The Zen Leaf

**Let me preface the following post by saying that 1) I do not have diabetes, pre-diabetes, or high blood sugar; and 2) I have PCOS, which is a hormonal imbalance that usually includes insulin resistance regardless of blood sugar levels or diabetic status.**

Ozempic is an injected medication used to help control blood sugar in patients with type II diabetes, but also results in weight loss, especially in patients with PCOS. Back in late July, at my six-month follow-up for PCOS, my doctor put me on Ozempic. She first mentioned it at my last appointment in January, but back then, I was still dealing with major hives and I didn’t want to add anything more into the mix. In July, after nearly three months hive-free, I took a shaky breath and said yes. The medication is, I was told, extremely effective (every patient she’d put on it had lost weight) and had very few, if any, side effects. I might get some nausea or other indigestion issues, but most likely even that would be light. And if the side effects weren’t bad, I could expect about a pound per week of weight loss, possibly more.

Despite the rave review, I was really nervous. First, I’d never self-administered an injection, and needles aren’t my friends. Second, people who have really bad side effects end up with severe nausea and vomiting, and I have terrible emetophobia (fear of vomiting). That first night, Jason had to do this with me, because I didn’t know if I’d be psychologically able to stab my abdomen with a needle – especially after I discovered that it was visible! I thought I was going to put the pen against my abdomen and hit the button to make the needle pop out, but no, I had to watch the thing go in. !!! Jason also stayed home from work the next day in case I began vomiting my guts out.

Good news: Despite the psychological trauma of stabbing myself with a needle, I actually didn’t feel a thing, and all went well. For the first time, I’m kinda glad that most of my abdomen has been numb (nerve damage, grr) since my surgery back in 2014! I think that helped a lot. I also didn’t experience any side effects overnight, and the only thing I felt over the next few days involved a decrease in appetite and some mild nausea at times when I would normally eat but didn’t feel like eating. I had to get the balance right – if I ate too little, my blood sugar would drop too low and wake me up at 3am – but it was pretty easy to adjust to. And in the first week, I lost 2.6 lbs. Yay!

***What follows is week by week happenings. If you just want the gist of results, skip to the last paragraph.

Second week: More of the same, except that I began to have periods of food aversion. Mostly that involved not wanting to eat any meat or heavy fats in the evening, so I’d make meals of the primarily carb portions of our dinners. I also added back some exercise. In calories, the balance was identical to the first week, but in the second week, I gained back a pound. From the way my face/hands/feet were swollen every morning, I’d guess it was water weight from adding back the exercise.

Third week: Injection increased to a higher level, and with it, the mild food aversion I’d had over that second week grew worse, extending to the entire day and growing very specific. It wasn’t that I didn’t want food, it was that my body wanted wheat. After over two months eating gluten free, my body was begging me for wheat. Sigh. I decided to listen – mostly because just about every other food made me gag to put it in my mouth – and ate non-gf bread for dinner the day after my third injection. Over the next few days, I tried to pay incredible attention to my body. I only ate what it asked for, no matter how weird, and I stopped the second food no longer sounded good, even if that meant a 200-calorie lunch. Halfway through the week, the food aversions disappeared, and my appetite increased as if in compensation for the lower days. Conversely, my weight (which had been creeping up daily despite the low calories) dropped – but only dropped back to where I started this whole process, making it three weeks with nothing to show for it except some misery.

Fourth week: Injection didn’t go well this week, and the food aversion immediately hit again the next day. I wrote to my doctor to tell her about what was happening, since I only had five weeks’ worth of doses in my sample pack. Unfortunately, her response was supremely unhelpful: Let’s double the dose and I should eat a 1200-calorie low-carb diet! Um…no. I felt really triggered by her response all week, and ate much worse than I should have, leading to another gain, and taking me over where I began the process four weeks earlier.

Fifth week: After some long conversations with Jason, I decided to try the 0.5 mg dose for a third week, in case it just took that long for my body to adjust and the food aversion/sickness to abate. The prescription higher dose injections hadn’t come through yet from my doctor, and this was the last dose in my current sample pen. Surprisingly, there were very few of the food-aversion side effects I’ve been dealing with, and my weight did drop a tiny bit. It’s still cycling within the same three pounds from the previous month on this medicine, though, and I’m not sure it’s actually making any different long term.

Conclusion: Today is the start of my sixth week. I heard back from my doctor yesterday and found out that it’s unlikely my insurance will cover this medication or others in its class unless I actually have diabetes. She gave me another two sample packs, so I have 8-10 weeks’ worth of medication left. Honestly? I’m not sure the extremely mild benefits (five week weight loss: 1.5 lbs) have been worth the side effects (sluggishness, food aversions, lack of energy, unable to exercise, restless sleep…). I’ll probably give it a little longer, but I’m honestly not too sad at this point that it doesn’t look like this is a longterm option for me. Oh well.