It really depends. I think for some people who are younger and who don't have major underlying metabolic problems, yes, they have been able to come off and maintain. But in the clinical trials the SURMOUNT-4 after switching to placebo after weight loss, people gained about half their weight back after coming off on average. They really didn't do any special behavioral support for those people though. Yes, it's expensive, but IMO the costs of obesity and moving to diabetes are worse. I have no children, and we live fairly modestly (other than concert tickets LOL). The costs should come down as more medications come on the market. But I don't think I'd be able to come off. The plan is to look at spreading out my dose and likely titrating down in dose, but there is no protocol and everything is specific to the particular person.

BTW I've also seen people go to other countries where the medication (Mounjaro, only the US has two specific brands Zepbound and Mounjaro) is only about $150-200 per month. The pharmacy tech at Walmart was from Turkey and she said it's $100 per month there.

My doctor did say that some people stay on the drug but reduce the dose after reaching goal weight. Ive lost and regained weight before in my life so I know Id have to stay on it and I dont want to commit to that.

On the other hand, my hip joints would be yhrilled if I lost weight and kept it off.

Just saw this. there is a new study to look more at maintenance so this should be good to try to look at individual needs. Data won't be available until next year.

All we have to go by, of course, is present science and experience. But I'm sure there is a lot of time and money being poured into research and improvements.

The medications have been around for awhile but these newer ones are much more effective. One of earlier GLP-1’s (Victoza/Saxenda) is coming out on generic, but it is a daily vs. weekly injection and it’s not really that much cheaper, unfortunately. But so much on the horizon! I saw one economist on the news who said these are the equivalent of the iPhone in that we are not going back.

I know two people who have lost very significant weight with these drugs (not sure which ones exactly). A lot more than the %s above. They both battled weight for decades, with a lot of success, and eventual "failure" (I can relate!). They both expect to be on some sort of medication indefinitely, much like one does for other "diseases." (I know that term is controversial in this context.) I have heard snippets of all kinds of benefits this medication confers beyond weight loss, including treatment of alcoholism IIRC? It's all so interesting.

I am normally reluctant to take any sort of medication, but if you believe the science, obesity is so bad for your health, that the risk seems worth it. I lost my COVID weight very slowly and would have considered one of these meds but for the cost (over $1000/mo in my case), which seemed too wasteful for something I "should" be able to do . Moreover, I have thyroid nodules that are checked regularly and biopsied from time to time, and I know these meds are contraindicated with certain types of thyroid cancer so that is kind of a non-starter. Maybe new ones would be ok for me. I have never heard of using it just for maintenance, Kitschy, but from experience I know losing is much easier than maintaining (I have yo-yo'ed too) , so that usage intrigues me.

Congratulations on your hard-earned success, @gsciencechick. You must feel great!🩷

I started my little adventure yesterday. I picked one of the online companies, this one has a good reputation. I filled out a questionnaire, They will look over it and if all is good will be scheduled with a chat appointment with a doctor. If that goes well (pray for me) they will ship out the semaglutide via UPS.

I'd really advocate to stay away from compounded.

I respect your opinion but even with insurance the brands are more than what I want to budget for this adventure. But I will be careful.

I hope it goes well for you, Lucille.

I believe I may have shared in the prior thread about 2 people I know who have been using them, although I'm not sure which brands. One woman developed a severe health problem--not related to the drug, from what I know--and I'm not sure if she's still taking it. But she did lose a significant amount of weight.

Another friend started a few years ago, and has slowly dropped weight. She feels terrific, and this has allowed her to incorporate more exercise and general activity into her life. Like Gscience, she uses the drug as a tool in her overall approach to health. I don't know if she will ever stop taking the drug, but I do know she has developed much better eating and exercise habits that seem to be making a difference, as well. She had trouble just walking before she started it, because of her previous weight. She's thrilled with her new life.

DBIL did the same as you, Lucille, because his insurance would not cover the meds.. He has lost 40 lbs. He has gone from morbidly obease to just plain obese. Now his insurance will cover Zepbound for morbidly obese and he doesn’t qualify. His doc is going through the appeals process to try to get him qualified.

