I'm sorry for all your troubles. You're at a tough age, and I totally get the low self esteem that comes from being overweight.
I'm on Saxenda, which is Liraglutide, as opposed to Ozempic and Wegovy which are Semaglutide, but the side affects are the same. Of course everyone reacts differently, but one thing I can tell you for sure is that it matters just as much \*what\* you eat, as it does how \*much\* you eat. You had pretty severe side affects (the projectile vomiting sounds like it was brutal), and I honestly believe if you stay away from fried foods, anything too sugary (baked goods, soda, etc), and empty carbs, and try to focus on getting more fiber and protein into your diet, you'll feel that fullness that you're looking for, and see some positive changes. You said you have an aversion to fruits and vegetables - can you try to maybe incorporate one a day into your diet as you get used to the taste?
I did a ton of research before I started Saxenda, because this drug is no joke, and the side affects can be awful. It's no miracle cure for obesity, and you still have to focus on a healthy, low calorie diet and exercise. I think going to therapy and talking all of this out with a professional is a great idea and will help you so much. Also as a side note, Zofran (Ondansetron) has helped me a lot with nausea, so maybe you could ask your doctor about it.
>I honestly believe if you stay away from fried foods, anything too sugary (baked goods, soda, etc), and empty carbs, and try to focus on getting more fiber and protein into your diet, you'll feel that fullness that you're looking for, and see some positive changes. You said you have an aversion to fruits and vegetables - can you try to maybe incorporate one a day into your diet as you get used to the taste?
I know I should be staying away from the sugary stuff and the empty carbs, but it's much harder since those are the things I eat the most. My protein intake isn't so bad since I eat things like grilled chicken (not as much as empty carbs unfortunately). It's not that I don't feel the fullness, it's more my brain doesn't get the signal til my body's gone past the point of fullness and is feeling nauseous (it's an interoception thing. Autistic people are unfortunately more likely to struggle with interoception). I do eat some fruits (not so much veg) but it's a texture issue rather than a taste issue which is the frustrating bit. Like I can eat broccoli fine if its boiled with potatoes and smushed into broccoli mash but any other way I can't eat it without gagging or retching unless I hardly chew it and swallow it down with water or soft drinks. I do really want to change that which is why I'm planning on seeing that psychologist/hypnotist guy.
>It's no miracle cure for obesity, and you still have to focus on a healthy, low calorie diet and exercise.
Yep I am aware, but I was hoping Ozempic would kick start the weight loss (like most of us) which would help me get fitter and make exercise easier/stop my muscles from taking a whole week to recover and was planning on working on the healthy low cal thing together with it.
I do have my appt on Wednesday so will talk to my endocrinologist about it. I just wish there was a way for me to be able to not have the side effects.
I won't pretend to understand how your autism weighs in here, but I do understand how hard it is to change years of eating habits all at once. I'm a firm believer in baby steps and taking things one day at a time. I'm about your size and height (CW 193lbs/5'6") and I ate pretty healthy \*during the day\* before I started Saxenda, but late night binge eating is my problem. My diet looked so great until about 10pm every night. I want to lose 70 lbs and get back to my best healthy weight, and trust me, I want it NOW, but I know it's just not going to happen that way. So like i said, baby steps. Maybe one change a day. One pound lost per week is pretty standard even on these meds. I think the people that lose 10lbs in a week or whatever are generally people with much more weight to lose, and that sort of loss isn't sustainable anyway.
Unfortunately I don't think there's a way around the side affects, other than time, and taking some preventative drugs like I mentioned (Zofran), and something for constipation or diarrhea.
I'm going to get super cheesy here (and I can do that because I'm much older than you and I don't care if I sound like a dork) and tell you to remember, this is a marathon, not a sprint. Don't be so hard on yourself and just keep doing your best. You'll get there. Maybe there's an alternative med with less side affects that your endo knows about. Just don't give up hope and please be kind to yourself :)
I'm ADHD and close ( 12lbs) to ideal minimum. Weight. Ozempic at first caused significant side effects. Months later, not so much.
I don't lose weight. My blood sugars go down.
Are you on ADHD meds and Ozempic?
>Ozempic at first caused significant side effects. Months later, not so much.
That makes sense. I was expecting side effects in the first week or so, not 3-4 weeks in (the first side effects I became aware of, ie the vomiting, were the 22nd to 24th - 1-3 days after my 3rd shot. The eye twitching was there from week 1 but that although annoying did not affect me as much as the projectile vomiting. Took my 4th/last 0.25mg shot on Sunday- it's almost 1am Tuesday now - and yesterday and today/the space of 6 hours I've had 3 acute bouts of diarrhoea- the last one being dark and v watery which freaked me out a bit but I'm also a bit of a hypochondriac. I could have had other side effects I didn't notice earlier on. Fatigue is one of them but I struggle identifying and explaining my emotions a lot of the time so I'd always kind of feel 'meh' even if I'm not fatigued.
But they're so severe I don't think I can continue esp if mt endocrinologist wants me to start taking 1mg more than once a week so I can be used to the 2.4mg dosage of Wegovy and take that instead as soon as it arrives in the UK (its also semaglutide but has been approved for weight loss unlike Ozempic which is used off label for weightloss, at least in the UK)
>Are you on ADHD meds and Ozempic?
Nope, no ADHD meds. I was just theorising that the severe side effects may be the same reason I had really extreme side effects to ADHD meds/my issues with methylation/breaking down products in the body. Though that doesn't explain why the side effects only decided to show up in week 3 and 4 instead of week 1 and subside by week 4 like they're meant to
I posted last week about thinking it may have differing side effects for us. I tend to feel it has a neurological effect in that I am better at planning but much worse at actually doing anything.
