Medical Weightloss intervention

[copperboom]

I have thought a lot about this, and finally made an appointment to talk to my doctor this week. I won’t go into all the things I’ve tried. If you have gone this route (medication), can you tell me what to expect when I talk to my doctor? I’m so nervous about it.

Respectfully, this is not the place to tell me why you don’t think this intervention is a good choice. I have looked into it and feel that it is right for me.

[brux]

I have nothing but great things to say about weight loss meds.

I started on Ozempic in June 2022 and have continued to take meds weekly since. I did have to switch from Ozempic to Wegovy due to insurance, but it’s the same medication.

At this point, I’m approaching 70 pounds lost and I’m in a “normal” BMI now. Not that I care about BMI really, but it’s the measure the insurance company uses to approve the med and monitor your progress.

I’m an open book about it, and I’m happy to answer any questions.

[brux]

I actually got on the meds because my dr suggested it. I’d never heard of it as even an option.

I was referred into a weight loss program by my primary care, and it was the weight loss specialist who suggested the medication options to me.

I also have checkups with food, water, and exercise goals.

[copperboom]

Mar 2, 2024 21:05:34 GMT -6 brux said:

I have nothing but great things to say about weight loss meds.

I started on Ozempic in June 2022 and have continued to take meds weekly since. I did have to switch from Ozempic to Wegovy due to insurance, but it’s the same medication.

At this point, I’m approaching 70 pounds lost and I’m in a “normal” BMI now. Not that I care about BMI really, but it’s the measure the insurance company uses to approve the med and monitor your progress.

I’m an open book about it, and I’m happy to answer any questions.

Thank you!
How did the conversation with your doctor go? I am concerned that mine won’t be open to the conversation, even though my BMI is very high.

[brux]

Mar 2, 2024 21:08:44 GMT -6 copperboom said:

Mar 2, 2024 21:05:34 GMT -6 brux said:

I have nothing but great things to say about weight loss meds.

I started on Ozempic in June 2022 and have continued to take meds weekly since. I did have to switch from Ozempic to Wegovy due to insurance, but it’s the same medication.

At this point, I’m approaching 70 pounds lost and I’m in a “normal” BMI now. Not that I care about BMI really, but it’s the measure the insurance company uses to approve the med and monitor your progress.

I’m an open book about it, and I’m happy to answer any questions.

Thank you!
How did the conversation with your doctor go? I am concerned that mine won’t be open to the conversation, even though my BMI is very high.

I think I answered this in my follow up, but my dr suggested it.

Go into this appointment with confidence and conviction that you want to try this as a tool.

If your doctor balks, I think it’s totally reasonable to ask why they don’t like it as an option. But also, you could look for another doctor who will let you try it. The biggest battle can be getting insurance approval and pre authorization. So you’ll need a doctor who is ready and willing to help you.

[icedcoffee]

I tried Phentermine before, insurance covered it with my BMI and I did see results. But it was affecting my heart rate and BP so I stopped. My doctor was willing to let me try ozempic/wegovy but insurance wouldn't cover any injectables. I could have tried Metformin, which they would cover, but I didn't want to go that route.

I dont know if my BMI wasn't "high" enough or what but I know it varies greatly with insurances covering it or not. My doctor is wonderful though and has always listened to my concerns so it was an easy discussion. I would just bring up your goals and what you hope to achieve and go from there

Eta right now I am not doing any medications. I've had some results from starting at the gym and doing weight watchers mid January (this is not to say you shouldn't ask about meds! Just giving my current situation). I told my doc I'm going to do this for now and she said if I hit a plateau or want to try anything again to just let her know. Hopefully yours will be just as helpful!

[sterling]

I’ve been on it for almost a year, since last April. I have lost 35 pounds and I’m this.close to a “normal” BMI. Which is dumb because I’m currently wearing a size 6 and feeling plenty normal, but you know. These fucking measurements.

I do Wegovy, it’s covered by insurance, and it has been an amazing tool in the toolbox. I am also eating healthier overall and exercising more than I used to but the drugs made the difference for me, I’m sure of it.

My doctor was supportive and wonderful, I have lost weight without feeling like an insane person (my previous MO), and it’s been slow, steady, and sustainable.

Happy to answer any questions you may have!

[roselab]

I haven't had the miraculous results that a lot of people had, but I am still happy with my results on medical weight loss drugs and will take them as long as my insurance covers them.

