Teri Parris Ford felt awful on her Ozempic medication. Two
years ago, her doctor had prescribed it to treat Ford’s prediabetes, for which
it was effective. Ford, a 57-year-old art teacher, experienced a drop in her
A1C (a measure of average blood sugar) and lost 9kg in six months.
اضافة اعلان
But Ozempic made her nauseated. On the days that she used
the medication, which she injected with a needle in her stomach, she would
dry-heave.
For a while, Ford took her doses on weekdays so she would not
waste a weekend being sick. But eventually she told her doctor she did not want
to feel queasy so often. They agreed that she could stop the medication.
In just two months, Ford said, she gained all the weight
back. On Ozempic, her appetite had practically vanished — a common side effect
of the drug, which was first authorized to treat diabetes and is now being used
off-label for weight loss. She might pick at a few french fries at a lunch with
friends, but she never finished a meal. After she stopped the medication, she
could finish a plate of fries and a burger and still crave dessert.
“I was insatiable,” Ford said. “I was like, ‘Oh, my God,
what’s going on? I’m hungry all the time.’ It shocked me how fast it happened.”
Her doctor prescribed additional medications to manage her
blood sugar, but she ended up on Ozempic a second time in an effort to shed the
weight again.
Ozempic and another drug, Wegovy, contain semaglutide, which
regulates blood sugar and insulin. It also reduces appetite and causes the
stomach to empty more slowly, so a person feels fuller faster. These drugs have
become increasingly popular in the past year for their weight loss effects. But
for people who take them to manage diabetes as well as those who do so
primarily to manage weight, going off them suddenly can take a toll. Doctors
say patients should be aware of these ramifications.
While some patients who try the drug choose to stop it, more
and more have stopped simply because they can’t find it anymore. The Food and
Drug Administration has listed Ozempic and Wegovy as “in shortage” for months;
Trulicity, another diabetes drug that can lead to weight loss, joined the list
in December.
Dr Andrew Kraftson, a clinical associate professor in the
division of metabolism, endocrinology and diabetes at Michigan Medicine, said
he was “overwhelmed” by messages from obesity and diabetes patients who
wondered where their next dose was and how they would cope without the
medication.
“When people cannot get it,” Kraftson said, “it’s a big
SOS.”
We asked doctors what happens in the brain and body after
someone stops taking these drugs.
Blood sugar risesDr Janice Jin Hwang, chief of the division of endocrinology
and metabolism at the University of North Carolina School of Medicine, said
patients would probably notice the effects of stopping Ozempic or Wegovy after
a week or so.
“Like any medication, when you stop taking it, it stops
working,” said Dr Robert Gabbay, chief scientific and medical officer of the
American Diabetes Association. When people suddenly stop semaglutide, the
amount of glucose in their blood can surge, Gabbay said.
Patients with diabetes may experience blurry vision,
fatigue, and excessive thirst and urination — symptoms that may have led them
to be diagnosed with diabetes originally. Some may end up in the emergency room
from exhaustion, Gabbay added, often because of spikes in blood sugar. They may
also become more susceptible to yeast or other fungal infections, which are
linked to higher blood sugar.
Hwang said physicians often try other therapies to help
control blood sugar in patients with diabetes, like metformin or insulin. But
starting and stopping drugs can be disorienting for patients and doctors as
they cobble together a plan, she said.
Cravings come backSemaglutide mimics a hormone called glucagon-like peptide-1,
which we produce in our intestines and which signals to our bodies that we are
full. The medicine affects the brain by blunting hunger signals and making
people feel indifferent to, or even actively repulsed by, food.
“They’re not ruminating about it all the time,” Kraftson
said. “They just have this low-drama relationship with food.”
For some, that’s “very liberating,” Kraftson said, but when
a patient stops taking the drug, those cognitive effects can dissolve quickly.
Some patients, he said, become more hungry after forgetting to take just one
dose of the medication.
“People will say they feel cravings come back,” Hwang said.
After weeks or months without Ozempic or Wegovy, many will gain weight.
Side effects subsideIn some cases, when people stop taking the medication, they
realize that they had been experiencing side effects while on semaglutide,
Kraftson said, like mild headaches or upset stomachs. For those with side
effects, ending the medication can be a relief.
Lee Levin, 67, who started Ozempic to help manage Type 2
diabetes, had such intense nausea that she once went to the emergency room.
When she stopped the medication, she said, that near-constant queasiness went
away “almost immediately.”
Those who return to a full dose rather than ramping up their
intake gradually may experience more severe side effects at first, Kraftson
said, including vomiting and diarrhea.
He also warned that patients might not follow all the
guidelines from when they first started taking the medications, like chewing
slowly and avoiding heavy foods so that they do not feel so full that they
become sick.
For those who slowly work up to their original dose, it may
take even longer to lose weight, adding another hurdle to an exhausting cycle
of medication.
“It’s been a whirlwind for our patients, and not in a good
way,” Hwang said.
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