VSG Maintenance Group
Friday, June 7, 2024
Tracking my food, not snacking and eating pretty healthy. Just need to add moving my body more!
Have been doing tons of research on the GLP - 1 meds and think I might pull the trigger. Insurance of course won't pay so I will go the compound route that so many of you are doing. I do have a few questions if you all don't mind....
Which on-line companies are you working with and are you also working with your PCP? I'm not sure but I think mine might not be too keen on me using a compound pharmacy.
About how many calories a day are you eating and it is pretty much like the post VSG guidelines, protein centered, light on carbs, little sugar and I read no alcohol.
Are most of you planning on taking indefinitely? Is there ever a point once you hit goal that you can take meds every other week or maybe once a month. Or start back up if you gain say 5 or 10 lbs.?
It seems there are 2 main drugs, the S one and the T one. From what I read S is less expensive, may not be quite as effective as T and possibly has more side effects. Is that true for you all? Looks like cost is around $300/month for S and $400/month for T.
Any other bits of information I should be aware of?
Nothing too exciting for me today. DH had start the probate process for his Mom's estate as she passed away a few weeks ago. I did some house cleaning, went to the garden center and picked up just a few things for my small raised beds and then DC #1 came over and we grilled out for dinner. Peppers, onions and zucchini and pineapple teriyaki chicken breasts with Swiss cheese. Super yummy!
5' 4" tall, HW: 242, SW:215.4 Weight Loss - pre-op: - 26.6, M1: -15.4, M2: -16, M3: -11.4, M4: -11.2, M5: -12.2, M6: -7.4, M7: -7.8, M8: -2.0 Goal of 130 lbs. reached at 8 months, 2 days post-op!
on 6/7/24 7:41 pm
I started with my doctor writing a prescription for Zepbound (tirzepatide) and switched on my own to compound when I couldn't find the name-brand anywhere. I haven't mentioned it to her! Mostly because I'm afraid she won't like it. But the alternative is not being able to get it.
I am currently using Emerge Weight Loss. They make it really easy if you have a prescription for name-brand and can't get it filled. Different prescribers will use different compounding pharmacies, sometimes varying depending on the state. Emerge uses Hallandale for Arizona (I have heard they use Empower in some other states). If your doctor is okay with compounding, they can send a prescription to a compounding pharmacy, but sometimes the costs are higher than the negotiated bulk prices some of these prescribing companies get. I'll let others chime in on who they use.
I know the food noise will come back if I stop, so I would like to stay on it, maybe at a lower dose when I get to my goal? And maybe stretch out my shots? I try to eat protein forward and much of that as I can.
I'm taking Wegovy , which is the semiglutide, and my insurance covers it. I was very skeptical of compounding, but I learned here from our friends, that compounding pharmacies are FDA regulated, and they are allowed to sell compound drugs if a shortage exists in the regular pharmaceutical inventory. I am now comfortable enough after hearing about people's experiences to offer to help my 31 year old daughter pay for it. (She is taking Trizeptide , and lost 7 pounds the first week.).
If I were paying out of pocket, I'd go with Trizeptide, because weight loss studies show it is more effective. Why not get the biggest bang for your buck.
I have no intention of stopping Wegovy, as long as insurance pays for it. I will be on Medicare in two years, so I may have to, because currently, Medicare is not covering it for weight loss. I'm hoping that, as fast as the market is changing, that there will be new products by then that will be less expensive, and/or Medicare will see the benefits of covering weight loss drugs.
How people take maintenance doses seems to be all over the place. Some stretch out days between dosing, like every 10 to 14 days. Some take a smaller dose. Some stay on the higher dose they were on when weight loss stopped. I get my prescription through my WLS clinic, and they will work with me on figuring that out when the time comes.
Others will surely weigh in (oh, unintended pun), and will have more specific information about compounding pharmacies.
Here's my experience with the GLP-1 meds. I am with Henry Meds and have been very pleased with them so far. For the semaglutide, it's $300/month. I was working with an endocrinologist who specializes in weight issues prior to deciding to go the compound route. I told her I was going to do it--she had recommended the brand name variety. She said she could not prescribe for a compound but that she understood why I was doing it (saving $1000/month!) and that she had a lot of patients doing the same. I have not told my PCP, but I have my annual physical this month, and I may or may not tell her, haven't decided.
The two drugs are semaglutide, which is what I have been taking, and tirzepatide. As I understand it, they both sort of work the same way but the tirzepatide targets more receptors so it is more effective for most people. But the semaglutide has worked amazingly well for me. I started off thinking I would try to lose 20 lbs, ideally 25, and get back into the healthy range. But I have lost 35-38 lbs pretty effortlessly and now I am back down to what I was shortly after the vsg. I plan to stay on it for as long as it is available as a compound, and I am currently trying to find the correct maintenance dosage, slowing decreasing. The PA I have been working with at Henry Meds says that many people maintain well on a half dose and some can stretch to every ten days. I'm not sure that taking the drugs once a month would work. From what I understand, it takes quite a while to build up in your body, as well as decrease. It took me 3 months, I think, to get up to the effective dose. Some people do it faster, but supposedly slower helps you avoid side effects. I didn't lose much weight those first few months.
From what I have heard anecdotally, both drugs potentially have side effects, most commonly constipation and diarrhea, both of which I experience sometimes--but I have always had some issues in that area, so...not sure.
I have not been NEARLY as strict about what I am eating as I was after surgery. Mostly, I have been trying to make sure I get enough protein and haven't worried too much about the rest. (I'm sure I would have lost more quickly if I had been stricter about the carbs though!) I have cut back on sweets but still have them occasionally. Well, daily, but not a lot. I also drink alcohol sometimes with no issue. Overall, my appetite and capacity really decreased--it's like being 5 months out from surgery for me. I don't understand how the drug does that -- it's not making my stomach physically smaller, but I often simply CANNOT eat very much.
That's all I can think of--hope it helps!
Lizanne
on 6/7/24 8:19 pm
Lizanne, do you have a Facebook account? I was thinking if you do, you should join our Tremendous Tribe private group. We mostly have it as backup for the day when this might not be available. But sometimes people share more personal things (haha, how can we possibly get more personal!) or pictures are easier there.
