When it comes to processing calories, we are not all the same. If your metabolism and hormones don't work well, it's much harder to lose weight. Now there's a medication that is helping to change that, but it might be hard for you to get.
Ramsey Hare says she was always the overweight child, then the heavy girl in high school, college and nursing school. By her 20s, her weight surged to 380 pounds. But at age 30, a birthday trip to the beach changed everything.
“I came back and I looked at the pictures and I was devastated. I had no idea that I looked like that,” said Ramsey Hare, 42.
She could no longer deal with the emotional pain.
A Wonder Drug?: “I have not ever been hungry since surgery. It was amazing,”
“Traveling on an airplane having to ask for a seatbelt extender, just little things like that that emotionally was traumatizing,” she remembers.
So 10 years ago she turned to Surgical Specialists of Louisiana for bariatric surgery called the sleeve. With her post-surgical stomach smaller, which also puts those dysregulated hunger hormones more in balance, Ramsey got down to the 150s in 15 months.
“I have not ever been hungry since surgery. It was amazing,” said Hare.
The weight stayed off for that decade. At 40 she became a newlywed and wanted to become a mom. But a year and a half of fertility treatments of injections of hormones, along with steroids, reversed a lot of the gains she had made in maintaining her weight loss.
“In the first probably six months, I was up already 40 pounds, and I was terrified. None of my clothes fit. My scrubs didn't fit for work. Brought back so many painful, you know, depression memories and just the anxiety,” said Hare.
But all of those painful emotions went away fast with the FDA approval of Wegovy.
“A wonder drug is new to the market, and so I was like, ‘Sign me up,’” Hare remembers telling the drug sales rep when he was demonstrating the once-a-week injection at her work clinic.
“It's simple. It's painless, and it was a miracle. In three weeks I lost 18 pounds, and by three months, I had lost 38 pounds, and so by six months, I was up to 47 pounds,” she said of her rapid weight loss numbers.
For several years Ozempic has been on the market to treat type 2 diabetes. It improves the way the body handles excesses of the hormone insulin. A side effect was that patients lost 15 percent of their body weight. So last year, in June of 2021, it was reformulated and approved for weight loss for patients, who are not diabetics, under the name Wegovy.
“This drug is not a stimulant. It simply makes you feel full. We know that it affects your brain. It mimics a hormone that affects the satiety centers in your brain,” explained Bariatric Surgeon Dr. Matthew French.
Dr. French of Surgical Specialists of Louisiana, says about 20 of the clinic's patients have used Wegovy.
“And they say they just don't get hungry. They don't want the food. They don’t have the craving. And that's a powerful tool for losing weight,” explained Dr. French.
“And I wasn't hungry, which was great. The best thing about this drug is it made alcohol taste horrible,” said Hare who noted she packed on part of her weight from the sugary calories in beer and wine.
But after six months, Ramsey is no longer on Wegovy. Her cost-saving coupon ran out. Most Louisiana insurance companies don't pay for weight-loss medication like hers. Despite the long-term cost savings when people maintain ideal weight, companies don't include it in their coverage. The other problem is the drug is in high demand and can be difficult to get.
When asked if insurance would cover it would a lot more patients be on Wegovy, Dr. French replied, “Definitely. Now it doesn't take the place of surgery. Surgery is still about twice as effective as this medication for weight loss, but compared to diet and exercise alone, it's a no brainer. Complete game changer.”
Wegovy is for people very overweight or obese. LSU Health exercise and obesity expert, Dr. Melinda Sothern, says too much insulin in the blood causes fat storage in the belly. So people who don't have a metabolism health problem and those who don't qualify for this drug, can get the same effect on controlling their insulin metabolism the old fashioned way. One is eating a Mediterranean diet.
“The reason why insulin is secreted is because you've ingested it, either sugar or some kind of starchy carb. That triggers it. So it's not just calories in and calories out. It's the qualities of your diet,” explained Dr. Melinda Sothern, Professor Emerita at LSU Health Sciences Center.
The other natural way, of course, is exercise.
“Interestingly, exercise, a combination of strength training and moderate aerobic exercise, will do the same thing, but it does it through the muscle action. It helps the muscles use the insulin more effectively,” said Dr. Sothern.
Ramsey does not exercise, but knows now that while Wegovy helped her through the hardest part, she will have to exercise to maintain her weight without the injections. And yes, she knows that includes cutting the sugary carbs.
“If I can get through Mardi Gras, you know. I only had one piece of king cake. Only one, and I didn't even eat the whole thing,” said Hare.
The injection can push your weight loss from 2 percent to 15 percent, over diet and exercise.
Side effects can be nausea and digestive problems in one to three percent of patients. Serious side effects are very rare.
Without insurance, the monthly cost is $1,500. With insurance, it is $25.