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I could stand to lose about 40 pounds. At my request, my doctor prescribed Wegovy, but it's on backorder so I was offered semaglutide from a compounding pharmacy. I've taken two doses so far; I really don't feel much of a difference yet. It kind of seems like I might feel something in the day or two after the shot. Maybe.

Does anyone here have much experience with semaglutide? Is it normal for it to take a while to ramp up?

Most of the meds in this category are very similar or the same, just from different manufacturing companies.
They can be very helpful. However it is not a miracle medicine. I should help you feel less hungry, and keep you feeling fuller longer, but if you are not following a low calorie, high protein diet, you will not get more than 20lbs of weight loss.
Most of them do ramp up the dosing some the first 2 weeks is a low dose, and then ramp it up again some it's a month between dosing changes.

The best thing you can do for yourself while starting/taking this is follow a diet like a post weight loss surgery patient would follow much smaller portions, and if you can stand it I would recommend a week of liquid diet w/ mainly protein shakes and bone broth. This will jump start the weight loss, and help shrink your stomach. It will also pop you into ketosis which will help your body start burning fat more efficiently. Make sure you are getting at minimum 80 grams of protein a day. Some weight loss experts recommend grams of protein equal what your ideal body weight is, so if you are supposed to weigh 145lb. then you should get at least that in protein daily.
Plus if you are getting plenty of protein your blood sugar levels don't spike and drop, and you won't get that ravenous feeling, it will also make you feel fuller longer, which makes it easier to follow a calorie restricted diet.

I would also recommend a food tracking app, and put EVERYTHING you put in your body in it. Everything you eat and drink. It will help you identify where some issues may be causing the slower loss, or consumption of something you thought was ok, but really had high carbs, or sugars in it.

Thank you! I haven't changed anything about my diet yet. I was hoping that feeling full would make that part a little easier, but so far, I don't really feel full except for a day or two after the injection.

I'm not much of a meat eater, so sometimes protein can be difficult for me, but I think I could easily get enough protein without breaking the calorie bank by drinking low cal protein shakes. Not sure that I could stomach a week of liquids, though. I just did colonoscopy prep last week and the thought of doing a whole week of that isn't very appealing. Also, I'm a WW member, so I could use that app for tracking.

I'm supposed to do 8 weeks of .25mg and then ramp it up. My next injection is tomorrow, so I'll start making a plan.

Thank you!

I have struggled with my weight my entire adult life.
I considered this and weight loss surgery. I ended up doing an endoscopic gastric sleeve procedure. It is NOT covered by most insurance plans but is starting to be. I reached a turning point a year ago Feb. I was massively overweight and in the worst shape of my life plus I ha e RA/PA and destroyed lumbar spine from 30 years of nursing.

I had to make some serious changes to get healthy and not be in constant pain. I met with the GI Dr that did my procedure and got serious. Since I was paying for it I had to make sure it was sustainable so for 60 days prior to I ate the serving sizes of what my post procedure diet would be. I lost weight. It was doable. I had the procedure last June. I'm down over 70 lbs. Been able to go from 2 xl to large and on occasion a medium. My total goal was 100 lb. I'm slowly but surely getting there. I still measure everything and make protein the priority. I dont restrict myself from anything. I mean I stay away from carbs and gluten because they don't do me any good and gluten. 2 days in a row causes significant joint pain.
That said most days I get about 125-150 grams of protein i don't crave sweets and on rare occasions i want pizza I get thin crust. I eat slow. I stop when I'm full.
Make your meals last at least 15 minutes. Chew each bite 20 times. Slow down. Put the fork down between bites. All of these change allow the hunger hormone and your brain to realize you have had enough before you eat too much.
Eating with smaller utensils off of smaller plates helps too.
I wouldn't expect the gluten to make much difference without making g significant changes too. I tell patients this everyday. Yes it makes weight loss easier but it is not a magic bullet.

Hi SacredSoul,

I've been on semaglutide for a year for diabetes. It took about 4-6 weeks to really ramp up. I think different people have different reactions. I actually cannot stand junk food anymore, like it makes me want to gag. I have always liked fruits and vegetables but I LOVE them now.

I have been keto on and off for five years but the pandemic really did a number on me, and I gained all the weight back that I had previously lost and then some.

I do follow a fairly strict modified keto/ diet (I do lean meats and nuts and I allow myself fruit and lots of veggies and I make keto breads and treats) I also exercise quite a lot.

I've lost about 175lbs over the past year. I have about 20 to go to hit my goal weight.

I have found the semaglutide a huge help over previous weight loss where I always felt hungry. I never feel hungry, in fact I have to force myself to eat often. I can't eat large meals anymore. Getting my carb eating under control got my blood sugar under control so it's been a huge win situation for me.

