two months on a GLP-1

all your questions answered

I got a lotttt of questions from instagram, and somehow at least half of them were whether I’m experiencing side effects… I guess I understand the curiosity, but if you’re trying to figure out if *you* will have side effects, my answer is unfortunately meaningless. I also got some more medically-oriented submissions that I don’t feel equipped to answer, like around potential risks and insurance questions. Anyway, I hope this is helpful, let me know your thoughts in the comments! (Please don’t make me regret this invitation.)

What dose do you take?

I took 2.5mg for the first month (4 shots) and 5mg this past month. My doctor said I would likely stay on 5mg but evaluate at 3 and 6 months.

How painful is the shot?

I don’t find it painful, it’s a very small needle and takes about 3 seconds. I do it in my stomach and put an ice pack on the spot for a minute to numb it beforehand.

Did you have any side effects?

Aside from the effects on my appetite (which I consider a main effect), not really. I tend to be on the less sensitive side when it comes to drugs’ effects.

Do you feel different, as in can you feel some sort of shift physically or mentally?

Physically, it feels similar to the shift when I went on metformin two years ago, where things just feel more cyclically correct, for lack of a better word. Closer to an overall sense of homeostasis. It’s subtle but an improvement.

Mentally, it’s wild to think back on how many times I wished for a magic pill that could make me lose weight without needing to diet or exercise, and I could just magically be thin. Now we have something approaching that, but it intersected with a point in my life where I’m now trying *not* to focus too much on the exact thing (thinness) that I spent years believing would be my key to eternal happiness and self esteem. It’s like running into a former crush and feeling no excitement, but it reinforced something I try to remember whenever I find myself worrying about a hypothetical future: you might feel completely different about a scenario when/if it arrives.

How much weight did you lose? When did you start to see results?

I feel like I noticed within two weeks. I don’t know exactly how much I’ve lost, but I’m guessing around 25 pounds based on my clothing. I don’t have a scale at home and didn’t weigh myself right before I started, so I only know a ballpark number based on my weight at my physical a few months earlier. I also haven’t weighed myself, even though I’ve been meaning to, I just haven’t come across a scale in the past month (which is how you know I haven’t been to a gym either). My estimate is based on some clothing items from the late 2010s ED era that are fitting again.

How quickly did you notice a difference in your feelings toward food? Do you still enjoy eating?

I immediately became round-the-clock NOT hungry after the first shot in a way that made it difficult to eat. This wasn’t due to nausea (which I know is common), just lack of any appetite at all. The intense inability to eat waned after a few weeks, and now I notice that I just feel sated more quickly. It’s also much harder to ignore the feeling of satiety and continue eating to the point of extreme fullness. I still enjoy eating how I did before going on Zepound. (The big shift in how I feel about eating evolved through ending my cycle of restrictive dieting, more on this below.)

Does it make you want to drink less?

Yes. I would describe the feeling that GLP-1 engenders toward alcohol and (often) food as take it or leave it, when even the mere idea of those things would have formerly given me a dopamine hit. I’ve always found it hard to pass on an indulgence, both as a matter of my natural brain chemistry and on principle, because life is short.

I still don’t feel an aversion to alcohol and I’ll drink on the same occasions I always did, but the medication eliminates the grip of any given substance. It’s not a dampening of emotion in your life overall, but kind of an attachment-loosener. Like if you’re someone who can’t sit next to a charcuterie board and be fully present in conversation without a persistent little voice saying you better not compile another one of those fucking crackers…no not the grapes either (i.e., “food noise”), this takes the volume of that voice from 11 to 1.

Does losing weight bring up any old body issues?

Not really, but I’m well aware it could, so I’m trying to redirect old habits when they pop up. Noticing that I’m losing weight makes it tempting to body check, and this is part of why I haven’t more aggressively sought out a chance to weigh myself. Knowing the number doesn’t change the number, so what’s the point of re-introducing a metric I used to obsess over? I have no goal weight to measure against. My goal is to get my bloodwork done again at 6 months and take it from there with my doctor.

The other thing is comments from other people, on the occasions that I get them (though I think how public I’ve been about my ~body journey~ has made some people less likely to comment). Of course I love to hear that I look good, except my mother has been marveling at my pharmaceutically-induced weight loss like I personally brought the messiah.