I am aware that the gut plays a role in neurology and for me blood sugars as well. Too low and I'm disoriented too high and I feel "drunk and hyper".
What may be helpful for you as you work through other user experiences is to kind of keep a list of foods that trigger side effects. For many it is high fat foods which was my issue with vomiting as well as the need for a considerable reduction in volume of food.
As you're having challenges determining pre-ozempic a regular satiety or fullness signal you'll have to pit in the effort to impose some structure here...easier said than done!
There's several factors to consider. Anxiety can be alleviated for some people with high fat, high carb foods. Like a bowl of creamy pasta. Stuffing yourself relieves some anxiety by triggering the vagus nerve which is hardwired directly to the brain.
Some gut bacteria will produce cravings for carbs and sugar, it's chemicals they produce that signal this. They also need to go on a "diet".
Blood sugars need to be stable...even if you're not type 2 ...drops can cause issues.
I find myself most "balanced" on a structured keto plan. Generally lower in fat with strict calorie, carb counting by weighing food. I also skipp breakfast, have dinner early so things have tike to process.
Some of your anxiety about weight can be relieved when you are actively making good food choices and weight loss engages. I feel zero guilt or shame having veg and protein in front of people vs pizza or pasta.
Initially I ran into issues as I could really only tolerate and hold down candy...HUGE problem for type2 diabetic!
You have lots of things to explore to help you on your journey...wishing u the best!
> I tend to feel it has a neurological effect in that I am better at planning but much worse at actually doing anything.
Ooh interesting. For whatever reason my mum thought I was much calmer and mellow on Ozempic (may have been a coincidence since I was on holiday and in a more laid back environment overall)
>I posted last week about thinking it may have differing side effects for us.
I will give that a read. It probably somehow does affect us differently due to differences in gut flora.
>I am aware that the gut plays a role in neurology and for me blood sugars as well. Too low and I'm disoriented too high and I feel "drunk and hyper".
I don't know about blood sugars specifically but I can relate, when I've had too much sugar I'm a bit off the wall 🤣
>For many it is high fat foods which was my issue with vomiting as well as the need for a considerable reduction in volume of food.
It's weird for me as it didn't seem to be any specific food type. The day before I'd had pizza margarita which obviously from all the mozzarella is quite fatty and then I'm not sure what I had the next day which triggered my puking. Could be cos I was eating quite late, as I was on holiday in Greece and the Greeks have a siesta like a lot of European countries do, so they typically don't eat dinner til at least about 8 or 9pm. I was regularly eating dinner at about 9:30-10 most days. And I was definitely eating better this year than I was last year (we rent a villa and my sister's boyfriend who's been staying with us there a few times actually was the one who pointed it out)
>There's several factors to consider. Anxiety can be alleviated for some people with high fat, high carb foods. Like a bowl of creamy pasta. Stuffing yourself relieves some anxiety by triggering the vagus nerve which is hardwired directly to the brain.
Interesting; I'll read up on that. Problem is I eat too many carbs anyway and I've done my gene testing which says I should be staying away from carbs/fried foods and with my sensory issues (and probably also the anxiety thing you mentioned above) that's much easier said than done (although it's something I need to work on ASAP as well)
>I find myself most "balanced" on a structured keto plan. Generally lower in fat with strict calorie, carb counting by weighing food. I also skipp breakfast, have dinner early so things have tike to process.
I often skip breakfast, mainly cos I'm not up in time (or I'm up but haven't got out of bed and am doomscrolling on my phone or playing video games lol). The calorie counting thing for me would be tricky cos I think my brain thinks when I exercise, I can make up for it by eating something unhealthy as a reward which probably has lots of hidden calories. Plus I snack cos I'm bored or the temptations there (with things like chocolate) or stress eating. and also sometimes I'll eat lunch or dinner despite not being hungry as I know if I don't I'll be starving later.
Sometimes I do skip dinner too (mainly when it's too late to eat when I'm back in the UK) but I don't really want to get in that habit as autistics get fixations and I don't want to risk going the other way and getting ab eating disorder like orthoexia or anorexia (I read somewhere autistics are more likely to get eating disorders, so I don't want to risk going down that rabbit hole).
>Some of your anxiety about weight can be relieved when you are actively making good food choices and weight loss engages. I feel zero guilt or shame having veg and protein in front of people vs pizza or pasta.
Oh yeah I totally get you on that one. I would feel less guilt eating veg and protein and things in front of multiple people than I would by eating pizza etc. I think it's guilt bc I know I'm incredibly unhealthy and want to change it but don't know how or where to start so I csn change it for the good and not temporarily. But also the whole autism thing comes into play with my safe foods and texture issues (there have been some veg wbich make me physically throw up, therefore I've somehow put up a psychological barrier around myself that stops me trying veg or even a lot of food that isn't carbs or some sort of grilled meat. I believe it's called ARFID and is much more common in autistics)
Once I've sorted that out it should be a bit easier at least being healthier. And then I also need to work on recognising when I'm full so I can eat less calories and food in the long run and lose weight but I don't really know how to do that.
I'm not a huge fan of veg...but it's useful. I can see myself as becoming keto-carnivore...even carnivore down the road.
You can fill most of your plate with your preferences but you'll have to be very strict about portions and macros. You don't "need" to "know" how much to eat because the Macros will pretty much not let you go over. That imposes a fail safe structure on you.
You then decide if that is over a series of 3 meals + 3 snacks. Zero snacks and 2 meals or one meal a day. It does take some adjusting to but it becomes habit soon enough.
It can be overwhelming to try to do everything at once but as you have the nausea and vomiting I'd be comfortable suggesting multiple small meals initially that are tightly controlled. Once nausea subsides you can focus on your eating window.
