The Road to Weight-Loss Oz, Part 2: It Worked

It has been twelve weeks since I visited the office of Dr. Drew Varano and did my first shot of semaglutide, the active ingredient in Ozempic — this is the follow-up I promised, and the news is good. I have lost about 17 pounds. I got down to 125 which I never thought I’d see again in this lifetime. I had to take the dress I bought for Vince’s wedding to be taken in through the bodice, and it looks much cuter than it did before. For the rehearsal dinner I will be wearing a beautiful gold satin Tahari top I bought for my 40th birthday party (on the back patio of a long-gone lesbian bar in Austin called Chances, sigh)… which I am able to zip for the first time in many moons. With gold sandals and skinny black pants with gold buttons. Very New Jersey mother of the groom.

Don’t worry, I’m not anywhere close to super skinny. My elderly skin is what it is—between four deliveries and a very sloppy appendectomy, I could never have a flat stomach again—but I feel great and am much happier with the way I look than I was in January.

As I told a friend recently over Mexican pinto bean bowls with all the toppings, it was easy. This friend has been struggling along with the Weight Watchers app and the tortures of self-discipline for a while now, and I was like, why? If you have the money, this is the way to go. 

Yet it’s too early to fully declare the win. I don’t know how it will go after I stop taking the drug altogether. Will I gain back some of the weight? Will I gain back all of it? Will I see any permanent changes to how much I eat and drink? Will I keep up with the consistent exercise I’ve been doing, hot yoga or sculpt five or six days a week? Will some horrible long-range side effect eventually crop up, as one commenter on the previous post suggested?  

Well — I’ll get back to you on most of that in a few months. For now, we’re just saying Yay. 

I took some notes starting with Week 6, which really aren’t all that interesting, so you can stop reading here if you don’t need the details, or skip ahead to the end to hear about how maintenance is going to work.

Week 6 and 7
Back in Week 6, I didn’t realize just how much liquid was in that little bottle and I started worrying that I would run out and have to buy more. I decided to drop to 5 units. I found that my hunger and “thirst” (for alcohol) increased a bit, though nowhere near pre-Oz levels.

I went down to Dr. Varano’s office with a friend, the third friend I’ve gotten on this party train with me. Ansley warned her that she has a kind of fat that is much harder to lose, visceral as opposed to subcutaneous, so she will probably have to take higher doses for a longer time. This was a bit discouraging but it turned out to be true so it’s good she said it.

I confirmed my six pound weight loss on their scale, and measured 3 inches smaller on waist and bust; hips same.

I forgot to ask about B12 when I was down there, recommended for fatigue, but then a friend showed up with a bottle of B12 and I’ve been injecting it intramuscularly about once a week. It might be helping but it’s hard to tell. 

At the end of Week 7, I went to an amazing wedding in Louisiana which involved lots of eating and drinking, though nothing like what I would have done normally. There was a point when I pretty much had to abandon a bottle of Miller Light halfway through because I couldn’t see taking another sip. That has literally never happened to me before.

Week 8
Having gained 2 pounds from the wedding weekend, I went back up to 10 units.

Week 9 and 10
(email to Dr. Varano’s office)
Great news. After weighing about 131-132 for the past 4 weeks, this morning I weighed 128.6! My original goal was 125. I’m not sure how much is left in the bottle, or how much to take this week.

They explained that there were 200 units in the bottle originally, so I still had over half left! Looking at my weight loss, which had pretty much plateaued, Dr. V. told me to go up to 15 units. (FYI, I have emailed these people A LOT, and either Varano or one of his assistants responds very quickly, every single time.)

This week I went to New York to accept my Service Award from the National Book Critics Circle. I wore a Nicole Miller cocktail dress with a Parallel jacket, which my agent and editor bought me at Bergdorf Goodman to wear on my book tour for Telling back in 1994. Proving once again that good clothes never die. The rest of the time I was in NYC, Sandye and I gave back-to-back dinner parties with front-to-front cocktails but fortunately, as noted earlier, excess isn’t quite as excessive when you’re on semaglutides.

Week 11 
Though I’ve had no other side effects to speak of, waking up in the middle of the night or very early morning has bothered me the whole time, cutting through the power of my various over-the-counter remedies (Benadryl, melatonin, doccylamine succinate.) When I mentioned this to my email pen-pals in DC, they said insomnia is not a typical side effect, and B12 should be helping with it, but also phoned me in a scrip for Ambien! Told me to start with half.