Like Tush I went from a 2xl to mostly mediums now, which feels great.

Along with the meds and diet changes I do yoga three times a week, weights two times a week, and I walk twice a day with my dogs. I also bike and swim. I've seen other people take semiglutide without a lot of changes to their size, and I really think you have to put the effort in to make changes to your lifestyle.

The one thing people don't really talk about is when your blood sugar is not well controlled you constantly crave sugary sweets and garbage. I feel like the meds helped me to get a handle on that which made the huge difference, and the weight loss has not felt like this huge burden to bare this time. (Hopefully the last time lol)

Look up the adverse effects that are associated with these drugs; I believe a common one associated with ozempic is cancer.

As great as it would be to peel off the pounds as quickly as possible, it’s not worth destroying your health in the process.

I looked into this earlier this year. A friend of mine was using them with great success, however she did experience some personality changes that went away once she stopped the meds. She also developed issues with her gallbladder and had to have it removed. In what I read, these side effects (personality and gallbladder) can happen with these drugs.

I have a co-worker whose wife is a nurse at a private clinic. The clinic offers Wegovy injections as one of their treatments and business has really boomed in the last year or so. My co-worker is a walking billboard as to what is possible. He's lost over 40 pounds in a 6 month period and feels better than he has in years. Now, if he could just quit smoking...

His wife has recommended much the same as tushnurse. People are not successful if they don't make lasting changes. The clinic informs their clients that you absolutely do not want Wegovy to be any kind of long term solution, and using it as just another "lifetime" med is highly discouraged.

I looked into it myself and saw my doctor last week for the first of my twice-yearly physicals. She recommended time-restricted eating/intermittent fasting after reviewing my blood work, with the idea of it eventually becoming my new lifestyle. So I'm a week into a baby step program with that.

I wish you the best and hope you continue to post on your progress. I've literally seen what it can do and I hope you are as successful as my coworker.

She also developed issues with her gallbladder and had to have it removed.

This is possible and likely even w/ certain patient populations w/ any significant weight loss, Especially if you resume a high fat diet after. Your body just can't handle it.
In the medical world you are more like to have gallbladder issues too if you have the 4 F's, fair, fat, female, and over forty.

I have seen people get approved for it through their insurance, only to have it yanked away a few months in, and then they have to stop abruptly and those folks have regained it quickly, and with a vengeance. It like weight loss surgery is a tool, but if you don't make real life long changes it won't last.

Y'all are inspiring! Thanks for sharing your journeys.

The four Fs definitely describe this Irish girl perfectly, but I've already had my gallbladder out, so that won't be an issue. I did a lot of searching before I filled the scrip, and I did read about the possible side effects of pancreatitis and pancreatic cancer, but the odds of that happening are very low. I weighed the risk and benefits. I have hypertension and high cholesterol, which can be helped by losing weight. Also, being overweight has been a frustrating issue for my whole adult life, so I went for it.

I read a lot about the rebound weight gain when one stops using semaglutide, and I know that those who have changed their habits are the most successful with keeping the weight off. That will be the hard part for me, I believe. I need to put together a plan for diet and exercise. I used to get 10k steps every day, but plantar fasciitis has stymied that. (Sidenoote: Oofos sandals are the SHIT for those with PF; my feet feel better than they have in a long time.) I'm strongly considering checking out the Pilates studio near my house. It's expensive, but if I actually enjoy it and DO it, it'll be worth it.

[This message edited by SacredSoul33 at 8:36 PM, Friday, July 21st]

Sacred,

Pilates is awesome, I do it as part of my weight lifting days. The more muscle you can gain as you lose the better for your permanent weight loss. If you have pf, have you tried pool walking or water aerobics for some cardio? I have pf as well and I've found New Balance shoes really help a lot.

Good luck on your journey!!

Jumping in as a nurse

PF is a beast and tough to get rid of. I too have had it 2 times. The only thing that ultimately got rid of it was getting a steroid injection AND getting properly fit for shoes. Do NOT go get shoes because someone else said x brand worked for them. They could be the opposite of what you need. Go to a running store or a real shoe store and be fit properly. Most have sizing tools and measure where pressure points are and it you pronate or rotate your ankles. All of this plays a role in PF and how it heals. Also toss any shoes that show heel wear put them on a counter and get down at eye level and if the heel is worn down more on one side or the other it will make the issue worse.

Pool walking is a terrific idea, and would be easy for me to do at home. I could walk in the shallow end and tread water in the deep end.

Tushnurse, to your point, I've tried two pairs of Birkenstocks because that's what the podiatrist recommended, but I can't stand them. They make my feet hurt even more. I think I might also have some damage from skating roller derby for five years in my 40s. Thankfully, I avoided any serious injuries, but it took a toll on my feet. My dogs aren't barking at the end of the day with my OOFOS, so I'm calling it a win for now.

