The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
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Semaglutide Trip Report (Real, Factual, as seen on Erowid):
Recently, due to a change in meds and an increasingly sedentary lifestyle, I'd packed on more pounds than I cared for. I'd bought a weighing scale but forgot to buy batteries, so it was only on my return to India that I found out I'd gained 5 kilos that I didn't need.
I'd convinced my mother to start oral semaglutide a while back. She desperately needed it, being very obese to the point that fatty liver was headed straight for cirrhosis. Not to mention she was diabetic, so it was a double whammy. After some difficulties with initial GI upset and nausea, she was happy enough on it, and probably lost about 5 kilos. Still plenty to go, so I keep hounding her to see her endocrinologist and up the dose.
I was already a semaglutide fan from early clinical trial days, so I had few qualms in ordering some for myself. By Indian standards, quite expensive, around 100 USD for a month's supply of 7mg tablets. By Western, or even UK standards? A pittance. I could afford that without any concern.
Normally, you're supposed to start at ~3mg OD for a month and then titrate up, but I was impatient and willing to take the risk of a higher dose. The degree of weight loss is quite dose dependent. I opted for 7mg, ordered several months worth to go, and went right at it.
It's been 4 days, but the effects were noticeable from day one. It absolutely slashed my appetite, I normally skip breakfast, and usually have 1-2 large meals a day, but whereas I normally get peckish past noon, I got to 6pm before getting hungry and realizing I hadn't had anything to eat.
I'd been out with friends and grabbed pancakes dripping with chocolate, and only managed to have half my plate before I had to give up. Later in the day, I can just about have one meal and consider myself full. I've had to force myself to eat more as I've been working out quite hard and wanted to see gains.
No side effects to speak of. My stomach is as it's always been, and the plumbing hasn't given out. I've been emboldened to order another 3 months of it, just to tide me over while I'm back in Scotland.
TLDR: Fucking amazing. I could drop my caloric intake to about half without being desperately hungry, and to about 70% while feeling entirely normal. I'd be willing to pay a much higher price for it if I absolutely had to.
So Doc, what's the latest on getting on/off semaglutide? My biggest concern would be long term impacts of use. Is it the kind of thing where one could run a 3-6 month cycle and lose some weight then return to more-or-less normal, or the kind of thing where if you start you might never be the same again for good or ill?
Long-term impacts? It's safe, or at least the risks, while not nonexistent, are still minimal. For someone grossly obese? Easily worth it. For someone just a bit overweight like me? Still safe enough to not bother me particularly much. I'm more concerned about sudden diarrhea than I am about pancreatitis or blindness.
My understanding is that you will gradually gain back weight if you stop, but even then, it's easier to lose weight with its aid and keep it off than it is to just lose weight without it. How fast? It depends:
https://pubmed.ncbi.nlm.nih.gov/35441470/
People bemoan this as Ozempic not being a "solution" as the weight loss isn't permanent. I find that deeply stupid, so many drugs we consider essential require regular use. If you don't take your insulin, guess what happens to your diabetes? If you stop your diet or exercise regime, you'll regain weight. At $100 USD, it's a no-brainer. At higher prices, well you might want to look for compounding pharmacies or grey market sources.
I've seen gray market sources selling the "constitute vials yourself at home" dosages for around $30/month. Presumably that's with healthy profit margin baked in due to legal risk.
Once these are out of patent I expect generics to approach $7/mo
I already had to do plenty to assuage parental concerns, I know about grey market sources but didn't consider them. Maybe if the oral form was way more expensive.
Unfortunately, if you want to wait for expiry of patents, that's a good while away. The best hope in the short term is a patent buyout and award
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