My DH has been on Ozempic all of a month. I think he has lost 10 pounds, to be at a healthy weight he probably has 20 more pounds to go. He has had no side effects. DH has Type 1 diabetes and had been having issue with his blood pressure. With Ozempic, low salt diet and blood pressure medication his blood pressure is now in the normal range, before Ozempic medication and a low salt diet combined was not doing the job. His insurance company is covering the meds. My understanding is that the doctor will cut back on the dosage if he is losing too much weight.

Another exciting possibility is that Ozempic and other Semaglutide may offer some protection from dementia. My FIL had dementia, although we do not know if my husband would suffer from dementia, anything that could lesson the possibility is huge.

Yes, this is all super frustrating. People should be able to pay reasonable prices and not have to jump through hoops. There is just a huge range of what pepole pay. Bbstx, yeah they have to do a continuation of care prior authorization based on original BMI. Jill302, there are some people with T1D who have had success on these meds, too.

I find the other effects of semaglutide and similar drugs really interesting. In addition to overeating it seems to help substance abuse and gambling addictions.

https://sph.brown.edu/news/2025-07-24/brain-science-glp-1s-addiction

Right, addictions, inflammatory diseases like rheumatoid arthritis, PCOS, kidney function, dementia, there are so many potential benefits.

I also had prediabetes with a family history of type 2 diabetes. I have finally gotten out of that range, but it’s still hard fighting aging and genetics. The pancreas just becomes less efficient as we get older.

The pancreas just becomes less efficient as we get older.

I feel fortunate in my old age, after actually being diagnosed with Type 2 diabetes, when I was able to return to normal value HbA1cs and discontinue diabetes medications by exercise and diet.

(I'm hoping that after my initial weight loss boost with semaglutide, I will be able to do the same with my weight).. I think there is still so much we don't know, but there is a lot of research being done.

The costs should come down as more medications come on the market.

The competition is fierce out there in semaglutide sales. I picked a company that charges $399 for the first 3 months and $499 for every subsequent 3 months. (There are less expensive companies but this one has a pretty good reputation).

Gsciencechick, Dr. Nadolsky is from my neck of the woods and well-known here. I follow him on Instagram and appreciate his dedication to science. A friend of mine sees his endocrinologist brother in person for Zepbound. Friend has lost 70# and says he has never felt better. He is off blood pressure meds and says he has so much more energy. He is almost 60 and has tried to lose weight for decades. He feels like he has a new lease on life and doesn't mind at all he needs to take meds the rest of his life if he can feel like this. I'm not sure what dose he's on but mentioned he's on maintenance at this point and only takes the shot every 10 days or so and seems to be maintaining easily enough. I do find it so interesting that these drugs dampen or eliminate cravings and have been helpful for people with addictions of all sorts.

Bluebell66 that is awesome. The fact there is no age restriction and there are plenty of people in 50’s, 60’s and 70’s having success. I feel the same way. I’m 62 and if I have to continue to use this I will do it. There are no guidelines for maintenance. Some people are on a lower dose weekly and some can spread out their doses.

I was approved for my plan (!) and should get my semaglutide shipped to me within a week. The cost worked out to be $133 per month and that will hopefully be offset somewhat by the planned lower grocery bills since I will be eating less.

Wow, Lucille, that is very reasonable. Good luck to you.

I was on Wegovy for little over a year9 May 23 - June 24, May and June were spread out doses, not weekly) but had to stop because my insurance stopped coverage. I lost 62 or so pounds, but 20 of that was muscle mass. I've been strength training at the gym since Feb 25 trying to get some of that back and lose more fat. Please, please make sure you bump up your protein intake and do strength training while on either of the shots! Even with my muscle loss, I would go back on it if I could afford it. I still would like to lose another 20 or so lbs (currently 193.5, lowest I got to was 190).

