Ozempic hints for success

The coronavirus quarantine, constraints on movement, and nonstop webexes have pushed my borderline diabetes over the edge. But I found I was unable to up my Metformin dose without raising my blood pressure significantly. So my doctor put me on Ozempic 6 weeks ago, selling me hard on the weight loss aspect.

Ozempic is not for everyone and dose matters. You may be put off by the reviews you read on the internet. Start small and be OK with the lifestyle changes, you won’t be able to eat the way you used to. With 0.25ml my blood glucose is under control (consistently <130-135).

The following are some tips I wish I had known from the start. (Note: I am not a doctor and the below is not medical advice)

• Administering
• The fine needle doesn’t really hurt at all. It’s nothing compared to the needle stick for blood glucose. It’s the soreness after the injection that can suck. For the first few weeks, my leg was sore for a few days after injection, requiring 2 extra strength Tylenol for a day and a half. I take Tylenol half an hour before the injection. Injecting into a skin fold helps considerably.
• Pushing and holding the button does not jostle the needle or create extra pain.
• Keeping my legs warm with leggings afterwards helped.
• I inject at night so I don’t have to deal with the soreness during the day.
• Inject in your thigh not your stomach. Folks seem to report more adverse symptoms when injecting in the stomach.
• How in the world a person is supposed to inject into upper arm or buttocks is beyond me. Yes of course I have a personal assistant to help with my injections.
• Inject at an angle or into a pinch of skin if you have less leg fat. Don’t hit the muscle, it’s very painful. https://www.drugs.com/cg/how-to-give-a-subcutaneous-injection.html

• Eating
• You will quickly find out how much food you can eat at a sitting as eating too much will make you nauseous. Not immediately but about 30 minutes later when it’s too late to do anything about it. For the first four weeks my meal size was about half the size of my fist. Depending on the size of the sandwich even half a sandwich can be too much. What you know as a “full stomach” will drastically decrease. I look at buffets totally differently now knowing that a meal is about 10 bites. But the good news is you can eat again in two hours lol. (OK I’m a glutton but I love Vegas and the gourmet buffets at Bellagio and Wynn)
• Skipping meals will also make you nauseous. Carry low glycemic index snacks with you at all times, or have a way to carry the rest of your lunch with you. For me, chewy granola bars work, I only need to eat 2-3 bites.
• You are now on a low carb low sugar diet. Avoid sugary foods as these will make you nauseous. I love carbs so this is a major challenge for me. Example: bread, croissants, bagels are OK but cake and cookies are not. I am finding that grocery store food with over 5-8 g sugar per serving, especially on an empty stomach, just can’t be tolerated (nausea). And if I try to sneak too much sugar, I just feel off all day.
• Or eat a small portion (like 2 bites) of high GI food after a decent meal. But 2 cookies on an empty stomach is right out.
• Dark chocolate can be low GI. The fat in chocolate seems to buffer the sugar for me. Become a label reader, I’ve found chocolate bars with less than 6 g of sugar per serving. But MnMs have way too much sugar (19g per handful).
• Any food where sugar is the 1st or 2nd ingredient will be a no-no. I am able to tolerate any kind of fruit tho.
• The ozempic may start to wear off towards the end of the week and your sugar tolerance will increase.

• Digestion
• With the low volume of food you may need fiber supplements to avoid constipation. My recommendation, Citrucel methylcellulose fiber supplements in caplet form. (I’ve found generic brand equivalents don’t work for me.) This is just plant fiber so it’s not habit forming. As a mild IBS sufferer I have used these for 20 years. Getting enough fiber from food would require me eating nothing but cruciferous veggies, but that’s just me.
• Keep up your water intake to avoid dehydration. This can be tricky when you are not eating larger volumes of food. This has also made traveling during the pandemic tricky since most public bathrooms (fast food/Starbucks) are still closed.

Given the above, no surprise that people lose weight. I’ve lost almost 10 pounds in 5 weeks but to me it’s like Atkins weight loss from stopping all carbs/sugar.

I can see that the next two big phases of living with Ozempic will be local road tripping (with family all over SoCal we do a lot of this), and airline travel. Among other things, Ozempic requires refrigeration. But with the ongoing pandemic, these phases, and that corresponding learning, are still a ways away.

Also give yourself time to adjust emotionally. I found this drug changed my relationship with food. I get hungry in my stomach but my brain doesn’t desire anything. And for someone who lives to eat I miss this. I’m in a major carb craving phase right now. I don’t like having to change my eating habits. Food is a major source of comfort and satisfaction to me. Deprivation is hard to handle. Travel is going to be harder with these additional burdens. What if I’m on a plane when I need to inject. Continuous eating (and managing hydration) while traveling and touring will be a challenge when timed travel (flights, trains, tours) is usually the constraint.

In short, so far I am not loving this. But what can you do. Life happens.