In addition to Ozempic (a weekly injection), there is a daily tablet called Rybelsus (with the same effectiveness), plus another injection, Wegovy, with a higher maximum dose.
Headlines described the mad scramble to buy it in the US and UAE; how Wegovy would soon be offered by the NHS as part of certain weight management services (now delayed to later this year); how Ozempic and Rybelsus are already being prescribed off-label here privately. Even Elon Musk tweeted in praise of semaglutide.
The side effects were also well publicized, including some rare but serious ones like a risk of pancreatitis, plus a warning about possible links with thyroid cancer. But that morning I woke up determined to get hold of it.
I could barely look at the GP as I sheepishly admitted what I wanted. I might as well have asked for crack. But she said she could not prescribe it; I will have to go to a private weight loss clinic.
That’s how I found my way to London Medical, which offers a weight management service – and to Dr. Abraham. After the first appointment, and after measuring my height and weight, taking my medical history, blood tests and checking my blood pressure and glucose levels, he – hallelujah – wrote me a prescription that was not labeled Rybelsus.
Only then was his clinic’s pharmacy sold out… Desperate I bought it from an online pharmacy and paid £169 for a month’s supply. (It’s staffed by registered pharmacists and I was forced to do eligibility checks digitally, but these were less thorough than through the clinic; I wouldn’t have done it if I hadn’t seen a consultant first.)
Then a small brown box arrived in the mail. On June 7, I swallowed my first pill. A month after. A Saturday evening in July. I’m lying on my bathroom floor with my face pressed to the tiles. I feel hot, my heart is racing, but worse are the stomach cramps that come in waves and make me rush to the bathroom. Afterwards I crawl back onto the floor – at least it’s cooler here.
I have been on Rybelsus for 31 days and today I increased my dose from the starting level of 3mg to 7mg as recommended. In another month I will increase further to a maximum of 14 mg. Only I can’t imagine doing that; the side effects are terrible.
The next day, still weak and ill, I meet my mother at the Royal Academy, but I wander around listlessly, struggling to concentrate. She is understandably concerned and is trying to talk me into stopping taking it.
But I had the same discomfort when I started with the 3mg dose and the side effects subsided after a week. In addition, I have already lost one stone and two kilos. I show her an article about some people who say they passed out in their sleep after taking semaglutide by injection. “Look, it could be worse,” I joke.
Five days later, my side effects have mostly subsided, except for the relentless nausea. But one night, as I walk into the subway station, I feel a familiar, terrifying sensation: a wave of hopelessness, an overwhelming, ‘What’s the point?’ It takes me back to episodes of depression in my early 20s.
I could turn to the clinic – it provides support for side effects – only this time I know what to do myself: I sit in my garden, call a friend for a chat, sleep well. The next day I force myself to eat proper meals, even though I’m so nauseous I’d rather fast: some porridge for breakfast, vegetable soup for lunch, nuts and a banana to keep my brain going, salad and chicken for dinner. My mood isn’t quite up, but I know I’ll be fine.
The same week, the European Medicines Agency announced it was conducting a review of some weight loss pills, including Ozempic and Wegovy, after being warned of a possible link to suicidal thoughts and self-harm.
A search on YouTube throws up videos of people saying they’ve experienced similar thoughts. A young woman with two million subscribers describes her experience on Ozempic in a video published earlier this year. She describes feeling a ‘life-giving’ doom; an ‘I must run and jump as high as I can feel’.
She remembers shaking and crying. ‘For me it’s not worth it (the mental-health aspects).’ It’s impossible to verify whether these YouTubers were taking semaglutide made by pharmaceutical company Novo Nordisk – knock-off versions are reportedly starting to appear in the US – but either way, it’s worrying.
So when two friends tell me they’re toying with buying something online – one wants to shed two stone to reach her pre-pregnancy weight – I’m horrified. Don’t do it, I say. I would not recommend this to anyone except those who need to lose a lot of weight for their health; it’s not like popping a vitamin tablet.
Why are you so into it, they say. Why don’t you just eat less and exercise more? This is the hardest part to explain. Imagine spending your adult life going about your normal business while voices scream in your head. You can’t turn the volume down and they barely pause except when you sleep. Then one day you find a contact and you flip it, and – away. Silence.
This is the only way I can describe what happened. I had never even realized how loud that noise was until I was suddenly free. There is no clinical definition for food noise. But it’s clear it’s hitting millions, as videos related to ‘food noise explained’ have had two billion views on TikTok alone.
Going to the supermarket also feels different. I can walk the aisles with complete passion, no temptation. At first I assumed it was just because I wasn’t hungry, but I soon realized there was more to it.