You didn't ask about this, but I will include in case anyone is considering other medication: I started on Qysima ( combo pill of phentermine & topirimate) after the Wegovy and took that until July 25; had to stop due to side effects. I had only lost 8 lbs in that whole year on Q (some fat and some muscle still), so I went up to the highest dose in June, after 6 weeks, I started waking up and my hands would be frozen, couldn't move my fingers, and when I pulled down on one, the knuckle at the base would snap like a green bean and the finger would still be straight out. Sitting up and moving them around, they would finally loosen up enough to where I could crack my knuckles. Once I got up in the morning and moved around, they were usable, but they still felt kind of numb and sore, and the feeling went all the way up past my elbows. So, I had to stop taking it. Seems it is a result of the topirimate (generic of Topamax they prescribe for epilepsy but has the side effect of weight loss). I now take just the phentermine (appetite suppressant). My hands are not 100% back to normal, asking my PCP abut it when I go in next week. One study I read about it says it can take up to 2 months or more to resolve, hope that's the case & it didn't cause permanent issues.

Besides side effects and cost, my hesitation is what happpens after youvee lost weight. Do you stay on the drug forever? Do you regain the weight when you discontinue? Its a lot of money for a semi permanent result.

This is a concern for me as well. But I don't think that weight regain is confined to GLP-1. I was diagnosed with diabetes type 2 in June of 21. At the time I was grossly overweight. I lost a huge amount of weight (almost 100 lbs) in the following year by myself, no diet meds, but the incentive was that I was ill and miserable when diagnosed with diabetes and so wanted to get both my weight and my HBA1c down.. In the years since I have regained about half of the weight back. I tried to lose again on my own but it is far more difficult than it was years ago. For one thing, my diabetes is solidly under control with all recent years of HBA1c within normal range so I don't have those concerns nipping at my heels.

I'm looking at my semaglutide adventure as a jump start for maybe 6 months, and at that time see where I am and where GLP-1 research is, and go from there. I also think that while demand is high, supply is going to rise to meet that demand and I suspect the price will go down.

Just a hopeful thought: Right now with the branded GLP-1s so expensive insurance is being very picky. But I see the day hopefully not too far in the future when supply rises and prices fall, that employer programs and the like will pick up the costs to have their employees drop weight, and insurance companies may do likewise because at a certain point they will be paying out more for the productivity/medical issues associated with obesity that they will be by paying for the GLP-1.

I started waking up and my hands would be frozen, couldn't move my fingers, and when I pulled down on one, the knuckle at the base would snap like a green bean and the finger would still be straight out

Straitlover that is terrifying. I am hoping for you that you regain all normal use of your hands.

Yes, it was very scary when it first started. Now, it's just my ring finger and pink on each hand, but they're not completely frozen if i wake up, just stiff and pop when I bend them (can bend on their own, I don't have to grab it), sounds kinda like when you crack your knuckles. Weird!!!

Today I caught an unexpected glimpse of myself. Yowza, not good. I went back and reread all of this and for the first time i may consider it. Lucille, keep us posted on your progress.

an unexpected glimpse of myself.

I call foul!

Aww, @dedtired, those are the worst.

My self-image is always based on the most flattering (and probably inaccurate) photo taken of me in the trailing 5 years (or 10 if need be!). I simply freeze that image in my head, all evidence to the contrary.

God forbid someone takes a candid shot! My world is shattered. I will not show it here, but I recently shared with my BFF, my "idee fixe" photo side-by-side with a candid action shot (eek) of me playing shuffleboard. It was ... umm...not good.

On point, saw this yesterday

https://youtube.com/shorts/8gklX-n_9ds?si=PbuuVXut_O5_jg0A

@gsciencechick can probably add more to this, but, I don't think these medications themselves cause muscle loss.

AFAIK, any time you lose weight, regardless of the method, you lose muscle (and every other component).

And, any time you lose weight very quickly, you may lose a disproportionate amount of muscle.

So I don't think this is an issue with the medications; people have been told for years it is better to lose slowly. If you are losing very quickly, it is often because you are not eating enough, in particular protein.

Maybe you covered this, but have you asked you PCP about this? I agree, those items make them seem nonserious.

Lucille, I'm sorry, I should have told you good luck on your journey before blabbing on about my issues. Sorry! Please do post on how it's going.

Mntnredux_gw, correct, it's not the med itself causing the weight loss. That's why I said for people to up their protein intake and do the strength training while on it. You lose quicker because you eat so little & once the body burns the glucose it has, it heads straight to the muscle for the energy it needs to live on. Hope I worded it correctly!

Right, it is the weight loss in general and not just GLP-1. And no one can say how much muscle vs. other lean mass (bone, water, organ tissue, etc). We just don't have that data. They also want to look at muscle quality/density, such as the amount of intramuscular fat.

