A Sad Semaglutide Postscript

Part IV in a series

It’s been a year since I posted what I thought was the last article in my Ozempic series, and I really wish I didn’t have to write this follow-up. But readers are still being inspired by the story I told in February and April of 2024, when I easily and gleefully lost 17 pounds using semaglutide. Though many sources, including the doctor who prescribed it, told me you have to stay on the drug permanently to maintain the weight loss, I did not believe them. Or at least I hoped they were wrong.

But now that I have gained back every bit of the weight I lost, it is clear that they were right. 

And of my friends who tried it alongside me, only the ones who did not stop taking it maintained their weight loss. 

A few months ago, I saw the numbers on my scale climbing and panicked. I ordered a bottle of semaglutide from dear old Dr. Varano and while I was waiting for it to arrive, borrowed a couple of shots worth from my friend Mark — one of the smart ones who stayed on it to maintain his low weight. His wife is also taking it; they’ve each lost more than 30 pounds and they look great. Sadly for me (and my dog Wally, who adores them), they’re moving to Spain in October.  “Having lost over 60 pounds between us, we can easily fit into a smaller country,” says Mark. 

At first, the drug worked for me the way it did a year ago — one glass of wine seemed plenty, a whole bag of popcorn, unthinkable — but within two weeks it seemed I had developed a tolerance to it. I tried a higher dose, but perhaps not high enough because I never got more than a few pounds off by the time the bottle was gone, about 12 weeks. Then I quickly bounced back up to the dreaded high.  

I could go back for more, or I could switch to tirzepatide (aka Mounjaro or Zepbound) which is supposed to be even more effective, but if I am not willing to stay on it permanently, as I am with blood pressure medication and statins, I’ll end up right back where I am right now. Both for financial reasons and because the one side effect I experience — fatigue throughout the day — is hard to put up with, I can’t get my mind around that.

Everyone says I look great, but everyone always says this. Right? Perhaps the seventeen-going-on-twenty pounds I’ve gained are invisible to other people, but they aren’t to me, and my clothes certainly seem to know about them. The sad truth is, though I continue to work out several times a week and eat a healthy, home-cooked, mostly vegetarian diet, I feel fat again. I feel fat right now. And I bet a lot of people reading this know the feeling.

“If only we didn’t care so much. But we do.” That was the caption I wrote on my illustration for the article in which I so prematurely declared victory, now updated above.  “If only” is right. I am closing in on seventy years old, married to a dachshund, very far from having any reason to display a nice figure to interested parties at home or abroad. But these thighs are going to kill me, I swear, if the reflection of my chin in the iPad screen doesn’t get me first. (Wait, is this why Face ID doesn’t recognize me anymore?) Wrinkly and saggy is bad, but wrinkly, saggy and bulging is an unsightly bridge too far. Dear God help me. Though I don’t know how inclined He is to help fat atheists. 

Looking back at the first article in my series, written when I was a mere sprite of 65, I noted that “it’s very easy to put on pounds at my age, and increasingly hard to take them off. I have been losing and gaining the same few pounds every year or two, usually by cutting the booze and going on cabbage soup.” Then I proclaimed that with my new, fatter self, this was not going to be enough and I couldn’t get it together to do it anyway. 

Well, that’s probably not wrong, but it may be all I have left to stem the tide until I can rationalize spending the money to fix the problem, and make my peace with whatever side effects I incur. According to AI, semaglutide and its friends will likely become more affordable when Medicare price negotiations take effect in 2027, and when the patents of the brand-named versions expire around 2031. 

Until then, I will have to resign myself to the good part of not being on weight-loss drugs — eating and drinking! And cooking! May my profound and abiding love of food and beverages sustain me through the blimp years ahead, and may this annoying, narcissistic, sanity-destroying and ludicrously petty concern somehow fade, following along with my hair color, my eyesight, my skin tone, my hormones and my memory. Maybe I won’t even care by 2031.

Somehow, though, I think it’s going to be the last thing to go.