Greetings, Dr. Roach I shed 40 pounds with ease after taking Ozempic for around 10 months and gradually increasing my dosage to 1 mg. As if by magic, the need for sugar vanished. Then I became aware of my regression and my renewed need for sweets. My doctor changed my Ozempic dosage from 2 mg to 1.7 mg of Wegovy. I’ve gained eight pounds in around six months, and I still have cravings for sweets.
I want to know whether there are any studies that explain this and how best to deal with it. Should I take a different medication or raise the dosage even more? — J.A.
ANSWER: Ozempic and Wegovy both contain semaglutide. Wegovy is advertised for weight loss, whereas Ozempic is suggested for diabetes. They are also somewhat different in dosage. To reduce side effects, the dose must be started low and increased gradually. Each dose, in my experience, causes a specific amount of weight loss before plateauing, however this varies greatly from person to person.
It’s normally time to increase the dosage when the weight reduction reaches a plateau or reverses. In contrast to Ozempic’s maximum dosage of 2 mg, Wegovy can be increased to a maximum of 2.4 mg, administered by injection once weekly. I suggest that someone in your circumstance attempt the 2.4-mg dose of Wegovy because I prefer to take the highest possible dosage.
certain of my more experienced colleagues in weight loss medicine point out that while tirzepatide, another GLP-1 agonist, works better for certain people, semaglutide works better for others. It is available for weight loss (Zepbound) or diabetes (Mounjaro), just like semaglutide. Tirzepatide was somewhat more effective at promoting weight loss in a head-to-head trial, but every individual is unique. Furthermore, insurance frequently only covers one choice.
To increase the efficacy of GLP-1 agonists like metformin or topiramate, weight loss specialists will prescribe additional drugs. If a single medication isn’t working for you, I suggest consulting a weight management specialist.
Lastly, since the compounded forms of these medications have not been thoroughly examined for safety and effectiveness, I advise against using them.
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Greetings, Dr. Roach I was interested in reading your most recent editorial about polymyalgia rheumatica (PMR). This diagnosis was made for my husband when he went to the emergency hospital due to an abrupt onset of crippling headaches and shoulder and neck pain. His internist followed up with him. Over the course of a month, the discomfort, inflammation, and low-grade fever persisted. Ibuprofen and prednisone subdued it.
He tested positive for Lyme illness a month later. At the beginning, he had received a Lyme test, which was negative. Luckily, a clever friend who worked as an emergency room physician assistant recommended a follow-up test because Lyme antibodies can take four to six weeks to form. After starting doxycycline as part of his Lyme treatment, all of his symptoms quickly and permanently disappeared.
After two years of investigation, I’ve discovered that undetected Lyme disease can resemble a variety of illnesses, particularly those that cause neurological pain in the joints, head, neck, and back. I just wanted to share this potential realization. — K.M.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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