ozempic?

I went to my family doctor today. He's not impressed by my regain. I started at 285. Was 270 at RNY surgery. I weigh 209 today. My lowest was 161. So I'm up 48 lbs from my lowest. Today he recommended I go on Ozempic to loose weight. He said "it will change my relationship with food." Hmmm... we've heard THAT before. Anyone else on Ozempic to deal with regain? I really don't feel on board with this. Nothing like back to the basics right?

If it's optional and you don't feel good about it, I'd just say no -- on the other hand, you do know the things that worked for you in the past and if it helps with the willpower to give you a kick start, that could be a good thing! Maybe research how long it takes to get therapeutic levels and then set yourself mini goals around that and just used it for a bit?

Good luck finding what works for you now!

I would have some serious doubts about it.

It is, and has been a somewhat popular thing amongst family docs to prescribe off label diabetes drugs such as ozempic or byetta for weight loss, as they do have that side effect along with their effect on diabetes. However, they are not certified for use as a weight loss drug (why it's an off label use) so the longer term effects have not been tested and verified (you're being a lab rat.) Given the size of the potential market for weight loss vs. simple diabetes, they are no doubt being tested for that purpose with the intent of being certified for it. Also, being off label, will your insurance pay for it, if you aren't diabetic? If you research it more closely, I suspect that you will find that the weight loss effect is temporary, as long as one is on the drug, and weight will come back once one is off the drug. Since you have a regain problem, this does not look like a compatible use of the drug.

Of greater concern, is in how this drug works. It slows the release of food into your intestines which helps blood sugar control, and also the insulin spikes that can lead to more rapid hunger and over eating, presumably by slowing the action of the pyloric valve that meters stomach contents into the intestines. Great. Problem is that you don't have a pyloric valve in your active GI tract - it's been bypassed along with the majority of your stomach when you had your RNY; Will this drug even work in a bypass patient, whether for diabetes or hunger control? Has it even been tested on bypass patients? Does your family doc really understand what was done to you when you had your RNY, and does he understand how the drug works (or is he just taking the word of the drug salesman that visits his office dispensing goodies in exchange for writing Rx? I don't know the answers to all of these questions (though I have my suspicions) but they are things I would seriously be asking before getting involved with this line of treatment. If it was your bariatric program suggesting it because they have used it on patients similar to you with some success, that would hold a bit more weight (so to speak) in my mind.

Another consideration is the "five year rule." This is a informal conservative medical practice that holds that one should avoid medications within five years of their certification. The reasoning is that drugs are certified on the basis if a few thousand (2-4,000 typically) patients using the drug for a few months or maybe a year or so. If all goes well, it is certified for sale and then you see hundreds of thousands to millions of people taking the drug, and that is where those occasional rare but serious side effects can show up that could cause the drug to be pulled from the market. If there are existing drugs on the market that treat your problem with minimal or acceptable side effects, one should go with them in preference to the new kid on the block; if the new drug works substantially better than those that are existing, or without notable side effects, then it can be worth the risk. But it is not something one should go into blindly, or assume that the newest is the best - it might or might not be.

Side note - I had the same pitch given to me by a doc (not my PCP or surgeon) regarding Byetta before I had my VSG. The drug has changed now (same basic mechanism, though) but the sales pitch is the same.

The US FDA approved it for weight loss in June of this year, so it's no longer an off-label use.

OK, good - I was just looking at their website (for ozempic) and they were still listing it for only diabetes, stating something to the effect that weight loss was one of its side effects, but it was not a weight loss drug.

I would still question its viability for an RNY patient owing to their altered anatomy.

Thank you for the detailed response. I too thought about kick backs for doctors when he said this to me. I appreciate your input.

I haven't tried semaglutide (ozempic), but I did try liraglutide. I think semaglutide is a longer-acting form, so I'm basing my comments on that.

My internist said that while most people only have modest weight loss with these drugs, some people are super-responders. She suggested I try it just in case. A week later, I didn't have the sense of fullness that the drug is supposed to give you, so she took me off of it and we went for WLS.

You should know if it works in a week to 10 days, so it might be worth a try for such a short term. If it does work for you, maybe discuss the side effects with your doctor and then decide if you want to stay on it.

Thank you. I don't have a pyloric valve so it may not be the best for me. I still have to research more :!