Welcome to the Land of Oz, aka Ozempic, Where Weight Loss Dreams Come True

Are Ozempic-type drugs right for people who have 20 pounds or less to lose, and a limited budget? First in a series following one pilgrim’s progress.

No matter how overweight they are or aren’t, most people have spent a few birthday candle wishes on the dream of being magically slim. But only in fairy tales is such a transformation painless and easy. If you’re like me, you’ve devoted a significant percentage of your life to worrying about and dealing with your weight. I started in early childhood.

This is why, in the five weeks since I first shot this stuff into my inner thigh in a doctor’s office in D.C. and then almost effortlessly lost 10 pounds, I have come to feel I am in Oz. 

Short for Ozempic. Brand name for semaglutide, the weight loss drug that’s been in the news as Oprah, the Kardashians, Jonah Hill and Amy Schumer flaunt their svelte shapes. I somehow didn’t pay much attention to it until this past January I set eyes on a friend who had lost a great deal of weight and looked fantastic. The resolution to get my hands on the magic potion began to form.

Ozempic was originally designed for Type II diabetics, and according to a recent New York magazine article titled “What if Ozempic is Just a Good Thing,” it is now considered a miracle drug for those who are dealing with obesity and complications such as kidney disease and heart disease. As one might expect, it is paid for by insurance if one’s BMI falls into the Obese range — but not if it doesn’t. 

Though I used an online calculator to determine my BMI was not Obese, rather on the line between Normal and Overweight, I was not happy with my shape. I had recently gone from the mid-to-low 130s, not ideal but okay for my 5′ 2 ½” height, up into the 140s. I eat a whole foods, home-cooked, mostly vegetarian diet, and go to hot yoga class several times a week, but I drink too much and I’m 65. 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. With my new, fatter self, this was not going to be enough and I couldn’t seem to get it together to do it anyway. And I have two big weddings coming up this spring.

It was when I heard that Oz makes you not just un-hungry but also takes away your desire for alcohol, possibly even opioids, possibly even other compulsive behaviors, that I knew I had to get my hands on it. To put it plainly, my whole life has been driven by desires, to the point that I have no idea who I would even be without them. (I haven’t done hard drugs in 40 years, but I have an ancient history with them and actually only got off Vicodin, prescribed for chronic pain, right around the time doctors stopped easily writing prescriptions for it.)

At this point I was not taking no for an answer.

Getting Started

I determined early on that without a prescription the drug costs as much as $1000/month, so tried emailing my doctors. I have two of them, and both wrote back they could not prescribe Ozempic for me since I am not obese. One added that she’s not a fan. “My concern is that once you drop the weight and stop the drug, the weight often rebounds. This is not good for your body/metabolism. There’s also concern that the weight loss is most often muscle and there’s known to be a negative impact on bone health as well. If you’re doing strength training 2-3 times/week and eating a mostly plant-based whole food diet, you’re doing the best thing possible to support your health.” Also, she noted, it’s very expensive.

She was not the only one against it. Every time I brought it up, I was told that I’m so tiny! And that it’s dangerous, and costly, and I’ll have to take it forever if I want to keep the weight off. Also, haven’t I heard it’s taking drugs away from diabetics? 

Yeah, well. People who think I’m so tiny are not looking at these thighs or trying to button these pants. As for the possible dangers and side effects — meh, I’ll take my chances. As for the diabetic shortage, online research shows the drug companies are scrambling to address it, ramping up production to meet strong demand. (Now there are three semaglutide drugs, Mounjaro from Eli Lilly in addition to Ozempic and Wegovy from Novo Nordisk.)

The one thing I agreed with for sure was the money complaint. I couldn’t see paying $1000 a month, but maybe I could find a better deal. If I did, I thought I might just treat myself to it. I’ve been spending so much money lately on my son’s upcoming wedding and my daughter’s grad school and other things like that — instead of the constant scrimping, how ’bout I do something for me? 

If only my dear mother were alive, she would certainly support the idea. Back when I was a chubby 10-year-old, she took me first to Weight Watchers, then to a diet doctor to get dexedrine and a bunch of other candy-colored pills. The outome of this was not weight loss, but life-long obsession, including a version of bulimia in my 20s and 30s. In some ways, I feel I’m on the other side of all that, but at the same time it’s coming full circle. 

I think Mom could live with the paradox, as can I. 

After a few more futile emails with medical providers, I moved on to my best friend Google. One of the online vendors I found, Henry Meds, had an introductory discount deal but you had to pay before you even got on the phone call. This did not feel right. I just kept Googling different search terms until I found a doctor in Washington, D.C. who offered generic semaglutide for about $300/month. Ta da!

