This week, I began a three-month course of Ozempic, the wonder drug touted to reduce cardiovascular risk for the overweight and those with diabetes. I have some cardiovascular risk, although risk is no longer the correct term, being that I underwent coronary artery bypass surgery last year. While I had a pristine cholesterol panel, never needed a statin, and with smoking not really a sound choice for a vascular surgeon, my most significant risk was what I chose to eat and how I chose to exercise. As a result of some bad decisions earlier in life that became habits, I was a little out of breath one day last year.
Shortness of breath is not a definitive symptom of coronary disease, more likely to be related to my prior pulmonary embolus, but “out of an abundance of caution,” my cardiologist sent me for a calcium score. A typical value is 2 or 3, values in the range of 100 lie at the border of coronary artery disease. Much, like when I was 19 and eligible for the draft lottery drawing #18, I was once again a winner, with a calcium score of 1000. That led to catheterization and a decision to forgo an equivocally helpful stent for the “original gangsta” (OG) of cardiac care, coronary artery bypass.
Flash forward a year, and I am on a statin, a blood pressure med, and an anticoagulant. I now have one of those little plastic boxes to keep my pills in order, something ironically now, I thought was a little too “much” in my younger years. Despite episodic efforts at exercise, especially the Peloton, which I love, my eating, or at least the poor portion choices, have been more consistent, and my weight has been rising. Enter Ozempic.
I have been discussing the value of starting Ozempic with my two most important health counselors, my wife and cardiologist, for a few months. At the last visit it was agreed to give the GLP-1 a whirl. This post serves as the anchor of my reporting on what will be a standard 3-month treatment course.
If I were of a younger generation, I would begin with a video of the “unboxing” of my Ozempic doses. Others have already established that beachhead. There are also videos on how to set the pen’s dose and self-inject. It is not rocket science, but the written instructions were more “off-putting” than any of the available quick videos.
In any event, I was able to painlessly self-inject despite the close supervision of my wife, an ex-nurse and keeper of my health. Now, a few hours later, I feel no different; well, that is not entirely true; I have mixed emotions of virtue and defeat in starting Ozempic.
Day 1
I am not eating as much, but I suspect this is more of a placebo effect than any real change in my appetite or feeling of satiety.
Day 4
I was indeed correct about Day 1; placebo all the way. Now, I find that I am just not that hungry, or perhaps a better way to say it is that I am not constantly searching for a snack. My prior walks through the kitchen, especially when I was bored, most frequently ended in opening the refrigerator and having a standing snack – after all, everyone who diets knows, eating while standing contributes few calories. Now, it just doesn’t seem to be on my mind.
As for satiety, I think if challenged, I could still consume a great deal of food when eating quickly, although not as fast or as much as Joey Chestnut. I have slowed my consumption a bit, or more accurately, become more self-aware of my consumption speed. Satiety and hunger now seem to blend. I’m just not that hungry, so as Mary Poppins, trained nutritionist, would state, “Enough is as good as a feast.”
Day 7
Those calories seem to disappear. Down a pound. Is that good or bad? As the inpatient sort, it would be nice to see that number double or triple. Maybe the effect ramps up over time?
On a more positive note, given that I am now feeling full sooner, leaving more on the plate, I have begun to reduce my portion size as my eyes readjust to my new stomach size. [1] If I can turn that choice into a habit, then there is the potential for a lasting change once the Ozempic no longer courses through my body.
New week, new injection. New goal: slow my consumption and not be the first one done with a meal—further episodic reporting to follow.
[1] To be wholly accurate, I doubt that my stomach size has decreased and that adjustment is to my new satiety “set point.”
Chuck Dinerstein, MD, MBA
Director of Medicine
Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.
