The media is full of stories about the new class of weight-loss drugs, of which the best-known are Ozempic and Wegovy. I’m not going to get into the other drugs currently on the market. That would take up a lot of time and this post isn’t about the industry.

What is the difference between Ozempic and Wegovy? There isn’t any difference. They are both a drug called semaglutide. They are both manufactured by the pharmaceutical company Novo Nordisk. However, they are approved by the FDA for different conditions. Ozempic is approved for Type 2 diabetes. Wegovy is approved in a higher dosage for overweight. Both drugs are in such high demand that they are difficult to get in the United States.

How does Semaglutide work? From Drugs.com: “Semaglutide works by mimicking the action of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels. By binding to and activating the GLP-1 receptor, it stimulates insulin secretion and lowers glucagon secretion when blood glucose levels are high. It also causes a slowing down in how fast the stomach empties.” The end result is that it dramatically reduces appetite.

What are the potential side effects? Low blood sugar levels, nausea, vomiting, diarrhea, abdominal pain, and constipation are the most common side effects. There is also an increased risk of pancreatitis. And people with certain medical conditions shouldn’t take it. Do your research before starting one of these drugs.

My Experience of Taking Semaglutide:  The first step was that the nurse practitioner I was working with, Ashzra, prescribed Wegovy. My insurance turned it down because weight loss is not a condition covered by Medicare Part D. Then she sent me a prescription for Ozempic and gave me a Canadian pharmacy to contact. I did so, and without any further ado, I received my first Ozempic pen in the mail. I had to wait for more than a month to receive instruction from a physician on how to use it, so it sat in my refrigerator for all that time—it has to be kept cold.

I finally got a doctor to go over how to use it. So one Tuesday morning three weeks ago, I sat in my home office with the patient instructions Ashzra sent me. The instructions said to prep the pen and make sure no bubbles were in it, etc, which I did. Then the instruction said to turn the pen until the proper dosage appeared in the little window. I thought I’d start with .25mg, as I was worried about side effects.

I dutifully clicked the pen until a number appeared in the window. It was a 1. A second try yielded the same result. I pondered this for a while, and then pulled out the instruction sheet inside the prescription box. It turns out that my pen injects 1mg every time—you cannot select the dosage.

Okay. I swabbed my upper thigh with rubbing alcohol and regarded the needle protruding from the end of the pen. It is a short needle, and very fine. But I still needed to—willingly—shove this needle into my tender skin. I set up the pen and stabbed my thigh. I depressed the plunger, and it clicked back to its starting position. I held the pen against my skin for another six seconds, as instructed, to make sure the entire dosage was injected.

It didn’t hurt much, I will say that. There was a tiny red dot at the injection site, and I covered it with a little bandaid, just like at the doctor’s office.

By dinner time, I was feeling distinctly uninterested in food. The next morning, I fixed my usual breakfast, something I normally enjoy—one piece of avocado toast with fried eggs and hot sauce. I wasn’t just feeling uninterested, but nauseous. I ate about a fourth of it because I wasn’t sure whether this was how I was supposed to be feeling, but could go no further. Another couple of hours found me giving back not just breakfast but everything I had eaten after giving myself the injection. I also felt extremely fatigued.

The nausea and fatigue lessened a bit every day. The nausea went away entirely when I remembered how effective ginger is against nausea and other stomach troubles. Despite a total lack of interest in food, I forced myself to eat because I didn’t want to get malnourished. By the end of the week, I started enjoying eating again. I recognized that constipation was going to be an issue, and took stool softeners and dietary fiber to combat it.

After the second injection, I felt mildly nauseous but did not vomit. I wondered whether “reduced appetite” actually meant “revolted by food.” The fatigue got a little better, but I still felt pretty tired. The third injection left me feeling fairly normal, except for a reduced appetite. I have resumed enjoying food, but I can’t eat a lot of it. I think this is the desired state.

Semaglutide will reduce your appetite, but you still have to eat properly to lose weight. I am sticking to the Weight Watchers diet and gradually increasing my physical activity. I have not lost any weight over the past two weeks, but I am still hopeful. Weight loss is unpredictable and tends to happen when I least expect it.

The weight loss physician who instructed me about using the pen also tried to get a prescription for Weygovy approved, as she said there are some new guidelines.  After the second injection, I tried to find out from my clinic how to get the second semaglutide pen—should I go back to the person who prescribed the Ozempic? Should I coordinate with the weight-loss physician who was trying to get me Weygovy? Or…?

It was a bit of a clown show. Every time I tried to contact someone like Ashzra, someone else would answer my email who had not read the case notes and didn’t know what was going on. Even Ashzra didn’t answer my direct question about whom to coordinate with about getting another prescription. I finally drove to the clinic and asked to speak to a member of my doctor’s staff, explaining that I needed a new prescription and had been unable to get information from anyone I contacted via email. After a wait of perhaps half an hour, a nurse came out to talk to me. She had spent the time reading all the emails and understood the problem. I left the clinic with a prescription, emailed it to the Canadian pharmacy, and received a rapid acknowledgment.

By the way, my insurance for Medicare Part D refused the second prescription because weight loss is not a condition…etc. Being overweight creates other medical conditions that they WILL have to pay for, but if you expect the insurance industry to make sense, don’t. All they are concerned about is making profits. I worked for an insurance lobbyist for a while; I know what I’m talking about.

I hear many worse tales about our current medical system from others. Apparently, we lost a lot of medical personnel during the pandemic, and the strain on our system is showing. I completely understood putting Ashzra in place to shoulder some of the doctor’s load, and she is a very impressive person. But it seems that the load-spreaders are overwhelmed, too. If things get worse, we will lose more medical people who just can’t take the stress.

I can’t report any more reduced poundage, but here’s another token of progress: my belt. I am now on the last notch.