The office of Dr. Drew Varano, Medical Cosmetic Enhancements, offers everything from liposuction to Botox to laser tattoo removal to many treatments I never even heard of. (I later learned this type of place is called a medi-spa.) When I submitted an info request, I got a call from Dr. Varano, who explained how the drug works and what the side effects are. You can read all this elsewhere, so I’ll skip it here. He explained that he dispenses a generic version of semaglutide, which is not yet FDA-approved and cannot be prescribed to diabetics (so no connection to shortages), which may also be why it is so much cheaper.

In fact, it costs $312/month for the first two months, including medical supervision, and you sign up in two-month increments. We didn’t focus on the financial aspects during this call but I later determined that after the introductory deal, the tab is $335-400/month, depending on your dose. The initial intake visit is typically in his D.C. office; after that it can be on the phone and medicine can be shipped (for a $50 fee, plus $15 for the syringes.) He also mentioned that he would need current bloodwork, which seemed reassuring. 

I asked about the problem of gaining weight back. He said if you can stay at the goal weight for six months, you’re more likely to change your body’s set point, and he offers a low-dose, less expensive maintenance program for that situation. (Also, since I spoke to him, a friend told me she bought a month’s worth of the drug in L.A. last October, lost 7 pounds and has kept it off. This was good to hear. She told me of a few other success stories in our general circle. I’m not early to the party.)

I made an appointment for the very next day, mentioning it only to my daughter to avoid further pushback.

Day One 

Feeling I would certainly need my emotional support animal on this excursion, I took Wally along for the ride, wearing the Support Dog costume I bought him on Amazon. As advised, I parked at the Trader Joe’s on 25th Street and proceeded around the corner to a high floor in a fancy building, where both Wally and I were greeted with enthusiasm.

I never saw Dr. Varano, but had a session with Ansley, a personable young woman with shiny brown hair, no makeup, and a slim figure, who took my weight, measurements, and a series of headless photographs I did not want to see. We talked about my goal to lose 20 pounds, which she seemed to think reasonable, and my desire to look decent in the wedding pictures this coming April. I looked about as good as I could look at Hayes’s wedding in 2017, I told her, and would love to do the same at Vince’s.

Have you ever injected yourself? Ansley asked me. I snorted, but didn’t go into detail about why I am such an expert on getting the air bubbles out of the syringe. She walked me through the process of taking my first dose, a quick stick in stomach, arm or thigh. For some reason, she confided, inner thigh seems to work best… so I chose inner thigh. I will be repeating this process in one week’s time at home, by which time, she said, I’ll have possibly lost 6-8 pounds. Whoa.

During my second week, I’ll have a telehealth visit to discuss my progress, in particular whether I should stay with 10 units (.25 mg of semaglutide) or increase my dosage — depending on whether I’m losing, how fast, and whether I’m experiencing any side effects. 

I left the office of Medical Cosmetic Enhancements $625 poorer, but in good cheer. At checkout, I make sure to clarify when I would have to cancel to avoid the $195 recurring charge that begins in late March. There’s enough in this bottle to last as long as 10 weeks and I think it’s possible I’ll be done by then. I hope so. 

Day Two – Five

At the first meal after the injection, I find I can only eat about half of the bowl of tofu bulgogi I served myself, along with a mini glass of wine. I don’t feel overfull or sick — just not too hungry or thirsty. This was strange. I just don’t really want any more.

Through the week small meals and light sipping continue. No nausea or constipation, which were mentioned as the primary side effects. The only problem so far is sleep. I feel tired early, like before 9, but sometimes wake in the middle of the night, then sleep in a bit in the morning. Nothing too serious, though; I’m trying various over-the-counter remedies to deal with it.

Day Seven

I’m down six pounds and I feel great. I’m still thinking about food and recipes and enjoying eating, but I just don’t want as much as usual. Two or three small meals a day, no urge to snack. The effect is dramatic with drinking — after a small glass of wine or two, I’m done. But if, as the night goes on, I still have the urge to put something in my mouth, I have a cup of tea, or one of my Werther’s sugar-free caramels. It’s nothing like the actual munchies.

Friday night was a test of sorts, as I cooked dinner for my foodie friends in D.C. — people with whom I’ve enjoyed some of the greatest food-and-drink-oriented excesses of my life. I schlepped down my pizza stone and peel, a bowl of Neapolitan dough already on the rise, and all the ingredients to make both a Frank Pepe-style clam pizza and a Philly-type tomato pie. Rainbow chard on the side. Also some homemade pickles and Amish beet eggs to nibble as appetizers. We drank wine with dinner and bourbon on the rocks during our double feature movie night. (Nyad, meh; Logan Lucky, as great as ever.) I had a little of everything, and it was fine.

