddy said.
For now, Lewis plans to keep taking Ozempic for diabetes and weight management.
“If this drug can help lower my A1C and help me shed a few pounds, I will be more motivated to keep it off and feel better about my health and self,” she said. “[But], I really do not know how long I will be on this drug.”
Leave A Comment