Trying weight loss injections
Did I lose weight? Yes. Was that the most interesting outcome? No.
Introduction
Everyone is at it. The women in your life who’ve struggled to lose weight and suddenly become much slimmer could likely be using GLP-1 injections (Glucagon-Like Peptide-1). Whether that’s Saxenda, Ozempic, Wegovy or Mounjaro, they all work in a similar mechanism.
These agents work by activating GLP-1 receptors in the pancreas, which leads to enhanced insulin release and reduced glucagon release-responses that are both glucose-dependent-with a consequent low risk for hypoglycemia. Effects on GLP-1 receptors in the CNS and the gastrointestinal tract cause reduced appetite and delayed glucose absorption due to slower gastric emptying.1
That’s the science out of the way. Well done, scientists.
Background
I’ve always been a slim person. In my teens and early twenties, I’d go as far as to say I was uncomfortably thin and coltish-looking. I spent every waking moment moving; I never met a sport I couldn’t get involved with besides netball. Netball can get in the bin.
I was so active that I’d eat dinner with my family at five o’clock, then head over to my best friends and enjoy an extra supper with their family. They effectively gained another daughter. I floated through university thoroughly mentally unhinged but looking like a skeletal Topshop collaboration. I’d head out into the cold, rainy Cardiff nights, barely dressed with no excess weight in sight. At the end of the evening the crew would head to the kebab house. I’d sit and watch everyone else eat their food, then go home, vomit the remains of the vodka sodas into the toilet and fall into bed on an empty stomach. Yes, the hangovers were quite the occasion.
I don’t know why I didn’t get involved with eating adequately; it wasn’t a conscious decision. I spent so much time at university not eating, and it wasn’t to be thin or about money. I’d need more time with a therapist to uncover why. I do know that whenever I was anxious or upset, I’d stop eating, and this is a common reaction to stress for a lot of people.
When I moved to London, the meagre money I earned in various temporary roles went towards rent and frivolities; food didn’t factor into that too much. Occasionally, I’d go home to Southsea, relax in a safe home environment, and suddenly remember I was hungry. I’d then proceed to eat everything in sight. My mum always told me she never knew who would be turning up (personality-wise)." It’s a famine or a feast with you,” she’d say.
That was the key to me eating correctly. I had to be relaxed, calm, and content. Living a quiet life seemed to be something I found hard to achieve until it was thrust upon all of us in 2020 (my personal experience here only).
Over the pandemic and beyond, I put on weight upwards of three stone. Whilst people were stressed to death, losing loved ones, worried about money and their businesses, I’m ashamed to say I had the time of my life. I learned to fire champagne corks using only one hand and worked through every beige food offering from the freezer aisle. There was no obligation to go out; everyone else was just as bored and stuck at home. So I ate and drank too much, while barely moving. A new wine every night under the guise of exploration. Mac Forbes wines got a particular hammering. After freedom reappeared, the incredible trips to Greece and Prosecco in September 2022 changed things; I was so unhappy with my size.
The Experience
Suddenly, nothing but muumuus and tracksuits fit my more rotund frame. I had a slight panic about how I was going to go back to the office in corporate attire. Nothing I owned fit. My body felt like it belonged to someone else. I quite literally wanted to unzip my skin and take off the excess. It was so uncomfortable. I felt smothered and suffocated. This wasn’t the right weight for me. I didn’t want to be supermodel thin; I wanted a semblance of myself back. I don’t want a single person to read this and question their own weight; what feels right to you feels right to you. Living in a bigger body does not make anyone less beautiful or less worthy, as long as you feel good being you. When I was living in a bigger body, I lost a lot of self-confidence because I didn’t feel like myself.
I’d heard of Saxenda; I’d seen it on internet forums. I thought it wasn’t for someone like me but for people who were at a worryingly high weight or needed to lose a lot of weight before surgery. A switch flipped in my head, and I was determined to find it and try it. In 2022, you had to hunt around a bit for the pens; you must meet specific criteria: a BMI of over 30 or over 27 with mitigating circumstances like other health issues. That’s ok. I thought I’d simply need to tell a little white lie about my weight being more than it was, to fit the criteria. I needn’t have worried, I stepped on the scales and hit the BMI criteria comfortably. Brilliant. I ordered ten pens with needles, and off I went on my weight loss journey.
You start by taking Saxenda at 0.6 mg/l for a week and then move up in 0.6 increments until you hit the full dose of 3 mg/l. I was dubious that it would work, but it did. The first few weeks hit me like a steam train; I couldn’t even look at food without feeling like being sick. I couldn’t stomach more than a mouthful of anything. The foods I craved most were fruit and vegetables. Anything fatty or carbohydrate-based turned my stomach. After a couple of weeks, I was slightly concerned that, nutritionally, I wouldn’t be getting what I needed. So, I took a multivitamin and tried to make my small meals high in protein and vegetables.