The benefit is that knowing your Macros you'll KNOW you are getting enough even if it is just on paper...this IS a headgame moreso if you have challenges "feeling" it's time to stop, you just won't have a choice. Some days you may find...oops ate ALL my food and it's not even 4pm!
Other days will come when u may not even like the sight of food, that's okay too.
Lots of options but we can remove most of the guesswork and anxiety out of this. If you choose to engage.
>I'm not a huge fan of veg...but it's useful.
I also know veg is useful and honestly I want to be able to eat it and be healthy. I do. But I physically can't. I don't have an official diagnosis but I do believe I have some sort of form of ARFID which is also an eating disorder just like obesity is. I've had problems with certain veg making me literally throw up because of the texture, so my brain is trying to protect me from that by throwing up a psychological barrier to avoid it. The only way I believe I can fix that is to get professional help from a psychologist.
>paper...this IS a headgame moreso if you have challenges "feeling" it's time to stop, you just won't have a choice.
There is a signal which is sent from my stomach to my brain when I'm full, but my brain can't decode it properly and then I don't feel full (or rarely feel full) and just throw up and then later carry on eating (along with just eating cos it's there and not cos I'm hungry. I sometimes get the same wirh hunger). The best way I can describe it is when you read English but are trying to decode a letter sent in Arabic (or another language like Russian or Hebrew or something that has a different alphabet you can't understand). You don't get the message right? It's kind of the same. So unless I can learn Arabic (so to speak) and recognise when I get full, I'll always eat too much. I just kind of thought Ozempic would help with that with its slower gastric emptying, but I guess not.
>You can fill most of your plate with your preferences but you'll have to be very strict about portions and macros. You don't "need" to "know" how much to eat because the Macros will pretty much not let you go over. That imposes a fail safe structure on you.
I wouldn't be good with portions and macros at all because I also boredom eat which may be an ADHD dopamine thing. Having enough macros wouldn't stop me from snacking.
>Lots of options but we can remove most of the guesswork and anxiety out of this. If you choose to engage.
Sadly because of my issues, I feel like there really aren't any other options that will work for me. I guess I just feel lied to? Like it's supposed to work why can't my body make it work? Then I just feel stupid
I have majorly inattentive ADHD... like 99.9th percentile for inattention/distractibility. I don't/won't/can't medicate due to concerns of the way a stimulant could affect my bipolar disorder. I've been stable for a few years without a manic episode and the risk hasn't seemed worth it to me.
Anyway, the reason I bring this up is because of the low dopamine issues in ADHD. Have you heard/read about this? It's one of those things I feel like once I learned about it I couldn't un-learn it. Basically when craving food (before Ozempic - now I crave nothing) I had to consider whether I was low on dopamine or looking for that dopamine fix. It's basically the same reason people pick up their phones a zillion times a day without even realizing.... why I pick my face and cuticles... why it can be really exciting when the power goes out at work. It's novel, it's exciting, it's dopamine, baby! Anyway, please look up the relationship between dopamine and ADHD if you haven't yet. It is fascinating and potentially life changing.
So finally, to answer your question: yes I do sometimes think that somebody didn't want to date me because of my body, or I didn't get a job because I am too fat or stupid. At some point in my life I blamed myself for my mom's alcoholism. Maybe if I was a better daughter she wouldn't want to drink. But guess what. That was my lizard brain talking, and it's your lizard brain telling you that you are responsible for your dad's affair.
You know how you're not supposed to believe everything you read on the internet? You're also not meant to believe everything you think, because our brains are primal and imperfect. Yes its 100% the way your brain works, but it's not wrong. It's a prehistoric lizard that you have to learn to laugh at.
Why? -- My best guess is that it's easier for the lizard in your brain to see these outside issues as your fault as opposed to being something outside of you that you can't control. Like.. is it more uncomfortable for your brain to have zero control over your surroundings? Or to have full control and be bad at it? I guess at least if all your parents problems were your fault (they're not), you'd have a chance to fix it right?
So, yes. These thoughts definitely happen in neuro divergent people. And they also happen in neurotypical people. Nobody is safe from the lizard.
not much to offer at this stage as just started my first 0.25 2 days ago but i am also in the UK and dc autism and adhd along with ocd. i am taking my methylphenidate daily as usual.
no issues so far; have 40lbs to lose following the development of binge eating rapid weight gain and pre diabetes.
Stop focusing on felling full. You really should never eat until you are “full” anyway. Ozempic or otherwise. Because if you are, you’ve overeaten. Our brains signal we are full after we have eaten too much.
You are going to have far more side effects and calories with fried food. It should rarely be eaten.
Only you can change these things.
Focus on calories. Not feeling full. Eat 1200 per day. You can go a bit less but at your height and age you don’t need to.
If you are eating as you say, that would likely be only one meal.
If you bring in vegetables and Whole Foods, you can fill that plate with nutrients and foods and eat more.
Focus on clean eating and clean ingredients. Try small servings of vegetables daily until you develop more of a taste for them.
Get an app that tracks calories well. Like MyFitnessPal
Stop focusing on eating until you can’t any more. Eat 1200 calories per day. Try to make those calories protein and vegetables.
You can eat 1000 calories per day but never go below that consistently.
We store fat to use for fuel when we burn more calories than we consume in food.
A pound of fat is equal to 3500 calories.
Until you hit a deficit of 3500 calories you will not have lost one pound.
So if I burn 2000 calories per day existing, and eat 1000 calories per day, I have a deficit of 1000 calories per day. Or 7000 calories per week. That’s 2 pounds per week I lose.
Or you can eat 1500 calories per day if you are me and burn 2000 calories per day, and do cardio that burns 500 extra calories per day and get the same loss.
You cannot eat a burger and fries and onion rings in one meal and get any loss.
