Thinking of trying semaglutide to lose weight? If you've had a lifelong struggle with your weight like I have, I totally get the attraction. After a lot of research and careful consideration, I decided to give compounded semaglutide a try. It wasn't a decision I took lightly, but I've been taking it for about six months now. Here are all the things I've noticed.
It Wasn't an Easy Decision
I have a very complicated history with my weight and my body and an even more complicated history with food. I was in college in the mid-80s, and I had eating disorders (bulimia, orthorexia, and compulsive exercising). In the 90s, I turned to extreme fitness trends and a starvation diet to be thin until my metabolism broke (I have Hashimoto's thyroiditis, which has made it a real challenge). And after I had a baby? The weight piled on, my stress levels rocketed, and my disordered eating habits from the past came roaring back.
I dropped a ton of weight back in the early aughts, thanks to taking Topamax for migraines. It wasn't the intended effect of the meds, but one of the side effects was that I lost all interest in food to the point that I'd actually forget to eat (and it also helped with my migraines). Which was fantastic. But the medication also made me totally trip balls. It gave me synesthesia (I used to "feel sound" like it was made of colorful curly pool noodles that were growing from the back of my teeth), which probably wasn't great, and it made me lose about 20 IQ points plus all of my creativity. So I stopped taking it, and as soon as I quit, the interest in food (and the weight) was once again ever-present.
Since then, my weight has been a yo-yo. I've always been able to manage to lose weight (verrry slowly) through a combo of diet and exercise, but because I've had to be on pretty restrictive diets (think extremely low-carb and extremely low-cal) to get the weight off, they were hard to maintain, and it would always come back no matter how much I'd lost.
And as word spread about Ozempic (and other GLP-1 drugs), I was curious. But I was also incredibly cautious because I'm aware that with any medication, if it's strong enough to help, it's also strong enough to hurt. My initial decision was that I wasn't going to take it. But I've always been a super outdoorsy and active kind of gal, and my weight was starting to hamper my ability to do the things I loved.
After a particularly unsatisfying trip to Sedona, AZ, where I didn't feel up to doing my usual hiking, I realized that I needed to do something. In that moment, I decided I'd give compounded semaglutide a try, and if anything unbearable happened (like super nasty side effects), I could at least say I tried and cross that one off my list.
I Carefully Researched Compounding Pharmacies
I was well aware from reading all the news that not all compounding pharmacies are created equal. So I spent about two weeks just researching the different companies and seeing which seemed to have the highest levels of patient care. I also checked out patient reviews and expert recommendations. I found one that I felt super safe and comfortable with and made an appointment to meet with a nurse practitioner to get started.
I am not a doctor, health expert, or healthcare provider. This is my experience with semaglutide, but it's important that you do your own research and talk to your healthcare provider. It doesn't work for everyone, nor is it safe for everyone. This isn't intended to be health advice, but rather to share my own experience.
I Take Oral Semaglutide
After what felt like a fairly thorough health screen and face-to-face conversation with the nurse practitioner, I decided to try oral semaglutide. I knew I wouldn't be great with giving myself shots (plus, because the compounded injectable stuff doesn't come in pre-measured doses, it's easy to do it wrong and overdose), so I was happy there was a sublingual option. I take it every morning first thing and can't take anything by mouth (including other meds) for 30 minutes after taking it.
Even though I have to take it every morning instead of injecting it once a week, I'm happy with my choice of oral semaglutide. It's easy to take, mine tastes like mint (so it's not awful), and I already have to take my thyroid meds first thing in the morning, so I can't eat for an hour after taking that anyway. I just dissolve the semaglutide under my tongue while I work out, and by the end of my workout, I can take my thyroid meds.
My Health Care Provider Is Not a Fan
Her objection is primarily that compounded semaglutide isn't controlled by the FDA, and it's a valid concern. There are plenty of stories of people having adverse reactions because of substandard practices on the part of the compounding pharmacy or overdoses because the patients fail to measure their injectable meds correctly. There are also some fly-by-night companies selling compounded meds that use substandard ingredients or selling outright fraudulent "meds," so it's absolutely buyer beware. The compounded semaglutide marketplace on the internet is a bit of the wild, wild West.
I Started With a Small Dose & Titrated Up
It's standard practice to start with a smaller dose and then move slowly up to higher doses — whether you're taking compounded semaglutide or Ozempic. I learned that titrating minimizes side effects and maximizes benefits. So while I wanted the best results RIGHT NOW, I followed the titration instructions correctly, and I'm glad I did.
I Was Less Hungry Immediately
Semaglutide and other GLP-1 meds slow the rate at which food empties from your stomach, and that leaves you feeling full longer. So even on the very first day of meds, I wasn't as hungry. It made it easier to eat a little and stop as soon as I felt full.
I probably eat less than half of what I used to, and I'm perfectly satisfied with that.
The Food Noise Took About a Month to Fully Go Away (& Sometimes It's Still There)
Food noise — aka always thinking about food — stuck around a little longer. The loss of food noise was one of the few things I appreciated about my time on Topamax, so I was a little disappointed it didn't initially disappear when I started semaglutide. But it slowly waned, and most days, food doesn't really matter much to me. I also no longer particularly care what I eat, which is a blessing and a curse.
On the one hand, it feels so peaceful to no longer have those constant thoughts about food rattling around in my brain. On the other hand, as a food, cocktails, and wine writer, food and drink have been a huge part of my adult life and career, and it's odd to feel apathetic about something I was so passionate about.
