Dr. Ahmed This is the story of a patient who was recently started on Ozempic and Metformin for morbid obesity and insulin resistance. Fellow users are requested to help him tolerate Ozempic and relieve his nausea.
Here is me … Morbidly Obese
I am an obese male with a BMI of 49 kg/m², which is classified as morbidly obese. I’m just a few pounds shy of being labeled as superobese.
In my family, I am the most obese person. Despite this, I stay active, although my weight imposes some limitations on my workouts. I strive to be as active as possible.
I avoid junk food and prefer healthy options, but I haven’t found a way to lower my body weight effectively.
Recently, I decided to seek medical help because my wife and I have a 13-year-old daughter and are planning to have another baby.
I have Insulin resistance …
My doctor in Turkey conducted some tests and diagnosed me with insulin resistance. My HOMA-IR was more than five times the normal range.
Additionally, I have black, velvety pigmented skin around my neck, armpits, and groin (acanthosis nigricans).
I was prescribed Synjardy, which helped me lose a few pounds, lower my HOMA-IR, and improve my glycemic control.
I forgot to mention that I have prediabetes. My fasting blood glucose ranges from 90 to 110 mg/dL, and my random blood glucose is around 160 mg/dL.
Metformin for insulin resistance, Ozempic to get me in shape …
Recently, I visited another doctor who prescribed me Metformin 1000 mg twice daily and Ozempic 0.25 mg once weekly for four weeks.
However, after just a day or so of starting these medications, I began to feel severely nauseous and developed extreme anorexia.
I informed my doctor that I never had any stomach issues and that I had tolerated Synjardy well before. Synjardy is a combination of Empagliflozin and Metformin.
My doctor had mentioned the potential stomach-related side effects before starting Ozempic injections. I thought it would be as easy to tolerate as Synjardy.
Worse Nausea of My Life …
Unfortunately, after a day or so of taking Metformin twice daily and the Ozempic shot, I stopped eating and have been experiencing persistent nausea.
I messaged my doctor and explained the situation. He advised me to take omeprazole and itopride, which helped a bit but did not relieve my anorexia.
I reached out to my doctor again, and he suggested stopping Metformin for a few days until my symptoms improved, then restarting at half the dose.
He also recommended eating small, stomach-friendly meals. If my symptoms persisted despite stopping Metformin, he suggested delaying the next Ozempic shot for 10 to 14 days.
I’m now at a point where I feel Ozempic might not be the right medication for me. I’m losing hope in my ability to lose weight and lower my HOMA-IR marker of insulin resistance.
How should I proceed from here?
- Should I discontinue all the medications and try some alternative therapies?
- Should I wait and go slowly, giving my body time to get used to these medications?
- Should I try other medicines, such as Zofran, for nausea?
- Question of
How do you effectively manage nausea caused by Ozempic?
- Lifestyle changes like small meals and avoiding certain meals
- I take medicines along with some lifestyle changes
- Question of
Which medication has been most effective in relieving your nausea?
- Domperidone (Motilium)
- Dramamine (Dimenhydrinate )
- Benadryl (Diphenhydramine))
- Meclizine (Antivert)
- Metoclopramide (Reglan)
- Itopride (Ganaton)
- Zofran (Ondansetron)
- Question of
Should I consider discontinuing Ozempic?
- Yes, the side effects are too severe
- No, wait for the adjustment period to see if symptoms improve
- Unsure, consult with your healthcare provider
- Question of
How long does it typically take to adjust to Ozempic?
- Less than a week
- 1 – 2 weeks
- 2 – 4 weeks
- More than 4 weeks