I started with my primary care dr., and she didn't feel comfortable prescribing them to me (this was over 2 years ago now), but felt I was a good candidate, so she referred me to our health network's bariatric weight loss center. I've been seeing a dr. there ever since. I started on Ozempic but quickly switched to Wegovy. I was on that for about 2 years, but just a few weeks ago switched to Zepbound (Mounjaro) because my weight loss has stalled.

I started seeing the dr. every month, then went to every 2 months, and now I'm at like every 4ish months. She monitored side effects closely when starting and increasing doses. She also monitors my bloodwork several times a year (A1C, kidney and liver functions...these can be affected by these meds, and extra thyroid monitoring because mine was removed and previously I was only having it checked once a year, and full metabolic panel once a year).

The only side effects I had was when I 1st started and was 1st increasing doses, and mine were mild (some nausea and some diarrhea, but nothing terrible).

Oh, and every time I see the dr. at the weight loss clinic, I have to see the nutritionist too. I honestly hate that even though he's perfectly nice, but we go over the same stuff every time and it's pointless IMO, but insurance requires it.

I've lost about 23 lbs so far, but it was SUPER slow, like 1 lb a month until it stalled, and I haven't been losing on Zepbound yet because I'm on the starting dose still. But as I said, I'm happy with my results and my overall health, and most noticably, the not obsessing about food like I used to.

[treeofheaven]

I've been on Contrave since January 3rd and have lost 25 lbs. I'm happy with this option because it addresses the emotional eating aspect. I rarely have cravings for the foods I normally craved. It's weird.

[nelzie]

My DH started Wegovy in the fall and is down over 40 pounds so far. We honestly hadn't heard of these meds at that point and his doctor brought it up to him because he needs surgery but they want him to lose weight first.

I started on Mounjaro just after Christmas for a new diabetes diagnosis and weight loss. I'm down almost 20 pounds in 10 weeks. I've heard that diabetics lose slower because it needs to get your blood sugar under control first. I go back to the doctor in a couple of weeks and plan to ask her to run some labs (kidney, thyroid, etc) to keep an eye on them. My only side effect so far has been constipation and occasional heartburn. I take miralax and colace as needed.

We both have over 100 pounds to lose and these medications have been a miracle for us. We've tried so much in the past that hasn't worked. For me the "food noise" is completely gone. Before this I was constantly thinking about food. It's even helped with my diet pepsi addiction, I used to drink 3-4 16oz bottles a day, now I have 0-1 a day.

[treeofheaven]

Mar 3, 2024 10:36:45 GMT -6 nelzie said:

My DH started Wegovy in the fall and is down over 40 pounds so far. We honestly hadn't heard of these meds at that point and his doctor brought it up to him because he needs surgery but they want him to lose weight first.

I started on Mounjaro just after Christmas for a new diabetes diagnosis and weight loss. I'm down almost 20 pounds in 10 weeks. I've heard that diabetics lose slower because it needs to get your blood sugar under control first. I go back to the doctor in a couple of weeks and plan to ask her to run some labs (kidney, thyroid, etc) to keep an eye on them. My only side effect so far has been constipation and occasional heartburn. I take miralax and colace as needed.

We both have over 100 pounds to lose and these medications have been a miracle for us. We've tried so much in the past that hasn't worked. For me the "food noise" is completely gone. Before this I was constantly thinking about food. It's even helped with my diet pepsi addiction, I used to drink 3-4 16oz bottles a day, now I have 0-1 a day.

Food noise is a great way to describe it. This is the case with me as well.

[kittyriot]

I’m one of those who had an extreme reaction to Ozempic.

My doctor has switched me yo contrave and like @beckyconnor mentioned, it helps my craving wonderfully (so I’m so much more inclined to make a healthy choice when I’m legitimately hungry).

My weight loss has been all over the place, on ozempic i very quickly lost 15 pounds. Have gained it all back and a teeny bit more in the transition.

I’m really hopeful I start to see some better results soon.

[trueblue]

I don’t have any experience or helpful knowledge but I do hope your conversation with your doctor is positive and productive, that you leave feeling empowered and with a good plan/team to help you get to where you want to be, and that your insurance covers it all at minimal cost.

[icedcoffee]

To piggyback off of my earlier comment, my cousin tried ozempic and had horrible side effects. She then switched to mounjaro and she loves it. Way less side effects and I think she's up to 40 pounds lost in a few months.

So not my own personal experience but another anecdote!

[STP]

For me, I am intrigued by them specially for food noise. My weight is what it is, I made peace with it bc it's due to anti anxiety medication. But my mind is constantly revolving around food.

And I love food. Food is not bad or an enemy, and I won't make it one.

