"Why I take Ozempic…"
A very honest chat with a mate who's been on the "miracle" weight loss jab for a year and a bit, after buying it online.
My most wildly popular piece of the last few weeks was called Why We’re All Obsessed By Being Thin AGAIN. It was Paid Subscribers only, I’ve just de-paywalled it for 48 hours, because it’s relevant here.
After I posted WWAOBBTA, I was bombarded by readers’ thoughts, perspectives, experiences. Those of friends and subscribers who’ve struggled with eating disorders, those of people who haven’t - but have had nonetheless complex relationships with their bodies, their weight; some, grateful for my honesty, some - not quite so sure it was all that useful.
But - more than anything else - people wanted to know more about Ozempic, the weight loss “wonder” jab I talk about in that original piece, and which, I speculated, might be ground zero on us obsessing other thinness as much as we ever did.
I was really surprised to learn many of you had never even heard about it before, it feels like it’s all anyone’s talked about round my parts for the last 18 months. But nope - it was news to lots of you, who were clearly intrigued. Some of you just: mega keen to know where to get it.
So first, an explainer: Ozempic is the brand name of the drug semaglutide. Semaglutide was originally developed to treat diabetes; many patients on it, noticed it had a side effect which meant they lost weight. A lot of weight. Ozempic works by mimicking the action of GLP-1, the hormone released naturally by the gut after we’ve eaten, the one which tells us, we’re full. People on semaglutide report feeling that fullness all the time, which stops them eating nearly as much, which means they lose weight. Semaglutide has been tested, drug authority approved, both as a drug to treat diabetes, and more recently, to aid weight loss - in short: it’s legal. It’s available on the NHS in the UK - though, in the case of Ozempic, only for the treatment of type 2 diabetes, Brits using Ozempic for weight loss are paying for private prescriptions. Ozempic is so incredibly popular, it’s been compared to Viagra. Profits for Danish pharmaceutical Novo Nordisk, the company which produces both Ozempic and Wegovy (same drug, different brand name) were so vast in 2023, it single handedly saved Denmark’s economy from crashing.
Semaglutide’s weight loss application does not come without criticism or concern. There have been times when private demand has caused supply issues so severe, the people who needed it for diabetes, couldn’t get it. Some people have ghastly side effects, nausea, diarrhoea, sickness, headaches, flatulence and dizziness among them. Stephen Fry said it made him puke up five times a day. There are, inevitably, reports of people over-using them, doubling their dose in the hope of quicker weight loss, and ending up very sick indeed; there are also reports of people suffering from eating disorders, acquiring it, with obviously deeply troubling consequences.
There’s some terrible fake trash slopping around online, causing trouble and even: hospitalisation; there’s “O face”, the bitchy name for the phenomenon by which some of the celebs who used it - hit it hard and early - lost so much weight, their faces became drawn, hollowed, gaunt. There are even reports of people getting unexpectedly pregnant while on it - this appears to be predominantly related to PCOS sufferers suddenly getting control of their insulin, which makes them fertile which is… only good if you want to be pregnant.
There are, to put it mildly, questions.
But there are also life changing results.
I’m not in the business of promoting semaglutide for weight loss. I’m really not. In an ideal world, we’d all have the psychology, physiology, education and finances to keep ourselves at a happy, healthy weight, all the time. At the same time - I know, we all know, that isn’t how society works, how the food industry works, how we work. Obesity poses an epic health crisis to our society. It’s also class issue - it’s so much easier to be a healthy weight if you have the dosh for nutritious food, and PTs. Ozempic can easily be seen as - if not the answer, then, a part of it. And it just is intriguing, isn’t it? Evocative. Potent. For some people, it’s just straight up wonderful. Oprah Winfrey said of it, last year, in an interview in People magazine: “The fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift… I’m absolutely done with the shaming,”.
And I have a friend who is on it, has been for a while, and like Oprah, is really happy with it. I’m calling her Bea. She’s in her mid 40s; when she started using Ozempic, she wanted to lose somewhere between three and four stone.
Here’s what she told me about her experience.
ME: So, Bea - when did you first hear about Ozempic? And how?
BEA: March last year (2023). There was an article in The Times, and my friend P and my sister both sent it to me, straight away, without knowing the other one had. The article was about Kim Kardashian, when she wore the Marilyn Monroe dress [to the Met Gala]. People had been speculating, this is how she lost weight for it: with Ozempic.
[NB Kim Kardashian has always insisted it was a combination of nutrition and training which allowed her to get into that dress.]