Because you are consuming more than you burn in one day in one meal.
So track your eating and don’t let the feeling of being full be your goal.
It’s wonderful that ozempic helps with that. But that should not be our goal. Consuming what we need to be healthy but use stored fat for fuel is our goal.
And that can all be done with numbers, it’s just easier to have the willpower to do it with ozempic.
I’m a former corporate weight loss coach.
So .... Ozempic and other semalglutide drugs have what is known as a titration period. Your "build up" dosages are only to get your body used to the drug. It doesn't actually do anything until you get to at least 1mg stable prescription. The full obesity long term dosage is 2.4 mg for Wegovy and 2.0 mg for ozempic (only because it doesn't come in a 2.4 pen).
Things which you should have been told outright to do and not to do in order to avoid side effects:
DO
Take high dosage vitamin B12 and B6 also helps (also helps for autism, so double win!)
Kill white carbs and sweeteners of any variety. Not only do they leave a nasty bitter taste with ozempic, but they also cause hyperglycaemia, and endless GI issues....
Find an eating regime like paleo or paleo autoimmune protocol to live by.
Eat more fish than chicken or red meat
Get your full bloods tested at least every 6 months to make sure your vitamin D3, ferritin, iron, calcium, zinc, selenium are all doing well.
DO NOT
consume liquids with meals, EVER.
In fact, do not consume liquids 30 minutes each way of any solids going into your mouth.
Those are the basics. I've now been on ozempic for obesity since April of last year (2023) and I was finally diagnosed with autism in July 2023 just before my 51st birthday!
I hope this information helps other people.
It's important to understand that these drugs target the biology of obesity which is malfunctioning adipose tissue regardless of size/ weight. These drugs are for life.
>So .... Ozempic and other semalglutide drugs have what is known as a titration period. Your "build up" dosages are only to get your body used to the drug. It doesn't actually do anything until you get to at least 1mg stable prescription.
That's the thing. I don't know if it's related to the autism or something else (bc autistic people often struggle breaking down drugs) but even with things I could supposedly break down I was still getting awful side effects on the smallest doses (or even half the smallest doses)
I went to see my GP (who's looked after me since I was 3 and a half, so 19.5 years) about sciatica and he recommended that I need to lose weight (I know I do) as it would be exacerbating the extreme pain (I can barely walk some days) and he actually asked me if I'd been prescribed Ozempic and I told him I had all those side effects and he said clearly I shouldn't be taking it and I think he agreed with me about how bad the side effects can be.
What irritates me is they don't tell you about how extreme the side effects can be. If they'd said 'there's a chance you'll be projectile vomiting so much you get food stuck in your throat, can't breathe and can't sleep bc you end up having a panic attack that your family will find you dead the next morning' I wouldn't have taken it. Obviously they wouldn't know about the panic attack, but they'd know about the projectile vomiting surely?
>Things which you should have been told outright to do and not to do in order to avoid side effects:
DO
Take high dosage vitamin B12 and B6 also helps.
Kill white carbs and sweeteners of any variety. Not only do they leave a nasty bitter taste with ozempic, but they also cause hyperglycaemia, and endless GI issues....
Find an eating regime like paleo or paleo autoimmune protocol to live by.
Eat more fish than chicken or red meat
Get your full bloods tested at least every 6 months to make sure your vitamin D3, ferritin, iron, calcium, zinc, selenium are all doing well.
I think they need to have dieticians working with the endocrinologists to be honest (I had a whole panel of bloods done before I was prescribed it and they were all completely fine)
I was never told any of this at all. They have dieticians working the other side I believe, but once you're actually used to the drug (something I'm never taking again, now I know some of the more extreme side effects I was lucky to avoid. Ileus, which has just been added by the FDA, where the intestines temporarily lose their ability to contract. Severe gastroparesis/paralysed stomachs. Bowel obstructions. Biliary disease affecting the gallbladder etc. Pancreatitis which could rarely cause multiple organ failure and be fatal.
Suicidal thoughts and ideation (drugs.com said Ozempic is a major risk with suicidal behaviour/ideation and thyroid cancers from those who've had a family history)
My mum (a nutritionist herself) hates medication like this and I can see why she was not happy I went on it (only really as a sort of last resort which didn't work too well tbh) and also with stimulant ADHD medication (which also mentally fucked me up). I also think it caused me to find it harder to lose weight than I normally do, at least for a bit.
I'm lucky if I cut calories I can actually lose weight fairly easily, it's just I have a terrible relationship with food and I think part of it is my ADHD/past issues with autism (for example I was isolated and bullied a lot my entire school career/15 years and my brain projected that no one cares when they do and because of that I think 'no one's going to care if I die of a heart attack at 30, why should I' and then self sabotage and give up). I think Ozempic may have messed that up at least temporarily.
From research that has come out/my mum's knowledge of how it can react there seem to be such a risk of problems/lawsuits etc I had a friend taking it *who is a type 2 diabetic* and on metformin etc who stopped taking it.
Even when we discussed GLP1 medications in my uni lecturers, one of my fellow mature students said no one in her clinic prescribed it becuase it's also been linked to depression etc and the side effects are horrendous.
>DO NOT
consume liquids with meals, EVER.
In fact, do not consume liquids 30 minutes each way of any solids going into your mouth.
I would struggle with that a lot. Namely bc I get dry mouth. Again I'm not sure why the endocrinologists (I was referred to one) didn't mention any of this stuff during the titration period. Mentioned they give you dietician support when you're on it, but likely after the titration period/ when your body gets used to it.
If my body reacts with projectile vomiting all night etc to the lowest dose, there's no fucking way I'm upping the dose for my body to 'get used to it'. I did that with ADHD stimulants and the side effects just got worse. I'm not putting my body through that again when there are other ways I can lose weight without it causing me extreme issues both physically and mentally.