Another BIG fan of Pilates here. While it’s not the dominant factor in weight loss, it is SOOOO good for mobility, and with more mobility, you are less likely to get injured with other forms of weight-loss exercise.

There are several methods of Pilates training. My old studio is one where all of the trainers are educated through Balanced Body. It’s also a PT clinic, so if I develop an injury of sorts, their PTs incorporate Pilates movement into their sessions. I just hope I can find a new studio that offers the same set-up now that we’ve moved cross country.

Pilates enthusiast and fellow PF sufferer here!

Pilates is GREAT for flexibility and strength training! Consensus is Pilates not a preferred exercise for weight loss or aerobics. I disagree. Burning calories and developing muscle mass only HELPS weight loss. And I can attest to the aerobic benefits of reformer Pilates once I reached a proficient level. Reformer Pilates also helped lick PF symptoms! The foot work on the reformer really stretches out ankles, feet and all important achilles tendons. Pilates mat is lovely and all that, but something special about how the reformer integrates springs for muscle strength, bar and box for balance/flexibility. Pilates can be expensive for sure. Taking a group class rather than one- on-one instruction could help. Or maybe there's a studio member/friend you can duo train with?

ETA:

My PF does flair up occasionally. Usually when I get cocky and wear shoes I shouldn't . PF more of a chronic condition for me, so I have to watch it. Keeping physically active and STRETCHED super important to keep PF managed. Podiatrist fitted shoe orthotics were also a game changer. Yes, fitted orthotics can be expensive if you don't have insurance or insurance doesn't reimburse. If your medical insurance doesn't cover fitted shoe orthotics, and you can afford it, I HIGHLY recommend investing in a pair. Assuming your doctor thinks they'd help your sitch. It could be the best money you ever spent! And, NO walking barefoot around the house - as tempting as that is. I slip on supportive shoes even when visiting the bathroom in the middle of the night.

I've also struggled with my weight. I can't address ?? about the meds you mention. Understand the attraction of getting a leg up on weight loss with meds. Good to see you're thinking ahead to AFTER quitting the meds.

I will share my experience re: long term diet/exercise. After decades of dieting/weight yo-yoing and exercise avoidance, I begrudgingly acknowledged maintaining a sensible FOREVER diet (minimal CHEESE :-) AND incorporating a three or four times a week exercise routine was the way to go - for me. Integrating exercise into my life was the toughest part. Finding something you like to do and sticking to a routine is key! Pilates was IT for me. Maybe it will work for you as well? Hope so.

Once exercise became a routine, it became a habit. Now it's a priority. Hoping the best for your diet and exercise success!

[This message edited by BoundaryBuilder at 5:34 AM, Monday, July 24th]

I started Wegovy in May. Then the back order hit (I had a one month sample box from my PCP) and I've been unable to get it until this past week. I'm holding off because of all of this abdominal pain I'm having even though it didn't start until 2 weeks after my last shot. I lost 12 lbs in the first 4 weeks and have kept off 10. I have a bunch of appointments coming up in the next few weeks so hopefully will be able to start again. After my foot surgery I gained 20 lbs on top of already being my heaviest weight ever. We'll see what happens.

Ugh, the heartburn has hit. I'm noticing a reduction in appetite, quick bouts of nausea, and increasing heartburn. The heartburn is the worst part. Not sure if it's worth it.

SS33 if you are having significant heartburn then you need to take something for it.
Here's the deal part of why this works is it moves the food out of your stomach slower. So you have more acid just sitting in there, most overweight people have a hiatal hernia, the sphincter at the top of your stomach at the esophagus is loose, it allows acid to wash up and that's where the burning sensation comes from, but here's the deal, if you are having heartburn you are having damage done by that acid.

So go get yourself a quality Proton Pump Inhibitor, these are sold over the counter. I'm a fan of the omeprazole, and esmeprazole (Nexium). Buy the store brand.
Take this first thing in the am, with a sip of water, wait at least 20 minutes before you put anything else in. These meds decrease heartburn and reflux by preventing the gastric pumps from turning on. If you take w/ your other meds, or wash it down w/ coffee, or eat right away the meds have to work 2 times harder to be effective.

I would also encourage you to take it both am and 30 min before your evening meal until the heartburn goes away, use the tums or gaviscon tablets too to help in the inbetween times. Usually take 3 days to heal any damage when you add this in, once it's quieted down I would only take in the am for a couple weeks and then see if it's better, if so great stop if not get the Ok from your Dr to continue it.

I don't usually have heartburn, thank goodness. Tums has been taking care of it, but Nexium or the like is a better idea. Thank you!

My grandma, mom, and daughter all had/have terrible reflux issues, so I'm grateful for Nexium. It's been a godsend for them.