But I need that swirling chatter to die down. It consumes too much of my day to day life.

[peachesncream]

I think many PCPs are hesitant to prescribe just because it can be a lot to manage, and it is a lifetime medication. If you get pushback from your PCP there are so many legitimate weight loss clinics/telehealth centers popping up all over, it's kind of a new fad for ARNPs right now, so those might be worth looking into since that is literally all they do! One of my ARNP friends was telling me that there is a new oral GLP-1 antagonist that is supposed to have fewer unpleasant side effects than the injectables.

[marygracerich]

Mar 3, 2024 10:30:51 GMT -6 treeofheaven said:

I've been on Contrave since January 3rd and have lost 25 lbs. I'm happy with this option because it addresses the emotional eating aspect. I rarely have cravings for the foods I normally craved. It's weird.

I am on the same thing (but the generic form so two pills instead of one) and I am happy with it. I am just not nearly as hungry as I was and I don’t crave anything. I have lost 12 pounds in 9 1/2 weeks and one of those weeks I spent in Disney world. 😂

My only negatives are the nausea I had the first 3 days I took it and I now have a very high aversion to coffee.

[Wtfshouldmynamebe]

I started doing it through an online place just shy of a year ago. I pay $300/month for the meds. I have lost about 65 lbs. DH started about 10 months ago and is down about 60.

It has been a game changer for me. I no longer constantly think about food. I am eating normal stuff, just less. I’m not obsessive about “is this ok to eat” like I was when I did weight watchers.

[brux]

Mar 3, 2024 12:50:02 GMT -6 STP said:

For me, I am intrigued by them specially for food noise. My weight is what it is, I made peace with it bc it's due to anti anxiety medication. But my mind is constantly revolving around food.

And I love food. Food is not bad or an enemy, and I won't make it one.

But I need that swirling chatter to die down. It consumes too much of my day to day life.

that was honestly my favorite part about it for a long time.

Until the chatter is gone, you don’t realize that it doesn’t have to be that way.

I used to have a really hard time with craving sweets and then with thinking about them constantly once they were in my house. Now I can have ice cream in the fridge and it’s no issue. It may take me a month to eat a pint of ice cream, because I don’t usually care if I eat it or not.

[sterling]

Mar 3, 2024 19:09:29 GMT -6 brux said:

Mar 3, 2024 12:50:02 GMT -6 STP said:

For me, I am intrigued by them specially for food noise. My weight is what it is, I made peace with it bc it's due to anti anxiety medication. But my mind is constantly revolving around food.

And I love food. Food is not bad or an enemy, and I won't make it one.

But I need that swirling chatter to die down. It consumes too much of my day to day life.

that was honestly my favorite part about it for a long time.

Until the chatter is gone, you don’t realize that it doesn’t have to be that way.

I used to have a really hard time with craving sweets and then with thinking about them constantly once they were in my house. Now I can have ice cream in the fridge and it’s no issue. It may take me a month to eat a pint of ice cream, because I don’t usually care if I eat it or not.

This is true for me too. And STP, I didn’t do it as part of a quest to fix my body or any such thing. But I wanted to have control of my hunger and stop gaining weight, and I felt like I didn’t have the tools. And now I do, the food noise is turned down, and I’m able to do the things I love more effectively (like running) than I could before. As a bonus I lost weight and feel healthier overall.

[sterling]

Not saying STP was saying that. Just confirming changing my body wasn’t a primary goal, health and reducing food noise without being a lunatic was.

[pearbear]

So I went a bit of a different route and I did the compounded form of semiglutude through my medspa with the oversight of an NP I’ve seen for years. I was overweight, but not enough to ever hope insurance would cover this medicine for me. I was having a lot of issues with tendinitis and other aches and pains from the extra weight and knew I needed help. The compounded formula was by far the most cost effective route I could take. I researched everything extensively before diving in and felt comfortable with this decision.

I’ve been on it since May and lost 55lbs. I hit my goal in December and have been on a very low dose since. For me it’s a miracle drug. It has fully changed my life. I have had a lifetime of dieting, counting calories, macros, obsessing over every bite I took. I had an ED in my 20s. I used this medicine as a way for me to FINALLY end all of that dieting mindset. I essentially reset my entire relationship with food over the last 8-9 months. It took away the food noise and cravings that others have mentioned and allowed me to figure out how to just eat for enjoyment and health again. I haven’t counted a calorie since May and haven’t even had the urge to do so at all in a long time. That’s something that doesn’t get talked about much with these meds, that I wanted to mention because it’s been so life changing for me. I really feel like after a lifetime of struggling, I’m finally free from that awful dieting mindset.