That actually didn’t work but a whole one sure does. And so far I have not left the house and paraded down the street naked, at least not that I know of.

Week 12 Ta-da!
I hit 125 for a few days running, and got this email from Dr. V. 

Congratulations! It took a little over 2 months and you lost almost 20 lbs to reach your goal. I would suggest continuing the 15 units this week then do 15 units every two weeks instead of weekly. This should keep you around 125.

The theory of “set point” is that your brain is like a thermostat and your body is the room. If your brain wants you to be 145 lbs and you get down to 125 lbs, even if you eat less and do all the right things, your metabolism slows down as your body wants to get back up to the set point. This is why when people go off the medication 2/3 of the weight can come back within a year. But if you can maintain a lower weight for 6 months, your set point resets about 10% lower.

The goal of maintenance is to keep you in that 125 lbs range for 6 months. We will continue to use  your current vial till it’s empty (they are usually good for 75 days past the “use by date”), and we offer a lower price during the maintenance period. We will go over that with you when you are ready.

I’m glad your sleep has improved!

That 10% sounds a little grim. I’m going to hope my old set point was actually 135, which is what I weighed normally before whatever holiday debauchery caused me to crest 140 in January. If it were 135, the new set point could be as low as 122.

So here is my chart as it looks now. As you can see I bounced back up to 127 by the time I did my weigh-in earlier this week, and have since been hanging out there. I blame those two margaritas I had with my ceviche at Calle last night. But I actually feel very trim and good in my body, instead of miserable every other minute, which I was back in January. I can actually do the cardio part of yoga sculpt (jumping jacks, burpies, football run, etc.) without old-lady modifications, which is a big change in my fitness as opposed to just my weight.

So far, the verdict for both the results and the process is: SO WORTH THE MONEY. Which, if you recall, was $625. 

Here’s a check-in from a few of the other people I have taken with me on this yellow-brick road.

Friend 1: “I’m on week 9. So far I’ve lost 19 lbs. Still at 19 units but I have a feeling I’ll be going up to 28 units as I’ve kind of stalled out and my appetite is coming back a bit. I do plan to keep going at least another 13 lbs worth.”

Friend 2: “After starting the drug in L.A. and losing 7 pounds, I re-started with the DC doc, so much less expensive and more convenient. Recently I was off it for a few days and gained a few pounds (it was Easter), and I think it’s because I had lost the constant vigilance, always being mindful of what and how much I eat. When you’re on semaglutide you can eat whatever you want, you’ll never overdo it. When I was off for that short period, I continued eating what I wanted and gained 2+ pounds. Now I am back on the drug at 38 units and have lost 3 pounds since April 1. On a positive note, though, after I stopped the first time, my old habits of watching what I eat at all times seemed to be intact… I was able to maintain the 7 pound loss for 2 1/2 months. Nothing feels as good as fitting in my clothes.”

Friend 3: An older neighbor sent me an email a few weeks ago, saying she’d been on Mounjaro for over three months, lost only 6-8 pounds, and now can’t refill her prescription due to shortages. With her BMI of 33, she should have been able to get insurance coverage, but Medicare wouldn’t pay. So she was raiding her retirement and paying top dollar. I told her to “call my guy” … turns out they can get a compounded version of Mounjaro for her, and will put her on a higher dose. (Key aside: The compounded drugs distributed by Dr. V. have no effect on the supply chain shortages of the name-brand GLP-1’s that are impacting diabetics.)  

Friend 4: “I’m the one who went on the field trip to the clinic with Marion. I am on week 7 at 19 units; a second bottle is being shipped to me now and I may be moving to a higher dose. I am down 9 pounds and have 11 more to go. It feels amazing to not be ruminating about food all day. It has given my brain a chance to take a break from old pathways and develop new eating habits. I feel healthy and optimistic though no big difference yet in how I experience my body. The B12 shots are a nice energy stabilizer.”

For the next installment of this series, probably in another four to six weeks, I’m hoping to do a Q&A. If you have a question about my experience or about either of the articles so far, would you please put it in the comments? Or you can email it to me, if you prefer, at mwinik@ubalt.edu. In the meantime, you might also want to watch Oprah’s recent special on the subject, now streaming on Hulu.