I’m still eating the foods I love — been going to yoga almost every day — and generally feel like I’ve been touched by a magic wand. If this drug really works like this for overeating and drinking, I feel like the government needs to subsidize it and give it to anyone who wants it.

Day Eight

Sill six pounds as of this morning, and I just took the semaglutide out of the fridge and did my first shot at home. It was easy. Later in the morning, I had a serious conflict with a friend and was in tears most of the rest of the day. I kind of gulped both breakfast and lunch almost didn’t go to yoga, though did in the end. In the evening I had a dinner date with two dashing older ladies of my acquaintance; was looking forward to a cocktail and a fancy meal as a break from the woe. We went to Alma de Cocina, which had that very day heard that it was a semifinalist for a James Beard Award. I had a margarita, a glass of wine, a sushi-inspired appetizer, and a complicated eggplant entree with a rich goat yogurt sauce. Left a couple of bites on the plate. Tasted one spoonful of each of my companions’ desserts.

Day Nine

Somehow was not surprised to see one pound come back this morning; not too worried about it. This is why you’re not supposed to weigh yourself every day. 

Day Twelve

After a day-long bout with digestive traffic jam, I am seemingly cleared up and down seven pounds. Bought prunes, as Ansley had recommended. Last night was another test because friends here for margaritas, chili and Scrabble. Kim could not fathom how it could take me so long to drink one margarita — but in fact it lasted all night. We had a good, emotional conversation about how it can be challenging for people with more serious weight problems to deal with people like me, who are more neurotic than truly overweight. 

Had my neuroscientist friend over for breakfast — he was telling me that they are even thinking this drug might help with compulsive behaviors like shopping and gambling. Also that the GNP of Denmark, home of the maker of Ozempic, is through the roof! 

I now weigh my “normal” weight of the past several years, so it will be interesting to see what happens from here. I’m still doing hot yoga almost daily, and it really is much easier and more enjoyable without those last seven pounds. CorePower is having their annual month-long challenge. I signed up to take 20 classes in 30 days, which I’ve done the past several years in a row, and my arms are looking a lot better.

Day Thirty

As Week 5 unfolds, my weight has gone down to just over 130 — a twelve pound loss. Emanuelle, the telehealth person from MCE, has recommended I stick with 10 units. Meanwhile, I took a quick trip to Kansas City for the AWP conference… did not drink a lot or attend anything that happened after 8 in the evening, but did not see this as a problem. 

While walking down the crowded hallway with a friend, I mentioned that I’m on Ozempic. Another woman turned around and said, So am I! We compared notes— and this actually happened twice. I also traveled to Boston to see my grandchildren, where I spent three days cooking everyone’s favorite foods. Ozempic has not changed my interest in thinking about, making, and eating good things — I just don’t eat a lot of them. Similarly, I still like to drink. But a bottle of wine lasts four days instead of four hours.

I have now sent three friends down to Dr. Varano, and plan to accompany one who has an appointment next week, just for moral support and to check in with my measurements. (I’m also going to consider getting the $25 B12 shot they can give you to combat the fatigue side-effect.) I still have a good bit of stuff in my little bottle in the fridge, and am scheming to see if I can avoid spending any more money. I think it is possible. I asked Emmanuelle if people have ever been successful with “one and done” and she said that if they don’t wean off carefully, they’re usually back in a couple of months, having regained not all but some of their lost pounds. I suggested a plan of cutting to 5 units next week, sticking with that for a while, then alternating weeks until the bottle is gone. That would cover a total period of more than three months. I wouldn’t mind losing a few more pounds, but feel so much better now than I did when I started that I probably don’t need to lose more than that. Yoga every day has made a difference. And I love not sucking down 500 empty calories of booze every night, I’m sure it contributes to my overall well-being. I hope this sticks in my post-Oz future.

Right now, I’m a poster child for people who have a less-than-critical weight problem and limited funds. But I will report back in a month, and perhaps again further on, because long-term results are the real test.

Editor’s note: The story of Winik’s weight loss journey continues here, in a second article in the series. In May 2024, she reviewed Johann Hari’s “Magic Pill” for the Washington Post. The book chronicles Hari’s own experience with semaglutide, the generic version of Ozempic and similar drugs. Readers can find that review here and sign up for notices of Winik’s other columns at marionwinik.com.