Ozempic has become the hot new thing among celebrities, models, Instagram stars, and other thin people who are determined to get even thinner, according to an article in New York magazine published earlier this week.
It was difficult not to come away from the article feeling disgusted by the way the medication seems to have encouraged existing on one and a half meals a day, plus some tea and a Xanax (which is how one of the women interviewed described her diet). We were curious to hear about the experience of someone diabetic whose doctor prescribed it for actual medical reasons. This essay is adapted from an interview with Ron Passmore, 55, of Richmond, Virginia, who kindly agreed to share his story. He has been on Ozempic for 11 months.
I think Ozempic gets a bad rap because some doctors are prescribing it to people who shouldn’t be on it. For me, it’s been a positive experience. I’ve been diabetic since my early 30s and have been insulin-dependent for about 20 years. I started taking it because my doctor wanted to find a better way to manage my blood sugar. I went on it in April, and I lost 100 pounds as of Feb. 1. My physician says I’ve lost more weight than any other patient he’s put on it. I had no expectations of losing weight. The average Ozempic patient loses 12 pounds. But I was at 387 pounds, so me losing 12 pounds would be like the Titanic losing a deck chair.
This was my doctor’s idea. He said let’s give Ozempic a try and see if we can reduce the amount of insulin you have to take. My blood sugar levels were in the controlled diabetic range, but I was having to take way more insulin than the average diabetic, injecting it in the abdomen no less than four times a day. When you take insulin, that causes you to gain weight. Large amounts of insulin cause additional weight gain. It’s a vicious never-ending cycle; when you have extra insulin free-floating in your system, that generates hunger and so you eat—or sometimes overeat—to cover the insulin. And then your sugar levels are so high that your brain triggers you to need still more insulin.
My doctor had been watching my weight go up for years. I’m 6’2, a big guy, so it came on slowly, maybe an average of 10 pounds a year. But before you know it, you’re morbidly obese. My doctor didn’t want me to hit 450 pounds by the time I was 60. He went over the standard stuff when he prescribed Ozempic: some patients tolerate it and some patients don’t; I might lose a few pounds.
I started on a low dose once a week. You take that for four weeks and then you increase the dose. With insurance it costs me zero, and so at first it was just another injection in my abdomen. Remember, I was still taking insulin when I got up in the morning, at lunchtime, in the mid-afternoon, and at dinnertime. I wear a Dexcom glucose monitor so I can see my blood sugar levels in real time. As the weeks went on, I found that I needed less insulin. Before Ozempic, my blood sugar looked like a roller coaster; it would spike and then I would take the insulin and it would come down. With Ozempic, that line flattened out to where I stayed level most of the day. Your A1C blood test gives you a sense of your average blood sugar level over the past 90 days. Mine used to be in the sixes and sevens, but now it’s down to 5.4, which reads as though I’m not diabetic.
For the last six months I’ve been on Ozempic, I haven’t had any issues, but there were some gastric issues at first. I never had any diarrhea, just more of an upset stomach. Those first couple of doses, there was also some mild nausea, but it only lasted a day or two. And then as dosage increased, there were a couple of times that I got a sour stomach, but I found if I drank a little baking-soda water that would fix it.
The pharmacology of the medication is that it slows your gut motility down so much that you hold on to stomach contents a lot longer. That’s what prevents you from being hungry. For me it’s not only that I have less hunger, I have less capacity. I’m the cook in my family. When I cook, I’m tasting as I go along. If I do that now, by the time I sit down for dinner, I’m already full. We had a big birthday dinner two nights ago and I made a pot roast, cream potatoes, and green beans. I just literally used a tablespoon to get a little bit of everything, and that was enough. My husband is on Ozempic, too, because he’s a Type 2 diabetic. Before, I would make a pound of meat, and now if I do that we get two to three meals out of it. I’ve had to spend tons of money on new clothes because I didn’t have anything that fit me anymore.
I’ve been a paramedic for 35 years and I also moonlight at the trauma center as a surgical assistant. When the paramedic arrives, everything calms down, and as a trauma specialist in the operating room, I have everything under control. I always felt judgment from colleagues: How good a paramedic can you be if you can’t control what you’re eating? It felt like a visible badge of weakness. Now I get all these accolades all the time from people saying, God, you’re melting away and you look great. But I almost feel guilty taking credit because I don’t feel like I’ve done anything to lose the weight. I haven’t been to the gym once. I haven’t been on “a diet.” I still eat what I want to eat; I just don’t eat the volume I used to.
My husband hasn’t lost as much weight as I have. He was around 290 pounds. After he lost 30 pounds, it plateaued. That’s because he wasn’t taking any insulin; before he started, he was just taking pills. My doctor says that it’s not just Ozempic that caused my massive weight loss; it’s Ozempic working like it’s supposed to control blood sugar. I’ve cut my insulin down by more than half. The insulin was causing the weight gain.
I wouldn’t advocate for any of my overweight friends that are not diabetic to take Ozempic. And this is not appropriate for thin people who want to be thinner. But doctors are businessmen, and if you feel like you need something and your doctor won’t give it to you, what are you gonna do? You’re gonna go to another doctor.