The weight soon started falling off. People asked me how I lost the weight. “Cocaine”, I joked. Less ashamed to say that than the truth. There are side effects; around six months in, I was combing conditioner through my hair in the shower and noticed far more than usual came out. I’d heard this could happen. The side effects are always a risk. Some people have ended up in hospital with pancreatitis. So, a little hair loss seemed fair. It also amplified my depression. I was extremely quiet on social media between 2022 and 2023 because I barely had the energy to work, let alone be on social media. Fewer calories meant less energy, and I’m pretty sedate even on a good day.
In the past, I had fought hard to lose weight through calorie deficit and exercise, in constant battle with my brain to lose a measly pound. The upside to these injections was not having to fight my brain to lose weight. That’s what you’ll hear many people say; the “food chatter” turns off. You don’t feel the need to plan your days around eating or ever get that feeling that you might pass out if you don’t eat in the next ten minutes. One can just simply live. Your brain goes wonderfully, blissfully silent. You don’t need a snacky snack or a sweet treat. This is hard for food lovers; I know many of you enjoy the taste and texture, the ceremony of food preparation and it’s ultimate enjoyment. I couldn’t care less. If I could take three completely nutritional, satiating pills per day, I would.
At a few months at the maximum dose of Saxenda, it felt like it had stopped working. My body had equilibrated. I still wasn’t quite at the weight I wanted to be, so I hunted down Ozempic, and yes, I had to bend the truth to get hold of the pens. I was technically now a healthy BMI. I used older photos to get past the prescribers. Ozempic is a more straightforward once-a-week injection; some people find it more intense than Saxenda, but I saw no real difference. The weight continued slowly falling off until I was exactly where I wanted to be by September 2023. (For some context, my weight in September 2023 was STILL two stone heavier than my weight at university).
It makes me quite cross when the press calls this sort of weight loss “cheating”, as if one is obliged to do things the hard way to get results. I was playing the weight loss game, but I was playing it in easy mode; there’s no need to torture yourself to become healthier in “hard mode”. There was also the vilification that we were depriving diabetic people of their medication. Firstly, I was paying privately, as was everyone else using these pens. Secondly, the potential long-term health savings for the NHS will be remarkable, with fewer weight-related issues, including diabetes, heart problems, high blood pressure, joint and mobility issues, and even cancers. Thirdly, these drugs were advertised everywhere; the onus should be on the supplier to ensure they can fulfil the demand, not on haranguing the end-user to desire the item beingadvertised to them.
Forget the weight loss for a minute, though. Here’s the one thing I REALLY want you to take home from this. These drugs are about to revolutionise the way we can treat alcoholism and potentially other addictions. A welcome and incredible side effect of this drug was that I could barely think about having a drink, or if I had one, I rarely finished it. Studies are underway as we speak covering this unexpected side effect2. It has also been shown to have promising results for those with OCD. I’m watching this area of medicine closely.
The Present Day
Here we are in January 2025; the weight has crept back on slightly, stabilising around a stone above my lowest in September 2023. I’ve decided to start back on Saxenda, at the lowest dose. For how long? I really don’t know. Everything works better when I take it. I drink one drink instead of all of them. Saxenda gives me an off button. The important thing is that I no longer feel the need to unzip my skin and step out of my body. I’d love to research this drug's broader social-anthropological effects in the next twenty years. Will thinness become synonymous with wealth (the pens aren’t cheap)? Will the perceived social power of being “thin” be diminished now it’s readily available? Will we become healthier as a society? Then there’s the economics;
pointed me to an article in The Times showing that fund manager Terry Smith has dropped Diageo from his portfolio because he believes the demand for alcohol will get even lower. I think the demand for alcohol and junk foods will completely tank in the next two decades. Watch this space.
I just read the annual shareholder letter of the UK’s largest investment fund, Fundsmith. They were early and large investors in Novo Nordisk a major player in weight loss drugs. Terry Smith observes that the alcohol suppression characteristics of these drugs could substantially reduce consumption. They sold their long standing position in Diageo last year.
I too had a good pandemic but maybe for different reasons. I got 3 months to practice being a retired guy, still getting paid but a little less than normal. Then even after going back to work everything has been less stressful since.
If it really does help with subsatance abuse that's quite a marvelouse breakthrough.
Counter argument about wealth, people on the drugs may envy those that can enjoy food because sometimes it really is enjoyable.