I think one of the most frustrating things for me is when people start on a GLP-1 (Ozempic & Wegovy) or a GIP/GLP-1 (Mounjaro & Zepbound) and quit within a week or a month because they think it isn’t working. I recognize that behavior because I have done it for 50 years. It’s called “Going on a Diet.”
The people that hype up diets, and/or diet products, through commercials, talk shows, news shows, books, magazines, and now social media, all promise immediate weight loss. So many of us fell for this as we promised ourselves, “This is the one I will stick with. This is the one I will lose weight on finally.” Then, when we do not lose the weight we were promised, we stuff the book onto the bookshelf, along with all the other diet books that promised the same thing. You had said the exact same thing about those books, too, didn’t you? You knew they were going to be The Ones you succeeded with.
Did we ever succeed? If we did, we wouldn’t be sitting here reading about GLP-1s and how I feel so many people treat them as if they were a diet that is finally going to be The Answer to their weight loss issues. If GLP-1s fit on a bookshelf, the empty pens would be piled on them next to all those diet books that also offered empty promises.
GLP-1s Are Not Empty Promises!
The reality is people are not giving the medications long enough to take effect. It can take 8 to 10 weeks to even get to a level amount into your body. Most of the time, that is during the titrating up period, from the loading doses to a stable dose that will take effect in your body. That is called the “Onset of Action.”
Sure, we are hearing about microdosing working for people. We know some people lost 50 lbs. on 2.5 mg. of Mounjaro. But these are the outliers, just like I am having lost 240 lbs. There is no test (yet) to see if the medications are going to work or not, although companies are trying to make one. It would make it so much easier if we knew we were on the right medication or now, but for now, it is trial and error.
I want to take the common analogy of having high blood pressure or even diabetes. You are given medications to lower each of those diseases, often diseases of obesity. If you took either the BP medication or the diabetes meds and/or insulin, it is ludicrous to think a week or four is going to make any difference in your body’s workings to lower the problems.
“It may take a month to six weeks to bring your blood pressure down by slowly raising your medication doses,”
Metformin will usually start lowering your blood sugar (glucose) levels in the first week of treatment, but it may take 2 to 3 months to see its full effect.
It is the same with GLP-1s.
Change of Mindset
I am really hoping that putting this in a different context can help those considering or on GLP-1s believing this is the fix of their lifetime, better than any diet, that the weight just falls off… is able to see things in a different light.
Sure, the weight seems to slide off some people, but most of us have to work hard to get to where we want to go. And even then, our bodies might have a different idea of what our “goal weight” will be.
And the reality, again, is this is not a diet.
There are not many choices for those of us with Type 2 Diabetes or Clinical Obesity except these medications. There certainly will be more down the line, but for now, this is what we have. Folks need to take gung-ho advantage of what they are able to use to save their lives.
Living with Side Effects
Many have to deal with annoying side effects, but that can come with the territory. I understand if they are unbearable, but most medications have crappy side effects. With everyday medications you might take, just because you don’t have outward side effects, plenty that might be happening on the inside. They could be tearing up your liver (acetaminophen) or your kidneys and stomach (ibuprofen).
I have taken psych meds continually since 1995 for Bipolar 1 and I have had many really-not-fun reactions: gaining 80 lbs. in 4 months on risperidone, Tardive Dyskenia (which I still have), narcoleptic-like fatigue that kept me from driving until I was off that medication, skin rashes, and the list goes on. When you need a medication to keep you alive, you suck it up and keep living even when it is a pain in the patootey.
Mounjaro, my GIP/GLP-1, for all intents and purposes, is a medication I will take for life. Even as my labs have become pristine or as I am now able to walk miles after being bedridden for over a decade, I will remain on these medications.
I cannot regain this weight. I have so many consequences to being fat again, it would, quite literally, crush me and my spirit. I can’t help thinking that the people who go on and off the medications willy nilly are just not sick enough yet, have not tried enough diets, would rather eat what they want instead of having discipline injected into them. I wonder if they will ever get to the desperation I did when I put that Do Not Resuscitate paper above my bed during COVID-19.
Strategies for life must be considered when taking, or not taking, GLP-1s. Whether you choose to go down in dosages to maintain your new life and body, go off and back on again if you regain some/a lot of weight, quit soon after starting, or, like me, stay on them continually forever. Thinking ahead is crucial.
These medications are Life for me. They represent an unrealized freedom from my fat, my fat-related illnesses, my fat immobility, and so much more. I have a life now and I plan on keeping it as long as possible.
I hope you do, too.
Well, Barb, your story inspires me greatly. I, too, received the Bipolar I diagnosis as a young woman in my late 20s. I took every medication they offered. Some were terrible as you alluded above. The weight gain was pretty crushing to my spirit. I spent a lot of my 30s and 40s weight cycling with diets and exercise. I was on seroquel and I knew it could cause diabetes because my psychiatrist made me test for it regularly. Seroquel has a lot of other problems, and I was able to taper off of it in my 40s. The weight it added seemed here to stay, but I was tired of the weight cycles and even though my PCP was testing regularly, I didn’t have diabetes yet. So i did the best I could at the size I was. 1 yr ago, I was diagnosed with diabetes and NAFLD and strictly instructed to lose weight. I complied with medication prescribed by my Dr including Trulicity but I didn’t figure I would lose much weight on it because no meds ever made me lose weight, even ones with weight loss as a known effect. Honestly, it still doesn’t feel real how much weight I’ve lost. I never thought of it as a diet or temporary because I was more worried about my A1c scores and the fatty liver. I have a ton of GI discomfort on this med but this is nothing new in my life, I’ve always had IBS stuff since my gall bladder was removed. It’s not worse, necessarily, with the Trulicity. I also am not sure but I think that the Atorvastatin she added 6 mo ago has made it worse. I’m kind of past caring. I will say it took a long time on Trulicity before I wrapped my mind around the fact that it made me not very interested in eating, whether or not I was experiencing GI problems. That was different. I was struggling with binge eating disorder starting in 2022 and it has subsided. The binge eating I hated and it made me miserable. I’m really grateful that something stopped it. I really hope I’m able to keep taking Trulicity or similar for the rest of my life because weight loss or not, I never want to have binge eating again. I worry because sometimes my pharmacy cannot get it from the manufacturer and I have to skip my dose until they can. I worry when I read side effects that I will get them and be forced to stop taking it. Sorry for the lengthy comments, your words strike a chord with me. Thanks for sharing your knowledge and experiences!
Wonderful to meet you, Beth! Our histories are definitely similar. I rarely meet anyone with BP1… aren’t hallucinations FUN!? ugh I’ve written about a couple of manic episodes in my non-GLP blog “Navelgazing Writer.” It might interest you, too.
Anyway, so Trulicity. I also lost 80+ lbs. on it!! It was in shortage when I was on it, too (2022-2023), so know those shortages as well. Then I heard about Mounjaro (from my daughter) and it is like Trulicity on steroids. It’s awesome! But, girl, if your insurance is paying for it and it is still working for you… not just weight (as you know), but your diabetes, too. My MASH is so much better after losing weight and being on the ‘tides, but I do need more imaging to check. Putting out fat-girl fires that still exist despite my 250 lb. loss.
If I had the side effects most people talk about… similar to yours… I would embrace them the way you are. Anything would be better than living in a bed. It’s hard to explain that to others who have not been as sick as you and I, though. I think unless they have lived our lives, in bodies like ours, they simply could not understand the trade offs.
Beth, please stay in touch. Email me if you want and feel free to comment as much or as long as you want. I think I understand you in ways many others cannot. You certainly understand me more than others in my life! Thanks for wandering in.