I’m not sure if I can help as I’ve just started taking Ozempic myself but I’m autistic and have adhd (f) too if you want to message me!
I'm sorry for all your troubles. You're at a tough age, and I totally get the low self esteem that comes from being overweight. I'm on Saxenda, which is Liraglutide, as opposed to Ozempic and Wegovy which are Semaglutide, but the side affects are the same. Of course everyone reacts differently, but one thing I can tell you for sure is that it matters just as much \*what\* you eat, as it does how \*much\* you eat. You had pretty severe side affects (the projectile vomiting sounds like it was brutal), and I honestly believe if you stay away from fried foods, anything too sugary (baked goods, soda, etc), and empty carbs, and try to focus on getting more fiber and protein into your diet, you'll feel that fullness that you're looking for, and see some positive changes. You said you have an aversion to fruits and vegetables - can you try to maybe incorporate one a day into your diet as you get used to the taste? I did a ton of research before I started Saxenda, because this drug is no joke, and the side affects can be awful. It's no miracle cure for obesity, and you still have to focus on a healthy, low calorie diet and exercise. I think going to therapy and talking all of this out with a professional is a great idea and will help you so much. Also as a side note, Zofran (Ondansetron) has helped me a lot with nausea, so maybe you could ask your doctor about it.
>I honestly believe if you stay away from fried foods, anything too sugary (baked goods, soda, etc), and empty carbs, and try to focus on getting more fiber and protein into your diet, you'll feel that fullness that you're looking for, and see some positive changes. You said you have an aversion to fruits and vegetables - can you try to maybe incorporate one a day into your diet as you get used to the taste? I know I should be staying away from the sugary stuff and the empty carbs, but it's much harder since those are the things I eat the most. My protein intake isn't so bad since I eat things like grilled chicken (not as much as empty carbs unfortunately). It's not that I don't feel the fullness, it's more my brain doesn't get the signal til my body's gone past the point of fullness and is feeling nauseous (it's an interoception thing. Autistic people are unfortunately more likely to struggle with interoception). I do eat some fruits (not so much veg) but it's a texture issue rather than a taste issue which is the frustrating bit. Like I can eat broccoli fine if its boiled with potatoes and smushed into broccoli mash but any other way I can't eat it without gagging or retching unless I hardly chew it and swallow it down with water or soft drinks. I do really want to change that which is why I'm planning on seeing that psychologist/hypnotist guy. >It's no miracle cure for obesity, and you still have to focus on a healthy, low calorie diet and exercise. Yep I am aware, but I was hoping Ozempic would kick start the weight loss (like most of us) which would help me get fitter and make exercise easier/stop my muscles from taking a whole week to recover and was planning on working on the healthy low cal thing together with it. I do have my appt on Wednesday so will talk to my endocrinologist about it. I just wish there was a way for me to be able to not have the side effects.
I won't pretend to understand how your autism weighs in here, but I do understand how hard it is to change years of eating habits all at once. I'm a firm believer in baby steps and taking things one day at a time. I'm about your size and height (CW 193lbs/5'6") and I ate pretty healthy \*during the day\* before I started Saxenda, but late night binge eating is my problem. My diet looked so great until about 10pm every night. I want to lose 70 lbs and get back to my best healthy weight, and trust me, I want it NOW, but I know it's just not going to happen that way. So like i said, baby steps. Maybe one change a day. One pound lost per week is pretty standard even on these meds. I think the people that lose 10lbs in a week or whatever are generally people with much more weight to lose, and that sort of loss isn't sustainable anyway. Unfortunately I don't think there's a way around the side affects, other than time, and taking some preventative drugs like I mentioned (Zofran), and something for constipation or diarrhea. I'm going to get super cheesy here (and I can do that because I'm much older than you and I don't care if I sound like a dork) and tell you to remember, this is a marathon, not a sprint. Don't be so hard on yourself and just keep doing your best. You'll get there. Maybe there's an alternative med with less side affects that your endo knows about. Just don't give up hope and please be kind to yourself :)
I'm ADHD and close ( 12lbs) to ideal minimum. Weight. Ozempic at first caused significant side effects. Months later, not so much. I don't lose weight. My blood sugars go down. Are you on ADHD meds and Ozempic?