Also need to be careful with rapid weight loss and gallstones. I had mine out about 10 years ago. I am a super slow loser. Some people lose 8-10 lbs a month, while I started January 2024 so it's ~20 months.

I am not a candidate for topiramate, but yes, it can have odd side effects.

Really, the resistance training is #1 followed by protein. The protein without the resistance exercise is only a small effect on improving muscle mass. And aging works against us, but we can still make gains.

Lucille, if you have T2D diagnosis, you might be able to get brand name Mounjaro or Ozempic, but what will it cost you on your insurance is probably key. Mine is not covered at all--our plan is totally exclusionary for weight loss, but I am granfathered in on the Lily manufacturer coupon for $550 for the injector pens. Otherwise, Lily Direct using vials and syringes is $349 for the 2.5 dose and then $500 per month afterwards. I'll probably switch to vials for maintenance.

Well, wrote a comment and it disappeared. Oh well. All i can say is Mtn is still gorgeous at 8 a.m. with no makeup!

How big is the needle or pen or whatever?

All i can say is Mtn is still gorgeous at 8 a.m. with no makeup!

mwah!

Lucille, I'm sorry,

Oh pleez, we are all friends here, no apologies needed.

once the body burns the glucose it has, it heads straight to the muscle for the energy it needs to live on

Actually, there is some muscle loss but mostly the body burns fat, that is what it is there for. Glucagon triggers the process of burning fat by signaling the liver to convert stored energy (glycogen) and fats into glucose and then ketone bodies when blood sugar levels are low

Lucille, if you have T2D diagnosis, you might be able to get brand name Mounjaro or Ozempic, but what will it cost you on your insurance is probably key

Thank you for mentioning that, and thank you for all your experienced input. Already checked insurance out and it is still waaay more expensive. I could always write the manufacturers but all that takes time, whereas with QueenRx I should have my meds at the end of the week at a price I can afford. I guess the big deciding factor is how well the sema works, but there are certainly enough reviews with people losing.

Mtn is still gorgeous at 8 a.m. with no makeup!

Mtn is gorgeous inside and out. Grace and beauty.

How big is the needle

Will post photo of everything including the needle when I receive it.

I will report back on my semaglutide adventure as it unfolds. I hope to get my meds at the end of this week or beginning of next. For anyone curious about details, the company I chose was QueenRx- https://www.joinqueenrx.com. I spent time looking at the Trustpilot site for reviews of this and other semaglutide companies. A few appear as if they might be ripoffs or just overwhelmed, this one seems like it does what it promises to do, the one complaint I noted more than once are some slight shipment delays of a few days.

I'm not yet endorsing Queen, I'm going to wait until I receive both shipments (the meds are sent in two shipments, with enough in the first shipment for 6 weeks) and I see whether what they send actually seems to be working. The doctor consult and shipping costs are included in the price of $399 for 3 months, ($133 per month) there are no additional fees. Some of the other companies priced the doctor visits extra.

Re the needle: don't know about with the vials, but for the pens, it's just a tiny needle. There's a button you push, and there's a cover at the end where you don't even see it.

I’d like to get rid of 15-20 lbs. If I qualified, I’d try the semaglutide class of drugs in a heartbeat. However, my maternal aunt had thyroid cancer and there are all sorts of thyroid problems on my maternal side. The WSJ podcast said Ozempic and the first of these drugs were contraindicated if there were a family history of thyroid cancer or other thyroid problems. I’ve been hoping that they will develop a drug that is safe for people with that history. I just checked Zepbound. Still not safe. If y’all hear a new development making it safe for folks like me, please tag me!

Received my starter kit. Needle is the standard insulin needle, very tiny.

Hoping this adventure works for me.

Encourage all who may be considering compounded to save $$$, to at least try getting it through their insurance before assuming insurance won't cover it. Your physician may need to fill out the prior authorization paperwork, but please dont skip this step. Know folks whose insurance is covering it due to cardiovascular risk factors and others due to sleep apnea (one person was on CPAP, another just got a sleep study done).

Update, talking with colleague who uses insurance (with large Chicago healthcare system) and the additional manufacturer coupon pays only $25/month.