BEA: So the article explained what Ozempic was, and how it worked. My friend P is Brazilian, and he was already taking Ozempic. I trust everything he tells me. He’s super smart and careful, also, Brazil is ahead of the UK in aesthetic treatments. P had to get blood tested before he could get his prescription.
ME: Did you immediately think: Ooooooh, I want this?
BEA: Oh yeah. I’d wanted to lose weight ever since I had my second child [eight years ago].
ME: Had you tried? The “normal” ways?
BEA: I don’t like to diet. But I’m quite active. I’m not someone who sits in front of the TV and eats… But…
ME: But it’s hard?
BEA: It’s hard.
ME: How did you get Ozempic? Private doctor?
BEA: No. I got this app…
ME: AN APP?
BEA: Yes!
[Bea shows me the app. I’m amazed - I’d had no idea people were acquiring Ozempic this way. After speaking to Bea, I find out this is precisely how a lot of people are getting it currently; three other friends are doing it with apps. I Google the legal situation on semaglutide apps, learn that - yup: Ozempic is being sold legally by online pharmacies via apps, including the one Bea uses. These pharmacies insist every online treatment request they receive is reviewed and appraised individually by a medical clinician. They also insist every participant has a BMI of over 30 - or 27, if they’re surfing with a weight-related condition like high blood pressure. The big name high street chemists are offering equivalent services -online consultations and support - to prescribe Wegovy. I simultaneously learn that the MHRA, the UK’s Medicines and Healthcare products Regulatory Agency, warns against buying weight loss jabs online, saying the internet’s awash with fake semaglutide, and that buying prescription-only medicine online without a prescription poses “a direct danger to health”. Would I take anything like this without seeing a doctor for a thorough consultation? I would not. Do I think you should? I do not.]
BEA: They ask you questions about your weight, they advise you how to do it…
ME: It’s relying on you being honest?
BEA: Yes. They did ask for a photo, which is a bit creepy because you just send it out. But not naked! Mainly here [she outlines her torso]. And they ask if you have any diseases, if you’re pregnant… So you do all that, and then they send you six months supply.
ME: Do you pay for the app?
BEA: No, but you pay for the prescription.
ME: How much?
BEA: £198, I think, a month. But then it went up because there was the shortage, just after I started. It went up to £229.
ME: So you just went for it? Same day you got the article?
BEA: Literally, it was ordered immediately. I wanted the solution.
ME: Were you worried?
BEA: About the needles - a bit. [Semaglutide is injected directly into the stomach, thighs or upper arm]. But it’s once a week, which made it a bit better. And the needles are so so small, in the end, I didn’t mind. They send you the needles, everything you need. It’s really hard to do it wrong. Like: it’s hard to do too much - unless you really want to. I told a friend about the app, who told her friend - but she got very ill on it. Kept being sick. My friend said to me: “Did you have any side effects?” I was like: “No!” She said: “My friend did… But she was doing double the dose.” I guess she thought she would lose weight faster.
ME: That’s friggin’ stupid!
BEA: No. I think people are desperate.
ME: Ah. True.
BEA: Or they want to lose weight for a wedding, for a holiday, they think they can do it quickly… They can’t. Me, I wanted to lose weight before I reach the menopause. Because I know: then, it’s so much harder to lose weight. There are all these clothes, that I used to wear before [pregnancy], and they’re still hanging in my wardrobe. I was looking at them, thinking: is it over? Or - could I wear you again one day? I know that’s vain…
ME: I don't think that’s vain. You love clothes. So do I. I understand.
BEA: I do. And it’s about health too.
[In May this year, a major study, big, and long term - funded by Novo Nordisk, but still, well-received in medical communities - found semaglutide delivered cardiovascular benefits regardless of whether those taking it even lost any weight.]
ME: So, the prescription arrives, you do the first jab, it’s fine… Did you notice an effect immediately?
BEA: No. For a month: nothing happens.
ME: Nothing at all?
BEA: Well, what is strange is, you fancy eating something, then when you start eating it, you’re just kind of full, and you don’t want it after all.
ME: Does it ruin food for you?
BEA: No! I felt good that I had something to look forward to.
[The journalist and SubSatcker
, who has also written and spoken about taking Ozempic, says something similar: that he’s more capable of enjoying food, of relishing it, on Ozempic, than he was before.]ME: When did you realise you were losing weight?
BEA: June 2023. I started in March ‘23, and at first, I was 90 kilos, then I was 89.5, then 89… then in June, after three months, it was suddenly 80.
