Although I’ve never been skinny, my weight took a turn north last winter and kept going. Weight gain isn’t new to me. I’ve spent my whole life gaining and losing the same fifteen pounds over and over again; measuring my self-worth by how many calories I had consumed or whether I was thinner or fatter than the day before. But this felt different. My old weight loss hacks weren’t working. No matter how many meals I skipped or hours I spent on my Peloton, the pounds kept piling on.
My first thought was menopause. Losing my lady hormones could make me extra flabby. I’m 51, so the timing made sense. Most nights I woke up in sweaty panic attacks and, during the day, felt terribly depressed. It would have been easy to blame low self-esteem and the pandemic, but, erring on the side of hope, I paid a visit to my gynecologist.
“Depending on you’re lab results, we’ll start bioidentical hormones,” she said.“But I’m sure you’re in menopause.”
“But what about the weight?” I asked, angrily pinching four inches of belly fat for effect.
“Yeah. Menopause makes you gain weight.”
“But I can’t live like this. It’s too much.”
She nodded. “Semiglutide.”
“The ice cream?”
“No. That’s semifreddo. Semiglutide. It’s the generic form of Ozempic.”
She went on to explain that semiglutide is a glucagon-like peptide-1 (GLP-1) analog. It helps regulate the hormones insulin and glucagon when blood sugar levels are high. It also slows gastric emptying, so you feel full longer. At higher doses, semiglutide acts on the brain to decrease appetite. It was FDA approved as Ozempic in 2017 for diabetes and in June 2021 for weight loss–for those of us with at least one other underlying condition.
My height and weight easily placed me in the near-obese BMI range. I also had chronically high cholesterol. I had always suspected I had polycystic ovary disease, which would explain my overabundance of body hair and adipose, but I had never been formally diagnosed.
When I was in my early forties, I met with a naturopath to review my genetic profile. She told me my hormones resisted weight loss. She didn’t know how to help me lose weight, but she congratulated me on not being even heavier. Her diagnosis, while heartbreaking, was also validating. I’d tried every diet, workout regimen, and medication on the market. Nothing worked. What’s worse, when I’d recovered from the torture of trying to shed weight, I always ended up gaining even more. My body held on to fat like a hoarder does old magazines.
“This semiglutide sounds too good to be true,” I said. “What’s the downside?”
“Gastritis. It’s kind of bad. And there are other serious side effects. But I’ve been on it myself for months, and I’ve lost 20 pounds.”
I was no stranger to stomach pain. Or acid reflux. Or bowel problems. What was a little diarrhea compared to control over what went into my mouth? I decided to take the plunge.
She ordered the medication from a compounding pharmacy instead of the standardly available pen. “Start with 0.1cc,” she said. “It’s less than the recommended dose, but, trust me. You’ll want to go slow.”
Two weeks later the package came in the mail: a tiny bottle filled with pink liquid and a bag of syringes. I followed the instructions, excitedly drawing up the dose and injecting it into a fatty part of my belly. Then I waited. Once it was in, there was no going back.
The belching started right away. After a few hours, I had heartburn but otherwise felt fine. By 3:00 pm I realized I hadn’t eaten anything, something I’d heard people brag about but heretofore believed was a lie. At his urging, I shared a Reuben with my boyfriend, wondering through burps how I’d never noticed that mustard tastes like eggs. By dinner time, I was still full, so I skipped it altogether. I went to bed without eating, certain my hangry stomach would wake me in the middle of the night as usual. It didn’t. I slept like a baby and woke up feeling refreshed. And still sated.
The rest of the week felt like an out-of-body experience. I was myself but a better version–freed from the burden of when, how, and what I ate and the judgment that came with it. My stomach controlled itself so I didn’t have to. I stopped eating when I was full because I was finally able to feel full. No longer a victim of faulty wiring, hormonal dysregulation, and genetics, I felt energized. Empowered. Free.
After several weeks, I was managing about one and half tiny meals a day. The weight came off so easily that I hardly assigned any pride of ownership. Semiglutide acted like a chemical lap band, preventing me from eating more regardless of what I wanted. One misstep with a spicy meatball or extra helping meant a miserable night in the bathroom and sulfur burps. But giving up control over my overconsumption also meant giving up my ability to eat enough.
As the weeks went on, my energy levels decreased. I stopped exercising. I also stopped drinking alcohol, which made my acid reflux even worse. My skin was sensitive, and my joints ached. I slept more and had brain fog, making it hard to write or create. I didn’t want to go out to dinner because the thought of food made me sick. Many of the things I used to love–the taste of food, the adrenalin rush of long runs, the excitement of writing a new article–were just plain exhausting.
I read that the side effects eased up over time, so I continued for another few weeks. I even tried adjusting the dose and adding antacids, like Pepcid. It didn’t make much difference. I was skinny but numb. Semiglutide took away my fat, but, like a greedy thief, it took my joy with it.
After eight weeks, I stopped taking the medication. The side effects subsided pretty quickly, and my energy returned–along with my hunger. I can exercise, eat, and create again. But now, instead of resenting my love of food or my need to exercise, I’m grateful for the joy these activities bring me. And while I get complimented regularly on how “good” I look, I don’t take it personally. I learned that the size of my body isn’t a reflection of my character or self-worth. It’s a result of my genes and hormones. I could gain all the weight back or stay this size — I don’t know what my body will do without the medication. But, for the first time in my life, I have a choice. And, for now, I’m choosing joy.