That's not to say I no longer take pleasure in food. Food still tastes delicious, and I enjoy it when I eat something yummy. But it's no longer an event for me, which has had some interesting (neither good nor bad really — just different) effects on my social life.
It's also weird to have empty spaces that were once occupied by food and drink or thoughts of food and drink. Again, it isn't necessarily bad — just still a bit odd. For example, food was definitely a coping mechanism. Now — it's not. I've actually had to cope with my emotions — probably overall something healthy but definitely uncomfortable at times. And in the past when my husband and I traveled, food and drink were a big part of that travel. Now — they aren't, which saves us money (yay!) and gives us more time to do other stuff like hiking (yay!) but also makes travel food a bit more of a challenge because ordering a whole restaurant meal feels wasteful since I'll eat maybe a quarter of it.
Oh — and occasionally, a little food noise still leaks through for a day or two, but it has been far more manageable than what I've experienced in the past.
I've Basically Stopped Drinking
Speaking of my social life — I wouldn't say I was ever a big drinker, but drinking has always been part of my social life with my friend group. With my mixology background, I'm the bartender. And my enthusiasm for bartending has waned because I have zero desire for booze. In fact, I've had one full drink and a sip of another since I started on semaglutide. And I've come to realize that alcohol was for me (and probably for a ton of people) a social lubricant that helped me through my social anxiety a bit. Now, I have to rely on my sparkling personality instead.
Constipation Has Been My Biggest Side Effect
I've been lucky in that I haven't had a ton of side effects. I had nausea once for about an hour when I first titrated to a higher dose. But I have had constipation from time to time — mostly as they were titrating up my dose. For the most part, it has resolved on its own when I drink more water, but if I had to cite an annoying side effect, that would be it. It doesn't happen often enough, nor is it severe enough for me to want to stop the semaglutide, but it is a little annoying.
But just because I don't have unbearable side effects doesn't mean that's everyone's experience. I'm aware that I'm lucky and that some people have had side effects that have made semaglutide not worth it for them.
It's Not a Magic Bullet
Semaglutide isn't a weight loss miracle. It doesn't lose the weight for you. Rather, it creates conditions that make it easier to make healthier choices and eat less food. I still have to monitor what I eat and make nutritious choices. I haven't had sugar in six months. I get up very early every morning and exercise and then go out and walk every afternoon. I stop eating the second I feel satisfied. I avoid deep-fried stuff and eat a lot of lean protein and plant foods. And when I go out with friends, I skip the sugary cocktails and indulgent foods and stick to a small amount of nutritionally dense foods.
But while it's not a magic bullet, for me, it's an effective tool that helps me make these choices consistently.
Related: 10 Ways I Connect With Nature in the Winter (& You Can, Too)
People Can Be Super Judgey About It
Look, I'm an open book because my choices are my choices, and they aren't really anyone else's business. I do what's right for me.
But people can be super judgmental — especially about taking a GLP-1 medication (but they can be super judgey about me being fat, too, so it's kind of a zero-sum game). I've had a lot of people indicate they think I'm somehow "cheating" (as if there's some kind of a rule book about the 'right' choices to make for your own health) and that any weight I lose isn't "legit." Frankly, I don't give a crap, but this attitude is out there, and anyone choosing semaglutide or another GLP-1 medication to lose weight will probably encounter it.
The other judgment I find is people who think that because I'm choosing to take a medication to help me lose weight (or even losing weight at all), I'm somehow betraying "my people" and am no longer "body positive." Fortunately, I don't feel the need to justify my choices — I think you can be both body-positive and still choose things that support your health and well-being. I lived pretty happily as a fat person, and I remain the same level of happy as the weight has come off. But my weight was keeping me from doing things I really loved (and I didn't love looking in the mirror), and I'm happy I have my active, energetic self back.
I Have Less Pain
This one was a surprise! Related to my autoimmune issues (Hashimoto's and celiac disease), I've always had a lot of pain and inflammation. But since I've been taking the semaglutide, my body just feels better. That happened within the first week or so of taking it. I don't know if it's an unintended side effect of the meds, or it comes with the weight loss or both, but I'm thrilled that I don't spend all day every day with my body hurting anymore.
I've Lost Weight
I'd be lying if I said I didn't take semaglutide to lose weight. Weight loss was a big part of my goal. And I've steadily lost weight since I started taking it. It hasn't been a rocket ship to weight loss, but I'm steadily losing 1-2 pounds per week, and I haven't hit a plateau yet. I've read that a plateau commonly comes at about 70 weeks, but I'll cross that bridge if and when I come to it.
So Far, It Has Been a Good Choice for Me
I'm glad I made the decision to take semaglutide. Based on my lifestyle and my own personal needs, it has been a tool that's been helpful. While there are a few annoyances, they haven't been dealbreakers. I'm aware that I'll probably need to take the meds for the rest of my life, and once the semaglutide shortages have been resolved, it's my plan to work with my primary healthcare provider to start using the actual version of the medication instead of relying on a compounded version. I'm also open to stopping if I have to (even if it means gaining the weight back) because the side effects suddenly become unbearable. I remain flexible, but for now, I'm thankful to be back to my energetic and active self. I'm headed to Sedona again in February, and I'm planning to do all the hikes. After all, that's what finally led me to make this choice.
