My Ozempic Journey: Lost in the Doldrums

Now that I am four months or so into my Ozempic journey, it is time for an update. Let’s begin with the big goal: weight loss. As I might have predicted, the weight continues to be shed, albeit more slowly. Early on, I was losing two pounds a week, but now I can eke out a half pound, so it is clearly not a silver bullet to weight loss. That diminished rate is primarily due to my body’s homeostatic survival skills – slowing my metabolism to compensate for the reduced calories I am providing.

While I have no special measure of how much weight comes from fat or muscle, there is a high likelihood that my body is attempting to control protein loss. As previously mentioned, all our protein is functional; there is no storage equivalent, so the loss of protein means a reduction in muscular strength and, more importantly, in the immune response. All that being said, my weight has returned to levels not seen in eight years. Is it wrong for me to want to get down to some mythical weight I had 20 years ago?

Psychologic and Physiologic Changes

The good news, at least for me, is that with Ozempic’s magic mojo gone, I am beginning to pay more attention to the how, where, and what I eat, using that increased behavioral space I wrote about previously. I eat less at dinner, especially when dining out – my wife and I have returned to sharing an appetizer or entree. I also find that dinner lasts a bit longer, although we can still be in and out of a restaurant in an hour. Another caloric saving, I think, has been that I no longer have a taste for a glass of red wine. Life is too short to drink swill or “plebe” wines, and if you can’t tell a good Pinot from a Mogan David Passover Classic, there is no reason to be drinking that good Pinot. 

Ozempic slows the passage of food from the mouth through the stomach and from our colon to the outside world. I was a bit slow on the uptake here, and it took the fact that I wasn’t using as many rolls of toilet paper a week for me to stumble upon the fact that I was not exactly constipated, but at least less regular. Because I am a firm believer in the medical aphorism that “stasis is the enemy of man,” I upped my fiber intake to soften the experience.

My dilemma now is whether to continue here in the Inter-tropical Convergence Zone, the meteorological name for the Doldrums, or to increase my Ozempic dose – and if increasing the dose, by how much? Per the FDA, Ozempic’s semaglutide is approved for managing Type II diabetes, and the higher dose of semaglutide in Wegovy is approved for weight loss. Both forms have guidelines for increasing the dosage at about this moment in treatment but warn that with increasing efficacy, there may be additional or more significant side effects. I must admit that I remain impatient, so I think that I will be raising the dose, and we will see how it goes.