I hope this is not hidden behind a paywall but here’s the link:
https://www.nytimes.com/2023/09/18/well/ozempic-weight-loss-plateau.html?campaign_id=190&emc=edit_ufn_20231003&instance_id=104286&nl=from-the-times®i_id=125282689&segment_id=146362&te=1&user_id=b2c55bea646e93f74ef32a6a0413b910
In my practice, I care for a lot of diabetics so I have a lot of patients on this med. But, I also know a lot of non-diabetics (nurses, techs, docs) who are using these medications for weight loss. Some of them have had a massive reduction in their weight whereas others have only lost a small amount. This article explains that the drugs will not work the same for everyone.
An interesting quote, from the article, about one of the people using Ozempic for weight loss:
He has tried increasing his exercise to take more weight off. “It’s been more work than I expected,†he said. “I thought I would lose weight easier, longer.â€
As an ER doc these drugs have become a real pain in my ass.
Oddly I don’t see any patients who “should” be on them. I see a lot of patients using them for weight loss or to support their eating disorder (and plenty of unscrupulous providers who prescribe them for $$$$). The side effects don’t look fun.
Intubating these patients is a nightmare. All the food that’s stacked in their stomach comes up.
As an ER doc these drugs have become a real pain in my ass.
Oddly I don’t see any patients who “should” be on them. I see a lot of patients using them for weight loss or to support their eating disorder (and plenty of unscrupulous providers who prescribe them for $$$$). The side effects don’t look fun.
Intubating these patients is a nightmare. All the food that’s stacked in their stomach comes up.
I thought these drugs mainly worked by suppressing appetite. Does food back up in the stomach, is that why they surprises appetite?
As an ER doc these drugs have become a real pain in my ass.
Oddly I don’t see any patients who “should” be on them. I see a lot of patients using them for weight loss or to support their eating disorder (and plenty of unscrupulous providers who prescribe them for $$$$). The side effects don’t look fun.
Intubating these patients is a nightmare. All the food that’s stacked in their stomach comes up.
I’ve heard from anesthesia about this same concern. Can’t recall how long anesthesia would prefer the patients to be off these drugs before surgery but I thought it was six weeks?
Yes. They delay the emptying of the stomach so you always feel full.
Generally the patients I see generally feel like garbage because of it. But hey they lose weight.
I’ve heard 4-6 weeks from our anesthesia guys.
Wife has been on ozempic for a couple years, since she was diagnosed as an insulin-resistant diabetic
.
Oddly enough gastric bypass is somewhat like this as well. With gastric bypass almost everybody loses lots of weight but about half the pts manage to put it back on.
With Ozempic some pts lose a lot of weight with the drug and it seems to work well.
Others lose 5-10 lbs but oddly want to stay on the drug. It almost seems to have some at least psychological addictive properties. Given the potential side effects I try to persuade people that for the sake of 5-10 lbs it isn’t worth it. I have only prescribed to morbidly obese patients most of those with diabetes.
I had one pt who oddly enough is a retired family doc with diabetes. He kept taking it and losing weight. He skipped his followup appts with me and lost so much weight he was on deaths door and then his family brought him in. Stopping the Ozempic and getting some food into him and he is getting better.
I’ve heard 4-6 weeks from our anesthesia guys.
I’m in the dept of anest. at my work place. And yes anesthesia-related aspiration is even more of an issue. I’m seeing a bunch of case reports for now.
This will change.
https://pubmed.ncbi.nlm.nih.gov/36977934/
Yes. They delay the emptying of the stomach so you always feel full.
Generally the patients I see generally feel like garbage because of it. But hey they lose weight.
A lot of patients have nausea and just push through with it or end up giving up.
I have had a number of patients tell me they were able to stop their “arthritis” meds (humira, methotrexate, etc…) because their joints no longer ached with the Ozempic. I explained this is likely from the weight loss, and should 100% be discussed with their rheumatologist, but apparently Ozempic has some kind of anti-inflammatory effect as well (I had no idea)
As an ER doc these drugs have become a real pain in my ass.
Oddly I don’t see any patients who “should” be on them. I see a lot of patients using them for weight loss or to support their eating disorder (and plenty of unscrupulous providers who prescribe them for $$$$). The side effects don’t look fun.
Intubating these patients is a nightmare. All the food that’s stacked in their stomach comes up.
