Tired of the Relentless Struggle to Stay Lean?
Thinking (Like Me) About Oprah and Ozempic?

Oprah’s many struggles with her weight appear to be over. Thanks to her recent highly publicized success with weight-loss drugs, their use has surged in popularity. And she’s not the only celebrity talking about their impressive results with Ozempic and its cousins.

Would it work for me? I don’t know.

Two of my relatives lost a ton of weight by getting Ozempic injections. One went from about 265 to 195, and the other from about 205 to 165. One had digestion issues the first few weeks, which disappeared when the doctor cut his dosage in half. The other felt some fatigue for a month or so, but now feels that he has even more energy than he had before he started on the drug. Plus, the aches and pains of being in his late 60s are fewer, he says, because of the weight loss.

Another relative has begun taking Wegovy – basically the same drug (semaglutide, which has typically been used to treat type 2 diabetes), except it’s a higher-dose version that was approved for weight loss. He’s only five weeks into it, but has started to shed pounds.

As you may remember, I began a weight-loss experiment of my own earlier this year – eating only one meal a day and limiting myself to eating for only one hour. It was taking the pounds off. Not as quickly as I would have hoped, but my weight was dropping. On the downside, the high level of mental discipline it required did not diminish over time.

Luckily, someone sent me an article from some magazine arguing that long-duration fasts are unhealthy. I didn’t bother to double-check the claims made in the article. My will power gauge was near empty. I went back to the old, midnight-grazing diet I was so accustomed to, and, sure enough, those lost pounds found their way back to me.

This was not the first time I gained and lost (and eventually regained) weight. In fact, now that I think about it, it happened each time one of our children was born. Commonly, it is the woman that gains weight during pregnancy and then struggles to lose it afterwards. For some cruel reason, nature had a different idea for us. K and I both got bigger together during each pregnancy. But after the baby was born, K went back to her former slimness within weeks, and it took me months – sometimes many months – to get back to my fighting weight.

After our third child was born in 1988 when I was 38, I got lean and fit before I turned 40. And I stayed that way for nearly two decades… until Number Two son and his wife had a baby. Well, I’ll be damned, but my instinctive sympathetic metabolism kicked in, and I’ve been on a roller coaster ride ever since. It’s no wonder I couldn’t make this last attempt at weight loss work. Number Three Son and his wife just had their second baby on Tuesday. So, here we go again!

By now, if you are still with me, you must be wondering: “Just how fat is Mark? After all, he’s the guy that’s always talking about working out so hard six days a week and competing in jiu jitsu tournaments and all that.”

Knowing this question would be at the top of your mind, I went online to determine my Body Mass Index. The BMI is a simple ratio that estimates how fat someone is by using just three factors: height, weight, and gender.

As a 5’10”, 224-pound man, I have a BMI of 30+%. That puts me well into the “obese” category.

But I don’t look obese. And my trainers and even my wife agree. I’m just “thick,” they tell me.

My trainers say the BMI is useless because it takes into account neither the density of your bones or the amount of muscle you have on your body. A strong-boned, 5’10” body builder could easily have a 32-inch waist and a true body fat percentage of 6% and the BMI would still classify him as obese.

Of course, I don’t have a 32-inch waist. I buy my pants with what I consider to be a respectable waistline (36 inches) for a man of my age. However, at this point in time, trying to fasten them takes a considerable amount of effort.

You can get a more accurate measurement of body fat and lean muscle mass with calipers or electrical stimulation. In the past, when I measured 30+% on the BMI scale, my actual body fat percentage, according to those more accurate measurements, was in the mid 20s.

So, no. I’m not obese. I’m thick. But I’d like to be less thick.

One of my trainers says my “ideal” weight would be about 205. Another says 195. Either way, I’m looking at dropping 20 to 30 pounds. So, it’s either back to a strict diet of some sort… or I can take a tip from Oprah and my relatives and go Ozempic!

My Doctor’s Surprising Response 

It so happened that I had a visit with Dr. B, my VIP MD, a few weeks ago – the once-a-year visit where he checks my bloodwork and we talk martial arts. (He’s a karate guy, but still.)

My numbers were pretty good… aside from the fact that, as he pointed out, I am eight pounds heavier than I was last year. So I told him about my failed one-meal-one-hour-a-day experiment. I also told him about the success my relatives have had with semaglutide injections and asked him what he thought about it.

Dr. B is a conservative physician. So, I was surprised that he didn’t dismiss the idea out of hand. He told me that some of the diabetic and prediabetic patients he’d been treating with the injections had not only lowered their risk of developing major cardiovascular problems but were also losing lots of weight.

But he added that both Ozempic and Wegovy come with negative side effects – most of them minor, such as burping and bloating, though there have been reports of more serious problems.

The Research: Reports and Studies 

When I got home, I did some googling that confirmed everything he said, including this:

* In trials of Ozempic (1mg dose), 30.8% reported gastrointestinal symptoms, including nausea (20.3%), vomiting (9.2%), diarrhea (8.8%), abdominal pain (5.7%), and/or constipation (3.1%).

* In trials with Wegovy at the higher dose (2.4mg), 74% reported at least one GI disorder: nausea (44.2%), vomiting (24.8%), diarrhea (31.5%), abdominal pain (10.0%), and/or constipation (23.4%).

And I found some evidence of the much more serious side effects Dr. B had mentioned. One study, for example, on semaglutide causing thyroid cancer in rodents, and two studies indicating a possible connection between the drug and organ damage (kidneys and liver).

But because the very serious side effects are rare, and because there is no sure evidence that they are the result of the injections themselves or other factors – and because there have been reports of rare, serious side effects for virtually every drug I’ve ever studied – I came away from my little bit of research with a new plan in mind.

What to Do? 

Here’s my plan.

I’m going to try my experimental diet again. If I fail at that, I have a somewhat less extreme version, which allows for two small additional meals (breakfast and lunch) of 200 to 300 calories of pure protein.

If that doesn’t work, then I’m going to try the most extreme diet I have ever undertaken, which lasted for more than a year and worked very well: I’m going to stop drinking wine and tequila.

Well, maybe I won’t do that. We’ll see.

Given Dr. B’s relative openness to semaglutide, and considering the rarity of serious side effects that have been associated with it (so far), I might consider getting on the Oprah highway and losing weight with the magic of pharmacology.