When I gained a lot of weight in recent years, it was pretty easy for her understand I didn’t want to hear comments about my body, positive or negative. This wasn’t only about not wanting to be insulted about my higher weight (although, duh), but about breaking an emotional link I had between my weight and how I feel about myself, which was also largely based around getting approval from others. My mother and I have dealt with similar “stuff” around eating as well as similar bodies (as so many mothers and daughters do), and hearing her say I lost weight used to be one of my favorite pastimes because she has an inexplicable way of perceiving even the loss of 1-2 pounds. Recently I’ve had to explain that frequent gleeful comments about my smaller size have the same impact as negative ones about weight gain, just in a nicer-seeming direction, so to please resist making this a common conversation point.

I know I need to set this particular boundary because this was really ground zero of my eating issues. The tie between my size and self worth was the generator of the disordered thoughts and behavior that caused me to diet cycle for two decades, fucking up my relationship with food, my body, my health, and my daily experience of life.

It goes roughly like this, with many problematic details spared: Countless signals throughout childhood teach me that I need to be thinner because thin is better and I am not thin enough ➡️ I restrict what I eat (and experiment with an array of other measures) to get thinner ➡️ I lose weight and get lots of positive reinforcement ➡️ I can’t maintain these extremely restrictive measures ➡️ I gain weight from loosening restrictions (and later on, binge eating and insulin resistance) ➡️ I feel bad about myself because I got way more positive reinforcement (from myself and others) when I was losing weight ➡️ Go back to restrictive measures ➡️ Lose weight again ➡️ and so on.

When this constitutes your life between ages 12 and 30, it not only has the potential to do long-term harm to your hormones and organs, but it also creates deep neural pathways around your disordered habits, dysmorphic perceptions, and psychological attachments/aversions to foods and experiences that are part of a normal life. It impedes your daily functioning, even for those who don’t have what some would call a “full blown eating disorder”. This is what I think people are describing when they say GLP-1s take away the “food noise.”

Do you feel like your “food noise” is gone?

Of all the things to come out of the GLP-1 trend, I’m especially happy that the concept of “food noise” is now more broadly understood, and no longer just the thing I found to be a debilitating invisible symptom.

I spent the past few years trying to evolve past my disordered behaviors and minimize my “food noise”, and the way I did it was through a period of letting myself eat whatever I wanted, in order to destroy the emotional ‘special-ness’ around things I restricted for years. This led to gaining a lot of weight, well into extended sizing, but with time (and through a more intensive process than I’ll go into here), I learned to accept myself despite being fat, by sourcing my self-worth elsewhere. If you want to tag it under a trend, my goal was body neutrality.

While that method worked for breaking my psychological attachment to formerly off-limits foods and the need to be thinner in order to be permitted to like myself (goal weight: always 20 pounds less), it triggered PCOS and insulin resistance. Some people may be healthy at any size, but I was not healthy at that size.

By the way, as freeing as it was for me to break what felt like an addiction to both eating food and restricting it, I experienced a bit of grief around the loss of food as an emotional crutch. When you restrict yourself long-term, foods actually taste better when you allow yourself to eat them, and some of the foods I used to put on a pedestal (shout out to the OG DST) literally taste different now. When you take it off its little disorder pedestal, it’s just a slice of cake. A genuine sense of sadness around losing the vice of emotional eating is something I’ve also heard people describe as an experience after starting a GLP-1, so I assume that’s why people asked if I still enjoy eating. And yes, I do still love cake, I just don’t ponder cake anymore.

Has it impacted your PCOS?

I don’t think I can answer this without bloodwork, but I’ll say that my period has stayed regular. While I’m not a doctor and an irregular period isn’t the only symptom of PCOS, I use this as one indicator of ‘normalcy’ for my body. This is because I never had a regular cycle in my life before starting metformin to treat PCOS, and then it immediately corrected itself.

How much does it cost and does insurance cover it?

Yes it’s covered by insurance, but it’s approximately $550 per month (4 shots) until I hit my deductible. It would have been slightly more but I used one of those rebate coupons to get around $150 off.

What are some things you wish you knew before?

I don’t think I’ve been on it long enough to answer this.

Do I recommend it?

My personal experience with it has been positive so far, but that’s a question for a doctor.