I thought these drugs mainly worked by suppressing appetite. Does food back up in the stomach, is that why they surprises appetite?
Multiple modes of action by acting on GLP-1 receptor. The worst aspect seems to be for anesthesia and ER docs who have to intubate pts. Over the last 30 years I have seen 5-6 weight loss wonder drugs that after widespread adoption major side effects come to light.
Semaglutide is a glucagon-like peptide-1 receptor agonist. By mimicking the action of the incretin glucagon-like peptide-1 (GLP-1), it increases the production of insulin, the hormone that lowers the blood sugar level. It also appears to enhance growth of pancreatic beta cells, which are responsible for insulin production and release. Additionally, it inhibits the production of glucagon, the hormone that increases glycogenolysis (release of stored carbohydrate from the liver) and gluconeogenesis (synthesis of new glucose). It reduces food intake by lowering appetite and slowing down digestion in the stomach, helping reduce body fat. It reduces hunger, food craving, and body fat.
Highjacked from wikepedia.
I feel this post is misleading. A dr would not recommend you take something to make money. That is preposterous.
I feel this post is misleading. A dr would not recommend you take something to make money. That is preposterous.
Wait— but don’t we want medicine our way, like at McDonalds?
I thought patients wanted to be able to buy the meds they want— not just what big pharma or the socialist government wants to give them.
I want ivermectin and ozempic! And a large order of fries!
We currently cannot get the 1mg strength of Ozempic. So much demand likely off label use for weight lose. A patient was on the 0.5 mg strength of which there still is a limited supply. He wanted to double dose the 0.5mg strength because he has lost limited weight on the 0.5mg. I can predict he will lose limited wt by double dosing him. I told he at this point it isn’t responsible to provoke no supply of the 0.5mg by double dosing it. He will have to wait.
I am a terrible person. Probably a communist
We currently cannot get the 1mg strength of Ozempic. So much demand likely off label use for weight lose. A patient was on the 0.5 mg strength of which there still is a limited supply. He wanted to double dose the 0.5mg strength because he has lost limited weight on the 0.5mg. I can predict he will lose limited wt by double dosing him. I told he at this point it isn’t responsible to provoke no supply of the 0.5mg by double dosing it. He will have to wait.
I am a terrible person. Probably a communist
You’re forcing the patient to wait? That sounds a little death-panel-ish.
We currently cannot get the 1mg strength of Ozempic. So much demand likely off label use for weight lose. A patient was on the 0.5 mg strength of which there still is a limited supply. He wanted to double dose the 0.5mg strength because he has lost limited weight on the 0.5mg. I can predict he will lose limited wt by double dosing him. I told he at this point it isn’t responsible to provoke no supply of the 0.5mg by double dosing it. He will have to wait.
I am a terrible person. Probably a communist
You’re forcing the patient to wait? That sounds a little death-panel-ish.
Short supply and patient wants to use more because weight loss was insufficient. I think the Doc is reasonable telling them to hold off.
We currently cannot get the 1mg strength of Ozempic. So much demand likely off label use for weight lose. A patient was on the 0.5 mg strength of which there still is a limited supply. He wanted to double dose the 0.5mg strength because he has lost limited weight on the 0.5mg. I can predict he will lose limited wt by double dosing him. I told he at this point it isn’t responsible to provoke no supply of the 0.5mg by double dosing it. He will have to wait.
I am a terrible person. Probably a communist
You’re forcing the patient to wait? That sounds a little death-panel-ish.
Short supply and patient wants to use more because weight loss was insufficient. I think the Doc is reasonable telling them to hold off.
Agree. I was teasing. 
We currently cannot get the 1mg strength of Ozempic. So much demand likely off label use for weight lose. A patient was on the 0.5 mg strength of which there still is a limited supply. He wanted to double dose the 0.5mg strength because he has lost limited weight on the 0.5mg. I can predict he will lose limited wt by double dosing him. I told he at this point it isn’t responsible to provoke no supply of the 0.5mg by double dosing it. He will have to wait.
I am a terrible person. Probably a communist
You’re forcing the patient to wait? That sounds a little death-panel-ish.
Short supply and patient wants to use more because weight loss was insufficient. I think the Doc is reasonable telling them to hold off.
Agree. I was teasing.
Usually my sarcasm meter is on point. Might need to take it in for a calibration check.