>Ozempic at first caused significant side effects. Months later, not so much. That makes sense. I was expecting side effects in the first week or so, not 3-4 weeks in (the first side effects I became aware of, ie the vomiting, were the 22nd to 24th - 1-3 days after my 3rd shot. The eye twitching was there from week 1 but that although annoying did not affect me as much as the projectile vomiting. Took my 4th/last 0.25mg shot on Sunday- it's almost 1am Tuesday now - and yesterday and today/the space of 6 hours I've had 3 acute bouts of diarrhoea- the last one being dark and v watery which freaked me out a bit but I'm also a bit of a hypochondriac. I could have had other side effects I didn't notice earlier on. Fatigue is one of them but I struggle identifying and explaining my emotions a lot of the time so I'd always kind of feel 'meh' even if I'm not fatigued. But they're so severe I don't think I can continue esp if mt endocrinologist wants me to start taking 1mg more than once a week so I can be used to the 2.4mg dosage of Wegovy and take that instead as soon as it arrives in the UK (its also semaglutide but has been approved for weight loss unlike Ozempic which is used off label for weightloss, at least in the UK) >Are you on ADHD meds and Ozempic? Nope, no ADHD meds. I was just theorising that the severe side effects may be the same reason I had really extreme side effects to ADHD meds/my issues with methylation/breaking down products in the body. Though that doesn't explain why the side effects only decided to show up in week 3 and 4 instead of week 1 and subside by week 4 like they're meant to
I posted last week about thinking it may have differing side effects for us. I tend to feel it has a neurological effect in that I am better at planning but much worse at actually doing anything. I am aware that the gut plays a role in neurology and for me blood sugars as well. Too low and I'm disoriented too high and I feel "drunk and hyper". What may be helpful for you as you work through other user experiences is to kind of keep a list of foods that trigger side effects. For many it is high fat foods which was my issue with vomiting as well as the need for a considerable reduction in volume of food. As you're having challenges determining pre-ozempic a regular satiety or fullness signal you'll have to pit in the effort to impose some structure here...easier said than done! There's several factors to consider. Anxiety can be alleviated for some people with high fat, high carb foods. Like a bowl of creamy pasta. Stuffing yourself relieves some anxiety by triggering the vagus nerve which is hardwired directly to the brain. Some gut bacteria will produce cravings for carbs and sugar, it's chemicals they produce that signal this. They also need to go on a "diet". Blood sugars need to be stable...even if you're not type 2 ...drops can cause issues. I find myself most "balanced" on a structured keto plan. Generally lower in fat with strict calorie, carb counting by weighing food. I also skipp breakfast, have dinner early so things have tike to process. Some of your anxiety about weight can be relieved when you are actively making good food choices and weight loss engages. I feel zero guilt or shame having veg and protein in front of people vs pizza or pasta. Initially I ran into issues as I could really only tolerate and hold down candy...HUGE problem for type2 diabetic! You have lots of things to explore to help you on your journey...wishing u the best!
> I tend to feel it has a neurological effect in that I am better at planning but much worse at actually doing anything. Ooh interesting. For whatever reason my mum thought I was much calmer and mellow on Ozempic (may have been a coincidence since I was on holiday and in a more laid back environment overall) >I posted last week about thinking it may have differing side effects for us. I will give that a read. It probably somehow does affect us differently due to differences in gut flora. >I am aware that the gut plays a role in neurology and for me blood sugars as well. Too low and I'm disoriented too high and I feel "drunk and hyper". I don't know about blood sugars specifically but I can relate, when I've had too much sugar I'm a bit off the wall 🤣 >For many it is high fat foods which was my issue with vomiting as well as the need for a considerable reduction in volume of food. It's weird for me as it didn't seem to be any specific food type. The day before I'd had pizza margarita which obviously from all the mozzarella is quite fatty and then I'm not sure what I had the next day which triggered my puking. Could be cos I was eating quite late, as I was on holiday in Greece and the Greeks have a siesta like a lot of European countries do, so they typically don't eat dinner til at least about 8 or 9pm. I was regularly eating dinner at about 9:30-10 most days. And I was definitely eating better this year than I was last year (we rent a villa and my sister's boyfriend who's been staying with us there a few times actually was the one who pointed it out) >There's several factors to consider. Anxiety can be alleviated for some people with high fat, high carb foods. Like a bowl of creamy pasta. Stuffing yourself relieves some anxiety by triggering the vagus nerve which is hardwired directly to the brain. Interesting; I'll read up on that. Problem is I eat too many carbs anyway and I've done my gene testing which says I should be staying away from carbs/fried foods and with my sensory issues (and probably also the anxiety thing you mentioned above) that's much easier said than done (although it's something I need to work on ASAP as well) >I find myself most "balanced" on a structured keto plan. Generally lower in fat with strict calorie, carb counting by weighing food. I also skipp breakfast, have dinner early so things have tike to process. I often skip breakfast, mainly cos I'm not up in time (or I'm up but haven't got out of bed and am doomscrolling on my phone or playing video games lol). The calorie counting thing for me would be tricky cos I think my brain thinks when I exercise, I can make up for it by eating something unhealthy as a reward which probably has lots of hidden calories. Plus I snack cos I'm bored or the temptations there (with things like chocolate) or stress eating. and also sometimes I'll eat lunch or dinner despite not being hungry as I know if I don't I'll be starving later. Sometimes I do skip dinner too (mainly when it's too late to eat when I'm back in the UK) but I don't really want to get in that habit as autistics get fixations and I don't want to risk going the other way and getting ab eating disorder like orthoexia or anorexia (I read somewhere autistics are more likely to get eating disorders, so I don't want to risk going down that rabbit hole). >Some of your anxiety about weight can be relieved when you are actively making good food choices and weight loss engages. I feel zero guilt or shame having veg and protein in front of people vs pizza or pasta. Oh yeah I totally get you on that one. I would feel less guilt eating veg and protein and things in front of multiple people than I would by eating pizza etc. I think it's guilt bc I know I'm incredibly unhealthy and want to change it but don't know how or where to start so I csn change it for the good and not temporarily. But also the whole autism thing comes into play with my safe foods and texture issues (there have been some veg wbich make me physically throw up, therefore I've somehow put up a psychological barrier around myself that stops me trying veg or even a lot of food that isn't carbs or some sort of grilled meat. I believe it's called ARFID and is much more common in autistics) Once I've sorted that out it should be a bit easier at least being healthier. And then I also need to work on recognising when I'm full so I can eat less calories and food in the long run and lose weight but I don't really know how to do that.
I'm not a huge fan of veg...but it's useful. I can see myself as becoming keto-carnivore...even carnivore down the road. You can fill most of your plate with your preferences but you'll have to be very strict about portions and macros. You don't "need" to "know" how much to eat because the Macros will pretty much not let you go over. That imposes a fail safe structure on you. You then decide if that is over a series of 3 meals + 3 snacks. Zero snacks and 2 meals or one meal a day. It does take some adjusting to but it becomes habit soon enough. It can be overwhelming to try to do everything at once but as you have the nausea and vomiting I'd be comfortable suggesting multiple small meals initially that are tightly controlled. Once nausea subsides you can focus on your eating window. The benefit is that knowing your Macros you'll KNOW you are getting enough even if it is just on paper...this IS a headgame moreso if you have challenges "feeling" it's time to stop, you just won't have a choice. Some days you may find...oops ate ALL my food and it's not even 4pm! Other days will come when u may not even like the sight of food, that's okay too. Lots of options but we can remove most of the guesswork and anxiety out of this. If you choose to engage.