Wishing you well on this journey, Lucille!

Yes, the $25 co-pay is great IF you can get it. Many health insurance plans are dropping coverage vs. adding it, unfortunately. My plan it is 100% exclusionary and doesn’t count towards my $3,000 out of pocket prescription maximum per year because it’s not covered. I use the coupon and pay $550 but I will likely switch to the vials in maintenance, but to keep the $500 price it has to be ordered every 45 days.

I’m trying to assist a family member with sleep apnea approval, but no one wants to do the prior authorization for them. Primary care won’t do it, pulmonologist won’t do it. I told them to go through the obesity management clinic through their hospital system. They do those all day. Also would consider the Nadolsky Vineyard telehealth and others online have had success with a company called CallOnDoc. Some report issues with Ro.

@lucillle, what do you think so far?

Thank you for asking. It is a journey, and I think a different journey for each person from the many accounts I have read, but so far, for me, it has exceeded expectations as the signup process was easy and side effects mild so far. But of course it will be some time before I expect to see any significant weight loss.

People have lost quite a bit of weight using semaglutide but those who do, do so in the course of six months or a year just like those who do not use medication.

There is also a significant movement by some to taper off of the medication after a goal weight has been reached, as apparently there is a difficult hunger rebound period when one stops that needs to be planned for especially sudden cessation after being on a large dose, after the medication clears from the body in a month or two.

I want to avoid a semaglutide jones so I will assess my progress at 6 months and decide whether to taper off at that point.

Unlike people who are on other types of medications for life, there are considerable, current, exterior, non medical forces in play in the GLP-1s, such as possible withdrawal of payments by insurance companies and legal attempts by brands to block ever cheapening compound competition. I think those who are considering semaglutide, especially compounded, need to be aware of those forces.

That’s great you are not having side effects. Oh yeah some people lose 10 lbs per month but that has obviously not been my experience. the initial doses are meant to be loading doses to get someone used to the medication but still some people will lose a fair amount on them. I lost something like 2 lbs the first month. I am moving up to 15 mg to see if I can get these last 4 lbs to goal. I had a small increase in nausea moving up to 12.5 but nothing where I needed to take an anti nausea medication. So hopefully no major side effects from this. I got my C booster yesterday so I’m a little fatigued today before I even take the Zepbound. Yes, need to remove my nail polish.

Yes @ gscience, colleagues have found best success with prior authorizations done by the "Lifestyle Medicine," cardiometabolic, and obesity medicine clinics/services. They know key words to include (and exclude) in the prior auth, and know doing them is part of their service line.

MDLN, thank you for helping to turn this thread into a resource that can benefit many of us.

And thank you everyone who is participating with experiences and information for treatment and prevention. Being overweight can be distressing and unhealthy, and difficult to tackle, and those who step up and contribute are very helpful.

Hello everyone!!

Sitting in the backyard in the shade, on 91deg day in Fargo!! 91....wth?! September is almost over!!

I've babbled here before on this, but I've been on Ozempic 2mg 1/wk for 3 years now? Also 2 Metformin/day. Lost 65lbs...and been holding @ 245 for a while!! I think that's what I was a couple Years ago in HS....1979 Grad.

I love being lighter!! A1c has been right around 7 a long time now. No complaints/issues at all with these meds.

Just turned 64 on 9-16, still got the long hair, & feeling pretty good! Retirement funds are looking pretty good....so hopefully a "Toy" in the driveway sometime soon!!!! 😁😇🤔🤪

That's great, Faron

Faron, great to see you here! Glad you are doing well! And thank you for the weight loss success story!

Don't be a stranger.

Costco is selling Ozempic and Wegovy to Costco members with a prescription for $500/mo out of pocket. Apparently, there are other manufacturers who have also reduced the direct-to-consumer price, including Zepbound. Links in the article.

Gift article, so it should be readable by everyone https://www.nytimes.com/2025/10/05/health/ozempic-wegovy-costco.html?unlocked_article_code=1.rU8.q3Al._ihA2P5rK5h0&smid=url-share

Costco is super convenient for a lot of people moreso than mail order through Lily Direct.

Faron, good to see you. Hope you new pup is doing great too!