If you’ve not heard of it, semaglutide (also known as Ozempic, Wegovy) is the wonder weight loss drug that is currently storming the world, and even Boris Johnson seems to think it has revolutionised the treatment of obesity, meaning the problem could be nipped in the bud very soon.
As someone who struggles with weight control, I’m always on the lookout for quick-fix solutions. So you won’t be surprised to hear I’ve been there, done that, and err… am larger than ever.
This is why I know it’s not the cure-all people are saying it is. There are several serious issues with the drug.
To understand why, you first need to understand how we arrived at the logic of prescribing it. Over 15 years ago Dr. Robert Lustig rocked the medical establishment with a new theory of obesity. It overturned decades of conventional wisdom about what makes people fat. The key driver, he said, was not laziness, too many fatty foods, or insufficient exercise. It was linked instead to a phenomenon called “insulin resistance”, a state that emerges from a sugar imbalance and which messes with healthy people’s metabolisms.
According to Lustig, the unconscious overconsumption of refined sugars, rather than fats, especially in the form of high fructose corn syrup, was the true driver of obesity across the modern world. That excessive consumption, however, had nothing to do with poor self-control or bad life choices. It was mostly a function of commercial practices in the food industry, as these harmful refined sugars were being snuck into food supply chains mostly for commercial profit. The theory finally explained why obesity was so closely related to Type-2 diabetes.
Unsurprisingly, the findings didn’t go down well with ‘Big Sugar’, which almost immediately set upon rolling out a sophisticated public relations campaign to discredit Lustig. The pushback meant his findings wouldn’t be taken seriously by general practitioners for years.
But then, unexpectedly, one of his online lectures went viral on the internet. As it spread, it began to make an impact on those directly affected by obesity.
The results spoke for themselves. And doctors had to take note. With the medical establishment not able to ignore Lustig and his sugar theory anymore, they began to embrace the idea that weaning yourself off sugar was comparable to weaning yourself off an addictive illegal drug.
What happened next is how the story became a pharma phenomenon.
The immediate effect of the medical establishment’s acceptance of the sugar theory was linking it to diabetes, and via that to diabetic treatments. Lustig himself keenly recommended those wishing to lose weight to emulate the advice given to those diagnosed as suffering from “pre-diabetes”. His advice was to remove as much refined sugar as possible from one’s diet. However, unlike the medical establishment, he stopped short of recommending insulin products for anything but the most extreme cases.
This is how semaglutide came into the frame. It is and always has been an anti-diabetes drug. But what Lustig’s findings implied was that prescribing it to those struggling to wean themselves off sugar naturally, could help kick-start the process by addressing the body’s insulin resistance.
This, however, created three problems: First, semaglutide started to be prescribed en masse without the associated dietary advice as a cure-all solution. Second, it began diverting the supply of the drug from actual diabetics who are too far gone for dietary interventions to work alone. Third, it began to transform people’s metabolisms in ways that hooked them permanently to the drug.
Lustig’s understanding of the side effects assured his preferred treatment remained the elimination of sugars from one’s diet naturally, not via medical intervention.
It’s advice that squares firmly with my own lived experience. There’s no doubt the most effective diet I’ve ever been on was focused on sugar elimination, in large part based on Lustig’s advice.
But, of course, if it was as easy as cutting sugar out of your diet I would be a size 12 by now.
The modern food system, it turns out, is hardwired to supply sugar to you at almost every point. Go into any traditional lunch or food venue and it’s almost impossible to find sugar-free options, even among the salads. It’s simply not a dietary thing. All the usual diet classifications don’t account for sugar. Vegan = sugary. Fat-free = sugary. Vegetarian = sugary.
Sugar is simply everywhere.
So yes, despite losing lots of weight by following the sugar-free regime in 2017, it slowly crept back on after the birth of my daughter. The pressures of work, motherhood, and more, meanwhile, meant I didn’t have the capacity to meticulously filter sugar out easily from then on.
Being well-versed in the theory of insulin resistance, however, I was very much aware of semaglutide. And so it was that when the drug was given the go-ahead for over-the-counter distribution about three years ago I jumped at the chance to get on it.
The experience, however, turned into a nightmare.
I experimented with the treatment two times. In the first instance, it was via an online agent who prescribed me a daily dose, to be injected in the belly. The first week, the transformation was incredible. I lost about 3kg in less than seven days and was visibly gaunt. The reason why it was so successful was obvious. The treatment had synthesised a gastroenteritis attack. I felt on the verge of vomiting the whole week, to the point I couldn’t even look at food if I wanted to.
So, yes, it had proved effective, but at what cost? The drug had made me feel horrifically ill. So ill, in fact, I couldn’t get out of bed, let alone work.
To combat these effects I was encouraged to drink water and to lower the dose.
Soon enough, the feeling of sickness gave way to a moderate feeling of permanent fullness and a swift appetite satiation at mealtime. I thought I was onto a winner. Not so. It wasn’t long until other negative symptoms emerged, among them brain fog, dizziness, and nausea, which hit me in unexpected waves a bit like morning sickness. I was anything but my best self at work or home.
With the moderation of the symptoms, the weight loss also began to plateau. But things were truly scuppered when I discovered that the best way to cope with all the bad side-effects wasn’t to drink water, as they recommended, but to eat something. And so it was I began to eat through the pain, and with that through the weight loss. It was a doomed cycle.
Simultaneously, I was struggling with the mode of delivery via an injection pen, which had to be stored in a fridge. For someone who was traveling a lot at the time, this was a real struggle. Inevitably, I forgot the pen in a hotel mini fridge one day, leading to a sudden and involuntary suspension of the regime. I never got back on course. Not least because by that point, I had developed such a tolerance to the drug I needed ever larger and more impractical doses to sustain the same effect. At a price of about £250 per pen it became unaffordable. I gave up.
Then came the really bad news. Withdrawal. This saw me balloon almost immediately beyond my pre-Ozempic size. In a few weeks, I was bigger than ever, despite not having changed my eating habits at all.
About a year later, someone told me that the drug was now available in weekly form. Convinced I had messed things up because of erratic dosing, I decided to give it another go. This time the immediate effects were negligible. I didn’t get my ego-boosting first-week mega loss. And overall, if the drug did anything, it suspended my continuing and ongoing weight gain rather than helping me to lose more. Nor did the weekly injections prevent the nausea or brain fog. The negatives weren’t quite as bad, but the upsides were far more limited.
Utterly underwhelmed and disillusioned, especially since the price of the pens remained prohibitively expensive, I gave up again. And, again, I ballooned after doing so.
I should really have checked out what Dr. Lustig’s opinion on the drug was before going ahead with the programme. For some strange reason, I didn’t. It’s a shame because he had predicted the negative cycle from the beginning. “It’s like putting a band-aid on obesity,” he noted in December 2022. Side effects too, he warned, were being underreported, as were the potential long-term effects on peoples’ metabolisms.
The positive press the drug is getting is failing to get any of this across.
Replacing a sugar addiction with an eye-watering expensive Semaglutide addiction simply cannot be the answer to mass obesity.
And if it’s true that high-powered execs like Elon Musk and Kim Kardashian are using it, based on my experience of what it does to your brain, I would seriously question their capacity to do their job while on it.
Of course, everyone’s reactions are different. No doubt some people will process it better than me. But, for many, it will end up the quickest and surest path to under-productivity, poverty, and depression. I’ve decided to invest in an electric bike instead. — IK