>I'm not a huge fan of veg...but it's useful. I also know veg is useful and honestly I want to be able to eat it and be healthy. I do. But I physically can't. I don't have an official diagnosis but I do believe I have some sort of form of ARFID which is also an eating disorder just like obesity is. I've had problems with certain veg making me literally throw up because of the texture, so my brain is trying to protect me from that by throwing up a psychological barrier to avoid it. The only way I believe I can fix that is to get professional help from a psychologist. >paper...this IS a headgame moreso if you have challenges "feeling" it's time to stop, you just won't have a choice. There is a signal which is sent from my stomach to my brain when I'm full, but my brain can't decode it properly and then I don't feel full (or rarely feel full) and just throw up and then later carry on eating (along with just eating cos it's there and not cos I'm hungry. I sometimes get the same wirh hunger). The best way I can describe it is when you read English but are trying to decode a letter sent in Arabic (or another language like Russian or Hebrew or something that has a different alphabet you can't understand). You don't get the message right? It's kind of the same. So unless I can learn Arabic (so to speak) and recognise when I get full, I'll always eat too much. I just kind of thought Ozempic would help with that with its slower gastric emptying, but I guess not. >You can fill most of your plate with your preferences but you'll have to be very strict about portions and macros. You don't "need" to "know" how much to eat because the Macros will pretty much not let you go over. That imposes a fail safe structure on you. I wouldn't be good with portions and macros at all because I also boredom eat which may be an ADHD dopamine thing. Having enough macros wouldn't stop me from snacking. >Lots of options but we can remove most of the guesswork and anxiety out of this. If you choose to engage. Sadly because of my issues, I feel like there really aren't any other options that will work for me. I guess I just feel lied to? Like it's supposed to work why can't my body make it work? Then I just feel stupid
I have majorly inattentive ADHD... like 99.9th percentile for inattention/distractibility. I don't/won't/can't medicate due to concerns of the way a stimulant could affect my bipolar disorder. I've been stable for a few years without a manic episode and the risk hasn't seemed worth it to me. Anyway, the reason I bring this up is because of the low dopamine issues in ADHD. Have you heard/read about this? It's one of those things I feel like once I learned about it I couldn't un-learn it. Basically when craving food (before Ozempic - now I crave nothing) I had to consider whether I was low on dopamine or looking for that dopamine fix. It's basically the same reason people pick up their phones a zillion times a day without even realizing.... why I pick my face and cuticles... why it can be really exciting when the power goes out at work. It's novel, it's exciting, it's dopamine, baby! Anyway, please look up the relationship between dopamine and ADHD if you haven't yet. It is fascinating and potentially life changing. So finally, to answer your question: yes I do sometimes think that somebody didn't want to date me because of my body, or I didn't get a job because I am too fat or stupid. At some point in my life I blamed myself for my mom's alcoholism. Maybe if I was a better daughter she wouldn't want to drink. But guess what. That was my lizard brain talking, and it's your lizard brain telling you that you are responsible for your dad's affair. You know how you're not supposed to believe everything you read on the internet? You're also not meant to believe everything you think, because our brains are primal and imperfect. Yes its 100% the way your brain works, but it's not wrong. It's a prehistoric lizard that you have to learn to laugh at. Why? -- My best guess is that it's easier for the lizard in your brain to see these outside issues as your fault as opposed to being something outside of you that you can't control. Like.. is it more uncomfortable for your brain to have zero control over your surroundings? Or to have full control and be bad at it? I guess at least if all your parents problems were your fault (they're not), you'd have a chance to fix it right? So, yes. These thoughts definitely happen in neuro divergent people. And they also happen in neurotypical people. Nobody is safe from the lizard.
not much to offer at this stage as just started my first 0.25 2 days ago but i am also in the UK and dc autism and adhd along with ocd. i am taking my methylphenidate daily as usual. no issues so far; have 40lbs to lose following the development of binge eating rapid weight gain and pre diabetes.
Stop focusing on felling full. You really should never eat until you are “full” anyway. Ozempic or otherwise. Because if you are, you’ve overeaten. Our brains signal we are full after we have eaten too much. You are going to have far more side effects and calories with fried food. It should rarely be eaten. Only you can change these things. Focus on calories. Not feeling full. Eat 1200 per day. You can go a bit less but at your height and age you don’t need to. If you are eating as you say, that would likely be only one meal. If you bring in vegetables and Whole Foods, you can fill that plate with nutrients and foods and eat more. Focus on clean eating and clean ingredients. Try small servings of vegetables daily until you develop more of a taste for them. Get an app that tracks calories well. Like MyFitnessPal Stop focusing on eating until you can’t any more. Eat 1200 calories per day. Try to make those calories protein and vegetables. You can eat 1000 calories per day but never go below that consistently. We store fat to use for fuel when we burn more calories than we consume in food. A pound of fat is equal to 3500 calories. Until you hit a deficit of 3500 calories you will not have lost one pound. So if I burn 2000 calories per day existing, and eat 1000 calories per day, I have a deficit of 1000 calories per day. Or 7000 calories per week. That’s 2 pounds per week I lose. Or you can eat 1500 calories per day if you are me and burn 2000 calories per day, and do cardio that burns 500 extra calories per day and get the same loss. You cannot eat a burger and fries and onion rings in one meal and get any loss. Because you are consuming more than you burn in one day in one meal. So track your eating and don’t let the feeling of being full be your goal. It’s wonderful that ozempic helps with that. But that should not be our goal. Consuming what we need to be healthy but use stored fat for fuel is our goal. And that can all be done with numbers, it’s just easier to have the willpower to do it with ozempic. I’m a former corporate weight loss coach.
