June 12, 2023 – Johnna Mendenall had by no means been “the thin pal,” she mentioned, however the calls for of motherhood – together with a sedentary desk job – made weight administration much more troublesome. Apprehensive that household sort 2 diabetes would meet up with her, she determined to start out Wegovy photographs for weight reduction.

She was nervous about potential negative effects. It took 5 days of staring on the Wegovy pen earlier than she labored up the nerve for her first .25-milligram shot. And certain sufficient, the negative effects got here on sturdy.

“The nausea kicked in,” she mentioned. “After I elevated my dose to 1 milligram, I spent the whole evening from 10 p.m. to five a.m. vomiting. I virtually stop that day.”

Mendenall is amongst a rising variety of individuals sharing private tales on-line concerning the weight reduction medicine Wegovy – and related medicine – delving into their typically disagreeable, and doubtlessly gut-wrenching, negative effects. 

Whereas gastrointestinal (GI) signs appear to be the commonest, a laundry listing of others have been mentioned within the information, on TikTok, and throughout on-line boards. These embody “Ozempic face,” or the gaunt look some get after taking the medicine, together with hair loss, anxiousness, despair, and debilitating fatigue. 

Mendenall’s major negative effects have been vomiting, fatigue, and extreme constipation, however she has additionally seen some optimistic modifications: the “meals noise,” or the urge to eat when she isn’t hungry, is gone. Since her first dose 12 weeks in the past, she has gone from 236 kilos to 215. 

Warning Label

Wegovy’s energetic ingredient, semaglutide, mimics the position of a pure hormone known as glucagon-like peptide, or GLP-1, which helps you are feeling well-fed. Semaglutide is used at a decrease dose beneath the model title Ozempic, which is authorised for sort 2 diabetes and used off-label for weight reduction.  

Each Ozempic and Wegovy include a warning label for potential negative effects, the commonest ones being nausea, diarrhea, abdomen ache, and vomiting.

With the surging recognition of semaglutide, extra individuals are getting prescriptions by way of telemedicine corporations, forgoing

 extra in-depth consultations, resulting in extra negative effects, mentioned Caroline Apovian, MD, a professor of drugs at Harvard Medical College and co-director of the Heart for Weight Administration and Wellness at Brigham and Ladies’s Hospital.

Specialists say beginning with low doses and progressively growing over time helps keep away from negative effects, however insurance coverage corporations typically require a quicker timeline to proceed protecting the medicine, Apovian mentioned. 

“Insurance coverage corporations are working towards drugs for us by demanding the affected person go up in dosage [too quickly],” she defined. 

Mendenall’s insurance coverage has paid for her Wegovy photographs, however with out that protection, she mentioned it might value her $1,200 per thirty days. 

There are related drugs available on the market, like liraglutide, offered beneath the title Saxenda. However it’s a every day, reasonably than a weekly, shot and in addition comes with negative effects and has been proven to be much less efficient. In one scientific trial, the individuals being studied noticed their common physique weight over 68 weeks drop by 15.8% with semaglutide, and by 6.4% with liraglutide.

Tirzepatide, branded Mounjaro – a sort 2 diabetes drug made by Eli Lilly that will quickly acquire FDA approval for weight reduction – might have fewer negative effects. In scientific trials, 44% of these taking semaglutide had nausea and 31% reported diarrhea, in comparison with 33% and 23% of these taking tirzepatide, though no trial has instantly in contrast the 2 brokers. 

Lack of Bowel Management 

For now, Wegovy and Saxenda are the one GLP-1 agonist photographs approved for weight reduction, and their maker, Danish drug firm Novo Nordisk, is going through its second scarcity of Wegovy amid rising demand. 

Private tales on-line about semaglutide vary from overwhelmingly optimistic – simply what some must win a lifelong battle with weight problems – to harsh situations with doubtlessly long-term well being penalties, and every part in between. 

One personal group on Reddit is devoted to a very disagreeable facet impact: lack of bowel management whereas sleeping. Others have reported uncontrollable vomiting.

