Starting Ozempic Chris Coyier

270.

That’s as fat as I’ve been in a while. I’ve also got a back injury I’m working through. The weight isn’t helping. Nor is my weight helping me do things I want to do: long hikes, skiing, and bringing big play energy to my kid. This all breeds a gnarly kind of self-loathing that I’m sure many of my fellow morbidly obese are familiar with. It’s not chill. But don’t weep for me.

I’m aware that it’s more en vogue to just feel comfortable in my own body and nobody should stigmatize me for it. I’m very on board with not stigmatizing the obese. Both my wife and I will literally turn off a show for lazy fat “jokes”. Look, the cartoon piggy can’t stop eating! Or this kind of rough rough garbage targetted at kids. But I can’t get there in my own head. Look, the web developer can’t stop eating! I could probably use therapy, but alas.

So I’m on a journey again. A journey for my back to feel better and a journey to lose weight.

I admit I do think about that weight number. But I’m of sound mind enough to know that the number is kind of dumb and health is a far more holistic thing. I want to feel stronger. I want my clothes to fit me better. I want my blood pressure to be lower. I want to do those things in life that I want to do. I want to feel like the world is full of possibilities in the way I do when I’m lighter. If those things were going well, I don’t think I’d care about the number. For now, it’s a convenient proxy.

The journey so far? I’m doing Yoga fairly regularly. I’m in physical therapy. I’ve got a heat belt for my back. I’ve got follow-up appointments with orthopedics. I’ve seen my primary care physician and kept her up to date. I go to CrossFit many times a week to get stronger, but (believe it or not) keep it chill. CrossFit is where I hurt my back (this time), so the external skepticism is high, but I still feel it’s helping me. My physical therapist(s) goes to the same CrossFit class that I do.

And, I’m trying to lose weight.

I told my primary care doctor this. I was nervous to even tell them, because I’ve had plenty of doctors in the past tell me my weight is a problem and that there is a very clear answer to this problem: eat less and move more. I can’t shake that thought. It’s just… true. At least it’s true for me. I’m aware the calories in, calories out chorus is bogus. It’s the lowest-hanging fruit crap that Michael Hobbes and Aubrey Gordon eviscerate on Maintence Phase on the regular.

Yet — any time in my life I’ve been able to rein in my eating and couple it with rigorous regular exercise, my body responds and I can get myself into what feels like a healthy place. Maybe a little fat still, but workable. Fat fit. Life full of possibilities. I tend to hang onto it for a while. Six months, a year, a year and a half, but then it all slips back. Slowly but surely. Eventually, I’m taking great (temporary) pleasure in shoving fast food into my mouth as often as I can.

There is an emotional toll to this rollercoaster. I told my primary care doctor this. I told her I know how to do it right. I know how to eat less and move more. I should do that. I’m gonna do that. But it’s just going to be the down part of the roller coaster again. And I’m rather sick of the rollercoaster.

My father, about one year ago, got bariatric surgery. He was, and is, stoked. It was his way of stopping the roller coaster. It’s been tremendously successful for him. He’s lost more weight than he ever has and it has stayed off so far. Crucially, for him, and for most who do this, it’s a literal physical barrier to failing again and riding the roller coaster back up. You can’t binge. There isn’t room in your body. If you do, it will be very physically painful and you probably won’t do it again. It’s not that people don’t fail after bariatric, they do, but you really gotta work at failing. It’s something of a permanent solution. A pit of success, as web developers might call it. I mentioned to my doctor that bariatric is appealing to me. I have a referral to a bariatric surgeon. I haven’t spoken to anyone yet, but color me interested.

Within this discussion, my doctor brought up a new drug called Ozempic (also talked about as Wegovy or, generically, as a semaglutide, I’ll just use Ozempic here). I had heard of this. Friends have mentioned it to me as something to look into and since then I see it in the news quite a bit — like Derek Thompson’s for The Atlantic: The Weight-Loss-Drug Revolution Is a Miracle—And a Menace. — they offered to write a prescription for it and I gladly accepted.

A new, actually FDA-approved miracle drug?! My 易: sign me the fuck up.