[pearbear]

Mar 3, 2024 19:33:19 GMT -6 sterling said:

Not saying STP was saying that. Just confirming changing my body wasn’t a primary goal, health and reducing food noise without being a lunatic was.

This is a much more succinct way of saying what my goal was too 🙂

[bearfootzcontinued]

I just started Wegovy so am going to piggy back on this.

Years ago I had luck with phentermine but when I tried it again I had to stop due to high blood pressure. I had also tried Contrave but couldn't get past the headaches.
My doctor was very open to using medications and wanted me to try Zepbound but it was not yet covered, but I was able to start Wegovy. I just finished my first month, have lost about 6 lbs but was told not to expect much the first month as it's just to get my body adjusted.

Listen to brux, when she tells you to up the fiber intake

[allthekristys]

copperboom when do you see your doc? Sorry if it says upthread, I skimmed.

I would just approach your doctor confidently and ask directly for it. And ask for it for the reasons you want it for, don't shy away from saying you are interested in it for weight loss, if that is the/one of the reasons. And if your doctor doesn't have a positive response, then I would probably reconsider your doctor (not saying you know more, but are your wants and needs aligned with your care provider? that would make me reconsider my care provider if they won't hear me out on a rational, reasonable ask for something). Good luck!

I started on mounjaro October 2022 and was on that until October 2023 when I had to switch to wegovy for insurance reasons. I've lost 110 lbs, most of that from mounjaro (about 20 lbs from wegovy). The side effects weren't too bad for me, I just recommend easing into them and giving it time, as I have little to no side effects now. As PP posted, it's the noise in my head that is the biggest win for me. I am so happy my doc referred me to a doc who recommended these drugs. It's been life changing. I finally feel good in the body I am in, and like I have control over my brain, and my body.

Good luck!!

[brux]

I want to also add that you should start making a plan now for what you'll do if/when you come off the med.

Because the drugs are newer, there are only limited studies about what life (and weight gain) is like when you come off the meds. Sometimes, the plan is to have this be a lifetime medication. That's what my doctor has said. But given the cost, I don't know if insurance will agree with that plan.

For me, I plan to stay on the meds for as long as insurance will pay for them. But I've read that insurance plans are focused on paying for the weight loss phase and perhaps haven't yet considered the coverage criteria for long term maintenance use. If my insurance stops paying for it, I'm prepared for pay OOP for a period of time, but I can't afford the $1000+ a month forever.

So you'll want to make lifestyle changes that you'll put into place while on the med and then use those lifestyle changes once you come off.

As my doctor put it - I'll need to find something to replace the impact of the medication in my life if/when I come off it.

[ellewoods]

I’m an open book - feel free to message me too. I started saxenda and then went on wegovy. I’ve lost 60 pounds from my absolute highest. I have ten pounds to go to be a normal bmi.

My doctor was completely supportive and said I’ll need to be on it the rest of my life because it treats the disease of obesity. It stops the food noise for me and stops me from binging. I eat what I want just smaller portions.

I do have constipation then I’ll take a stool softener then gave the opposite issue.

I highly recommend if you fit the criteria. I’d like to move to zepboubd but I think it would cost me a lot.

[ellewoods]

brux, I’m on a high deductible health plan so I pay a portion up front. My doctor said because I have demonstrated success insurance will continue to pay for it.

STP, I was always thinking about what my next meal would be. and I wouldn’t eat one candy bar, I’d eat two. Wegovy has changed that for me.

[bearfootzcontinued]

Mar 4, 2024 15:21:23 GMT -6 ellewoods said:

I’m an open book - feel free to message me too. I started saxenda and then went on wegovy. I’ve lost 60 pounds from my absolute highest. I have ten pounds to go to be a normal bmi.

My doctor was completely supportive and said I’ll need to be on it the rest of my life because it treats the disease of obesity. It stops the food noise for me and stops me from binging. I eat what I want just smaller portions.

I do have constipation then I’ll take a stool softener then gave the opposite issue.

I highly recommend if you fit the criteria. I’d like to move to zepboubd but I think it would cost me a lot.

My doctor was really hoping that I could go on zepbound as she was excited about how well it's been working for others.  But it was too new for OptumRx to cover it, at least when I checked in January.  Hopefully they add it soon.  

[zoeylucy]

I didn’t want to read and not respond but agree 100% with allthekristys approach. I wish you so much success with this journey.