Kimberly Carew of Clearwater, FL, began on .5 milligrams of Ozempic final yr after her rheumatologist and endocrinologist steered it to deal with her sort 2 diabetes. She was advised it got here with the bonus of weight reduction, which she hoped would assist along with her joint and again ache. 

However after she elevated the dose to 1 milligram, her GI signs, which began out delicate, grew to become insufferable. She couldn’t maintain meals down, and when she vomited, the meals would typically come up complete, she mentioned. 

“One evening I ate ramen earlier than mattress. And the subsequent morning, it got here out simply because it went down,” mentioned Carew, 42, a registered psychological well being counseling intern. “I used to be getting extreme heartburn and couldn’t take a pair bites of meals with out getting nauseous.”

She additionally had “sulfur burps,” a facet impact mentioned by some Ozempic customers, inflicting her to style rotten egg typically.

She was recognized with gastroparesis, the weakening and paralysis of abdomen muscle contractions that make it more durable to digest meals. Some sorts of gastroparesis might be resolved by discontinuing GLP-1 drugs, as referenced in two case experiences within the Journal of Investigative Drugs. 

Intestine Hormone

GI signs are commonest with semaglutide as a result of the hormone it imitates, GLP-1, is secreted by cells within the abdomen, small intestines, and pancreas, mentioned Anne Peters, MD, director of the USC Scientific Diabetes Packages.

“That is the deal: The negative effects are actual as a result of it is a intestine hormone. It is growing the extent of one thing your physique already has,” she mentioned. 

However, like Apovian, Peters mentioned these negative effects can seemingly be averted if photographs are began on the lowest doses and progressively adjusted up. 

Whereas the common beginning dose is .25 milligrams, Peters mentioned she typically begins her sufferers on about an eighth of that – simply “a whiff of a dose.” 

“It will take them months to stand up to the beginning dose, however what is the rush?” 

Peters mentioned she additionally avoids giving diabetes sufferers the utmost dose, which is 2 milligrams per week for Ozempic (and a pair of.4 milligrams for Wegovy for weight reduction). 

When requested concerning the medicine’ negative effects, Novo Nordisk responded that “GLP-1 receptor agonists are a well-established class of medicines, which have demonstrated long-term security in scientific trials. The most typical adversarial reactions, as with all GLP-1 [agonists], are gastrointestinal associated.”

Is It the Drug or the Weight Loss?

Nonetheless, non-gastrointestinal negative effects like hair loss, temper modifications, and sunken facial options are reported amongst semaglutide customers throughout the web. Whereas these circumstances are sometimes what’s identified within the medical world as “anecdotal,” that are private, however not at all times simply verified scientific experiences, they are often very heartfelt.

Celina Horvath Myers, also referred to as CelinaSpookyBoo, a Canadian YouTuber who took Ozempic for sort 2 diabetes, mentioned she started having intense panic assaults and despair after beginning the medicine. 

“Who I’ve been these final couple weeks, has in all probability been the scariest time of my life,” she mentioned on her YouTube channel. 

Whereas extreme despair and anxiousness aren’t established negative effects of the medicine, some individuals get anhedonia, or the “diminished capability for pleasure,” mentioned W. Scott Butsch, MD, MSc, director of weight problems drugs within the Bariatric and Metabolic Institute at Cleveland Clinic. However that may very well be a pure consequence of decrease urge for food, he mentioned, on condition that meals offers most individuals pleasure within the second.

Many different reported modifications come from the load loss itself, not the medicine, mentioned Butsch.

“These are medicine that change the physique’s weight regulatory system,” he mentioned. “When somebody loses weight, you get the shrinking of the fats cells, in addition to the atrophy of the muscle mass. This speedy weight reduction might give the looks of 1’s face altering.”

For some individuals, like Mendenall, the negative effects are value it. For others, like Carew, they’re insupportable. 

Carew mentioned she stopped the medicine after about 7 months, and progressively labored as much as consuming stable meals once more. 

“It’s the American approach, we have all bought to be skinny and delightful,” she mentioned. “However I really feel prefer it’s very unsafe as a result of we simply don’t know the way severely our our bodies will react to those issues in the long run. Folks see it as a fast repair, however it comes with dangers.”

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