My life with Ozempic – a weight-loss diary
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
Last weekend I went to a party. I wore a leopard-print Alexander McQueen pencil skirt with a black jumper. A belt was cinched around my waist. I bought the skirt in the mid-’90s and had let it out over the years until I just couldn’t fit in it any more. Recently, I had it altered to its original size. It fitted perfectly. I felt at ease in my clothes for the first time in years.
I’m on Ozempic, the “miracle” drug designed for type-2 diabetes and controversially embraced by people seeking dramatic and near-immediate weight loss. It works by mimicking the action of a naturally occurring hormone, GLP-1 (glucagon-like peptide 1), to delay the digestion process, and thereby manage hunger.
I don’t have diabetes, but I do have high cholesterol and arthritis. Ozempic can be helpful in managing both of these conditions but, for me, this is – if you will forgive the food analogy – just the icing on the cake. I have long struggled with my weight. (Obesity runs through my family, and I carry five to six kilos more than I should for my age and build.) More so than ever since I hit the menopause in my late 40s. I’ve spent long, tedious years thinking, talking about and denying myself food – or overeating and feeling guilty. Despite all the talk about body positivity (hard to embrace for someone of my age, 60), my relationship with my weight and food has never been an easy one.
Ozempic has changed things. I heard about it via rumbles. People in LA. Various celebrities who may have been on it. Friends reported that apparently “everyone” in NYC was taking it before their winter holidays. It’s that kind of drug: mandatory among the moneyed leisure classes.
Here’s what you should know about Ozempic
In the US, the FDA approved Ozempic in 2017 to help control blood sugar in type-2 diabetes.
In the UK, Ozempic is available only on prescription, to be administered once-weekly.
Ozempic is a trade name of the medication semaglutide. It stimulates the release of insulin, lowers blood sugar and slows stomach emptying. Under the trade name Wegovy and made by Danish drugmaker Novo Nordisk, semaglutide was approved by the FDA for weight management in June 2021. In clinical studies, the average patient lost 15 per cent of their body weight.
In March 2023, Wegovy was approved for NHS use for patients with a BMI that puts them near the top of the obese range, as well as those with at least one weight-related health condition. There is a two-year maximum limit for the prescription.
According to an August 2022 study, after coming off semaglutide, patients on average put back two-thirds of the weight they lost within a year.
Serious possible side effects are listed as pancreatitis, changes in vision, kidney failure, and “possible thyroid tumours, including cancer”.
In October 2022, the European Medicines Agency reported “an increase in demand for Ozempic, which has led to intermittent supply shortages that are expected to last into 2023”.
But I only started to think about using it myself after running into my supremely sensible gynaecologist Claire Mellon, who had lost a lot of weight and looked fantastic. An Ozempic enthusiast, she thought it was very beneficial for women who struggled with menopausal weight gain and described how positive the experience had been for their self-esteem.
Would she prescribe it for me? No, but she did refer me to Dr Tamsin Lewis, founder of Wellgevity, who specialises in neuroscience and the biology of ageing, as well as nutritional and functional medicine, to find out more. She too is an advocate for Ozempic but only, she emphasises, with proper medical supervision. “It is very effective at changing your relationship with food (and alcohol), because it has an effect on ghrelin, the hunger hormone, so that people get full quicker, and it discourages mindless emotional eating, which so many of us do.” Lewis believes it can improve multiple aspects of health. “When people drop their belly fat, it can help with cholesterol and likewise with inflammation and arthritic pain.” I was sold.
I was prescribed a three-month course by an aesthetic doctor who sympathised with my post-menopausal weight struggle. Friends were sceptical. I was either met with “but you don’t have diabetes” or “what about the short supplies [for diabetes sufferers] that are being reported in the newspapers?”. Detractors have also called it “an eating disorder in an injection”. But I was too curious for this to stop me. I paid £450 for my three-month supply.
I started the course in December, injecting the “pen” into my stomach once a week as instructed, and increasing the dose very slowly, at first taking 0.25mg and building to 1mg over several months. I knew the most common side effects – nausea, vomiting, diarrhoea and constipation – and the possible health risks. I sometimes had a little nausea, often in the mornings before I ate, but not badly – more like a mild car sickness. It would pass in minutes. My appetite decreased; I ate the same foods but in smaller quantities. I stopped thinking about food all the time.
On Ozempic I have lost weight steadily – about five to six kilos in four months. I don’t look gaunt (nor do I want to); I am back to my pre-menopausal size. Better still, my blood pressure and blood-sugar levels have gone down, the inflammation in my hips has benefited from the weight loss – and, most happily, I have a much more healthy relationship with food. I enjoy it. I eat when I’m hungry and stop when I’m full. I don’t feel guilty after eating.
When will I stop taking Ozempic? That’s more complicated. I know I have lost enough weight but I’m afraid of stopping. Studies have found that when Ozempic users stop taking the drug, the weight goes back on. Lewis advises: “It’s important not to go cold turkey. People do put weight on when they stop because it doesn’t have a lasting effect. So your appetite is going to come back, although, hopefully, people’s relationship with food changes.”
I’ve been nervous about writing about Ozempic. Although semaglutide (the medical name of the drug itself) has just been approved by the NHS for weight loss, I’m worried about other people’s judgement – for wanting to be slim in an era of body positivity, for it being seen as lack of discipline and a “quick fix” that won’t work long-term. Then there’s the fact that the makers of the drug have been suspended from an industry association for being in breach of its code of practice. Though I am being monitored by my doctor via regular blood tests, I also worry about whether there will be any nasty surprises as to the long-term effects. But the truth is, I feel the best I have in years, and have more confidence. My GP told me that this is a holistic journey and that I needed to put the work in with exercise and a healthy diet, and not just count on the drug. I have been.
My hope is that I will exchange Ozempic for more evolved, relaxed, less punishing eating habits. I hope to maintain this healthier relationship with food and with my body. Ozempic may not be a long-term solution, but it has made me understand that it is possible to have a healthy attitude to eating. And that must be worth it. Right?
This article has been corrected to make clear that Wegovy was approved by the FDA for weight management, not for general use