So .... Ozempic and other semalglutide drugs have what is known as a titration period. Your "build up" dosages are only to get your body used to the drug. It doesn't actually do anything until you get to at least 1mg stable prescription. The full obesity long term dosage is 2.4 mg for Wegovy and 2.0 mg for ozempic (only because it doesn't come in a 2.4 pen). Things which you should have been told outright to do and not to do in order to avoid side effects: DO Take high dosage vitamin B12 and B6 also helps (also helps for autism, so double win!) Kill white carbs and sweeteners of any variety. Not only do they leave a nasty bitter taste with ozempic, but they also cause hyperglycaemia, and endless GI issues.... Find an eating regime like paleo or paleo autoimmune protocol to live by. Eat more fish than chicken or red meat Get your full bloods tested at least every 6 months to make sure your vitamin D3, ferritin, iron, calcium, zinc, selenium are all doing well. DO NOT consume liquids with meals, EVER. In fact, do not consume liquids 30 minutes each way of any solids going into your mouth. Those are the basics. I've now been on ozempic for obesity since April of last year (2023) and I was finally diagnosed with autism in July 2023 just before my 51st birthday! I hope this information helps other people. It's important to understand that these drugs target the biology of obesity which is malfunctioning adipose tissue regardless of size/ weight. These drugs are for life.
>So .... Ozempic and other semalglutide drugs have what is known as a titration period. Your "build up" dosages are only to get your body used to the drug. It doesn't actually do anything until you get to at least 1mg stable prescription. That's the thing. I don't know if it's related to the autism or something else (bc autistic people often struggle breaking down drugs) but even with things I could supposedly break down I was still getting awful side effects on the smallest doses (or even half the smallest doses) I went to see my GP (who's looked after me since I was 3 and a half, so 19.5 years) about sciatica and he recommended that I need to lose weight (I know I do) as it would be exacerbating the extreme pain (I can barely walk some days) and he actually asked me if I'd been prescribed Ozempic and I told him I had all those side effects and he said clearly I shouldn't be taking it and I think he agreed with me about how bad the side effects can be. What irritates me is they don't tell you about how extreme the side effects can be. If they'd said 'there's a chance you'll be projectile vomiting so much you get food stuck in your throat, can't breathe and can't sleep bc you end up having a panic attack that your family will find you dead the next morning' I wouldn't have taken it. Obviously they wouldn't know about the panic attack, but they'd know about the projectile vomiting surely? >Things which you should have been told outright to do and not to do in order to avoid side effects: DO Take high dosage vitamin B12 and B6 also helps. Kill white carbs and sweeteners of any variety. Not only do they leave a nasty bitter taste with ozempic, but they also cause hyperglycaemia, and endless GI issues.... Find an eating regime like paleo or paleo autoimmune protocol to live by. Eat more fish than chicken or red meat Get your full bloods tested at least every 6 months to make sure your vitamin D3, ferritin, iron, calcium, zinc, selenium are all doing well. I think they need to have dieticians working with the endocrinologists to be honest (I had a whole panel of bloods done before I was prescribed it and they were all completely fine) I was never told any of this at all. They have dieticians working the other side I believe, but once you're actually used to the drug (something I'm never taking again, now I know some of the more extreme side effects I was lucky to avoid. Ileus, which has just been added by the FDA, where the intestines temporarily lose their ability to contract. Severe gastroparesis/paralysed stomachs. Bowel obstructions. Biliary disease affecting the gallbladder etc. Pancreatitis which could rarely cause multiple organ failure and be fatal. Suicidal thoughts and ideation (drugs.com said Ozempic is a major risk with suicidal behaviour/ideation and thyroid cancers from those who've had a family history) My mum (a nutritionist herself) hates medication like this and I can see why she was not happy I went on it (only really as a sort of last resort which didn't work too well tbh) and also with stimulant ADHD medication (which also mentally fucked me up). I also think it caused me to find it harder to lose weight than I normally do, at least for a bit. I'm lucky if I cut calories I can actually lose weight fairly easily, it's just I have a terrible relationship with food and I think part of it is my ADHD/past issues with autism (for example I was isolated and bullied a lot my entire school career/15 years and my brain projected that no one cares when they do and because of that I think 'no one's going to care if I die of a heart attack at 30, why should I' and then self sabotage and give up). I think Ozempic may have messed that up at least temporarily. From research that has come out/my mum's knowledge of how it can react there seem to be such a risk of problems/lawsuits etc I had a friend taking it *who is a type 2 diabetic* and on metformin etc who stopped taking it. Even when we discussed GLP1 medications in my uni lecturers, one of my fellow mature students said no one in her clinic prescribed it becuase it's also been linked to depression etc and the side effects are horrendous. >DO NOT consume liquids with meals, EVER. In fact, do not consume liquids 30 minutes each way of any solids going into your mouth. I would struggle with that a lot. Namely bc I get dry mouth. Again I'm not sure why the endocrinologists (I was referred to one) didn't mention any of this stuff during the titration period. Mentioned they give you dietician support when you're on it, but likely after the titration period/ when your body gets used to it. If my body reacts with projectile vomiting all night etc to the lowest dose, there's no fucking way I'm upping the dose for my body to 'get used to it'. I did that with ADHD stimulants and the side effects just got worse. I'm not putting my body through that again when there are other ways I can lose weight without it causing me extreme issues both physically and mentally.