ME: And were you delighted?
BEA: Oh, yes! I could start wearing my old clothes, people were noticing. It felt good. How it works: you raise the does, every month, by a very little bit. You start, they send you 0.25 mg, then, 0.5mg, then 0.75, until it’s 1.0mg. When the shortage happened, it dropped to 0.75 again… Then back up to 1.0. I stay at 1.0. Since August last year, I haven’t lost a lot of weight…
ME: So the weight loss plateaus if the dose isn’t increased?
BEA: Not completely, it’s just slower. Altogether now, I’ve lost 15 kilos, two and a half stone. I want to lose another stone, stone and a half. You’re supposed to lose about 10 - 12% of your body weight a year, which tracks with my experience.
ME: So, by my maths, you’ll be on it for about another year and a half?
BEA: Something like that.
ME: Are you worried about coming off it? Worried your weight might increase again?
BEA: No, because in the past, I’ve been able to maintain my weight. I’ve never been thin-thin, but I’ve always been stable. It was only that I put weight on with pregnancy.
ME: So you think that once you’ve achieved the weight loss you want with Ozempic, you’ll be able to maintain it, without?
BEA: I do. I think for some people, who have maybe struggled with their weight all their lives, it might be different, it might be more difficult. We all have such different psychologies.
ME: We do. Were you worried about ‘O Face’?
BEA: That’s why I don’t want to lose too much weight! I don’t want to look like I’m ill.
ME: Do you tell people you’re taking Ozempic, or is it something you keep secret?
BEA: No. If someone asks me how I’ve lost weight, I’m not going to say: “Oh, it’s because I’m so good at diet and exercise!” I’m not going to lie. But at the same time, there are people who I don’t think would use it well.
ME: Who you think would double-dose?
BEA: Or: if it’s someone who is normal weight, they just want to lose a little bit for the summer or whatever. If you want to lose five kilos: this is completely the wrong route.
[Stephen Powis, medical director for NHS England, has said semaglutides should not be seen as a “quick fix for people trying to get ‘beach body ready’”.]
ME: But you are a happy customer?
BEA: I’m more comfortable with how I look, yes. I’ve never been one of those people who hates the way they look, if I’m on the beach, or… No no no no! I’ve never had that issue, never been the one hiding myself. But…
ME: But now, you can wear the clothes you want to wear?
BEA (beaming. Beaming Bea): I can.
Hi Polly,
I think it's really important to talk about these types of drugs and treatments and why people want them. However in my previous job I was a diabetes nurse specialist and was involved in the first trials of GLP-1 inhibitors. Ending up being Ozempic. These medications are indicated in people with type 2 diabetes for a reason. They tend to have mixed hormone signals that interferes with their insulin secretion, which can increase their insulin resistance and cause further spikes in blood sugar which is a very serious impact of diabetes leading to significant long term health problems. The drug was designed to mimic the body's normal natural response to hormones in the gut whichake you feel full. Diabetes and obesity can mess with these signals. It is not clear whether this is as a result of poor eating and diabetes or because of it. The research is not definitive on that but research is improving. I'm not saying all this to lecture trust me I have worked in diabetes and obesity for a long time and have huge empathy for people such as Bea and also have my own weight issues.
The reason I am saying it is because a person who has a normal hormone profile and does not have diabetes can be put at risk being on GLP 1 activators. There are links to all sorts of diseases and also there is a risk of low blood sugar that is not normal and can be dangerous.
Bea doesn't seem to be too badly impacted but still it can harm the normal endocrine system. The GLP 1 drug group is now treatment for obesity without diabetes but that tends to be in people who are morbidly and dangerously obese.
Anyway I think it's important for people to know all the facts also Uay be interested to know that you can mimic Ozempics affect. In people who are slimmer and tend to eat high fibre diet and good protein and also exercise, particularly those who have always been slim and not experienced turbulent weight fluctuations are known to have normal GLP 1 process. These are people who feel full and are able to stop eating. Ozempic only exists because the body did it first. I know that can be unhelpful to hear but there is another way. Also the diarrhoea and nausea from Ozempic is severe. I had many patients who could not tolerate it at all because they were so fearful of not making the toilet.
I was reluctant to read this article when first posted. I have to say I think it’s a tasteful insight in how a person may choose to use it properly (minus doc supervision). It reminded me about how important it is to feel good in one’s own body which of course is highly individual. I would 100 advocate for doctor led prescription and guidance though.