ZepBound (???)

Dr. Dan is a fun guy who covers GLP-1s on his YouTube channel. He is a Canadian pharmacist who specializes in obesity treatment. I specifically recommend him and not doctors to you because you work in pharmacy yourself.

is his recent videos about the expansion of FDA approvals of GLP-1s to cover sleep, liver, kidney, and heart concerns. And there is increasing evidence

Cardiovascular benefits of GLP-1 drugs independent of weight loss - Peter Attia MD - Peter Attia, a well-known longevity doctor, on the cardioprotective benefits of GLP-1s independent of weight loss.

I bet we will learn more in the coming years. I wouldn't be concerned about lifetime use as long as you can afford it. And these medications will eventually become less expensive.

Like you, I am on levothyroxine for life, and I am much more resentful about it than about needing to be on Zepbound (or future, better drugs) for life. I am on levothyroxine because Lithium caused irreversible hypothyroidism, but in the end Lithium didn't work out for me. Obesity came as a result of other drugs, most recently Zyprexa, but Zyprexa works wonders and keeps me stable, energetic, and able to exercise a lot to counteract the weight-gaining tendencies, in addition to taking Zepbound. At least I know what I am paying for by suffering the metabolic side effects of Zyprexa. With Lithium and hypothyroidism, I am just paying and getting nothing in return. I do worry that one day I won't be able to afford GLP-1s, but I am not resentful about lifetime use. I have to take Zyprexa for life, use migraine prevention medicines for life, probably use low-dose Naltrexone for life, too. So what? It would be far worse if we had diseases that didn't respond to treatment or for which no treatment were available.

I had prediabetes when I started, initially on Ozempic, in late 2021. For several years, my A1C has been in the 4.7-5.1 range. I hope yours responds quickly to treatment and you never see 6.4 in your lab results again.

Strength training classes twice a week at the gym are a great start. Add very careful protein dosing so you give your muscles the fuel they need for hypertrophy, and you will be just fine. My body composition changed for the better: more muscle, much less fat. That, even though I am postmenopausal.

If the cost of injectables becomes a big issue, Wegovy pills are now available and more affordable, albeit less effective.

It is true that your thin friends do not need to deal with the things you have to deal with, but think of millions of obese people who do deal with the same stuff as you. Obesity and overweight are so prevalent now, even outside of the developed world.

I am with you. I just took Zepbound. I stayed on 2.5 mg the entire time and had zero major side effects. In 3 months I lost 20 lbs (of 40). It did really work.

The problem is... I found out about NAION. Basically that is an eye stroke. There is very little good information on the disease anyway but... it has been suggested it can happen with any GLP1. Basically you get zero warning. You just wake up with an eye (or both) that is blind. There seems to be no rhyme or reason. You can have it on a small dose... you can have it just being on it for a few weeks. They do say it is rare. 1 in every 100000. It is possible I will return to the drug when it is more clear if the GLP1 increases the risk. NAION happens to a bout 10K per year no matter what. Weirdly, if you are not white, you are likely missing a risk factor.... but I am white and have this risk factor.

For me... this is just too dangerous. I am single and I live alone. So I am reluctantly getting off. I do not have diabetes. But also I cannot pay the price. I paid for the drug for 3 months out of my health savings account but my doctor wants me to go up to a $500 per month drug. Just can't bring myself to do that. I also have heard a few new drugs are coming on the market and imho that will make Zepbound less expensive.

Here is my suggestion... do what I did. Take the drugs for a few months at the lower dose and see how it goes. I feel like I have a running start. And may be able to do the rest on my own. I learned valuable things when I was "normal" as the drug makes you feel that will help me in the future.

Wow, I was out on Lithium too, and it also screwed up my thyroid! And I had a lot of weight gain from the Zyprexa as a teenager— fun times, being obese and semi-comatose at 16 ��

Thank you for the information and the advice— I will look into this.

I wish I were told when I was prescribed Lithium in 2009 that in a few months it would kill my thyroid function. Why is this not disclosed, given that it is such a common, major side effect? I would not have started on it.

My psych who prescribed both Lithium and Zyprexa to me apparently did not keep up with the latest medical research— I found this out later after I’d found a new psych. And the doctor who initially diagnosed me as bipolar in the eating disorders unit when I was ten (which, admittedly, was out of his medical scope, so he had no business diagnosing me to begin with), was well aware of the effects of lithium on thyroid function, because he told my mom about it. I found this out long after I’d been in the ED unit. Unfortunately, I was a kid and teen during those years, and so I did not get to decide on my treatment.

It is a heartbreaking story, Indigo.

So, I administered my first dose yesterday— I thought I’d done it incorrectly at first, but I saw the pinprick of blood on my abdomen and saw the dosing meter change from 1 to 0 (as the instructions indicated it should), so I’m going to assume I did it properly. I do feel that the so-called food noise I’ve been experiencing is reducing, although it’s early yet. It’s not even about whether or not I’m full; I simply don’t feel a need to eat, which is good because i can start honing in on actual hunger cues. I did some research on the possibility of eye stroke, which NatalieJastrow mentioned— since it is difficult at present to determine if correlation equals causation and obviously, more research needs to be done, I’m simply going to remain vigilant about any changes in my vision. I’ve been reading about how people who stop taking Zepbound gain all the weight back that they had lost— is this just because they revert back to old eating habits, or is it because of changes in metabolism, and if it’s the former, I’m wondering if more mindfulness during the tapering-off period might deter weight gain. I don’t want to stop it; I’ve only just started, after all. It’s just something I’m curious about.

Congrats.

I never felt like I had less "food noise". And I definitely could over indulge. What I felt like was like I could just forget about food.

Like I recently went to the movies and I got popcorn. I went to the bathroom and put the popcorn away. When I came back... I forgot about it. That kind of thing never used to happen.

And for me, I would say a big contributing factor is also making conscious decisions along with the reduced food noise, so it’s definitely a combination of the two. One thing I’m really curious about is if it will decrease my nighttime eating.