Part of what makes it controversial is that the drug was designed for people with Type II diabetes. It just so happens that it has weight loss side effects, which are highly desirable (it’s a TikTok craze, I’m told). So now people after that side effect are buying it all up and people that need it for diabetes can have a hard time getting it. I rationalize this to myself in several ways. One, my dad is diabetic, granddads on both sides were diabetic, and I’m morbidly obese… I’m pre-diabetic, surely. Two, companies are making money selling this drug, they’ll make more.

So I’m going for the Ozempic thing. Will I just be riding the roller coaster back down again? Maybe. Probably. But sometimes that’s just irresistible. And this time, maybe I’ll end the journey with them slicing up my intestines or replacing my stomach with a Chutes and Ladders slide or whatever bariatric is. Or maybe this drug is actually so damn good it can keep me down. Let’s find out.

The first thing you should know about Ozempic is that it’s hard to get. First, you need a doctor to prescribe it for you which is never a walk in the park. I lucked out there. Then, you’ll go to the pharmacy and they’ll tell you your insurance doesn’t cover it. Reportedly, it almost never does. My doctor said she’d keep fighting for it, so we’ll see. So then you have to tell the pharmacy you’ll just pay for it. Then they’ll warn you about how expensive it is, and you’ll wave them off because you already know:

It’s $1,000 a month.

Mine came out to $934, and it’s actually 6 weeks, so it’s a little cheaper, but it’s super massively expensive. You’d think most people would absolutely scoff at a number like that and walk away. I’m sure some do. But many, including me, did not. It’s not a trivial amount of money to me, but I can afford it, by virtue of being just about as privileged as they make ’em and luckily picking computers as a job.

How do they get away with it? Such is the power of hating something about yourself and being shown a way out. I’m not paying $934 to lose weight. I can and have done that on my own. I’m paying $934 to, I hope, build some kind of barrier between me and Big Macs.

So what is it like?

I took my first dose this past Monday. Ozempic comes as this “pen” device with a needle on the end of it. You inject it once a week somewhere near your belly button. There is a whole procedure for it. I YouTube’d it. I was a little scared at first. I’m not particularly scared of needles, but I’ve never done this before. Stabbing yourself with a bit of metal that goes into your body isn’t a comfortable action. Allow me to comfort you: it’s literally painless. As you jab it, during the jab and injection, and after. It feels like nothing. Good job, pharma-science.

A lot of people, in my readings, experience side effects. Nausea is the most likely. I didn’t get that, although I was nervous about it and took a Zofran beforehand to prepare. I felt nothing. The first two days, I felt a greatly reduced desire to eat. That’s amazing. That’s exactly what I want. I was skeptical though. I want this to work so badly, that feeling could easily be a placebo effect. My own projection. Still, the result was a change in my feelings toward food. Something akin to indifference.

The feeling wasn’t “I don’t care to eat”, but “food is a thing that exists and I’ll need to eat some when I get hungry”. I enjoyed eating when I did, then stopped at a normal quantity. All that made me feel like a normal person, which was a neat little glimpse at the other side.

Ozempic, probably, and for now, has done a good job of preventing me from eating too much. It’s not the “I literally can’t eat anymore because there is a physical sleeve squeezing my stomach” of bariatric. It’s also not the “I don’t want to eat because I’m busy explaining to someone how John Bonham locked in with the guitar part, not the bass, and that gave Led Zeppelin the dynamic sound that no rock band has since achieved” of ADHD meds (or cocaine).

On the third day, I had a medium-sized breakfast. Then, my daughter didn’t eat her toast, so I jammed that into my mouth too out of that muscle memory I’m not proud of. And I felt sick. Stomach pain, nausea. I didn’t get quite to feeling like barf was imminent, but it was highly uncomfortable and lasted for hours. At dinner, I skirted that same edge again after two small tacos. Hell yes — this is exactly what I want: a barrier. I ain’t trying to starve, I’m trying to be normal.

This experience is proving another healthy insight. While my intellect wants to admit what science already knows, that obesity is a disease, it’s been hard for my deeper instincts and emotions to accept it. The fact that I can jab some science juice into my gut and it changes some chemistry in my body that finds its way to my brain and alters my relationship to food… well that just proves to me that there is something awry in bodies that causes the unhealthy behavior. Society doesn’t help. Main Street USA offering strictly junk food doesn’t help. But it’s still a disease.

Anyway.

268.

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