Bárbara lost 30 kg in 7 months and gained it all back

On the reel where I talked about Ozempic, Bárbara left a comment that deserves more than a reply.

She was into sport when she was young. Today, in her 50s, she has obesity. A year ago she started taking Victoza injections and lost 30 kg in 7 months.

But that wasn't the only thing she lost.

What she told me

On the first day, she took the injection at 11am. At noon she had a bowl of soup. At 2pm she spent two hours throwing up.

For the 7 months, her hunger disappeared completely. In her words, at most she could eat "one tablespoon of food a day". Anything more and she threw up.

She started losing hair. She had problems with her teeth, brittle nails, sagging skin, memory loss and became apathetic. She lost muscle mass.

After the 7 months, the medicine stopped being available in pharmacies. She thought she had the willpower to keep going on her own, by re-learning how to eat. She couldn't.

All the weight came back.

One spoon a day for 7 months

I'm not a doctor and I don't know her case beyond what she told me. But hair falling out, weak nails, lost muscle and no energy are what you would expect from someone who spends months without eating enough calories or nutrients.

And when you lose weight eating almost nothing and without training, you always lose muscle. In STEP 1, a large semaglutide study with no strength training and no protein target, close to 39% of the weight lost was lean mass.

When the medicine stops

What happened to Bárbara when she stopped is also in the studies. In the STEP 1 extension, one year after stopping semaglutide, people had regained two thirds of the weight they had lost.

The studies measure what happens. They don't measure why. My reading is the same as always: if nothing changed in the way you eat, in the choices you make and in your relationship with food, sooner or later you end up back where you started.

And it is hard to learn how to eat when you spend 7 months unable to eat.

She was under medical supervision

This is what makes me think the most.

Victoza is liraglutide, the same substance as Saxenda. According to the leaflet, you start on a low dose and go up slowly, week by week, precisely so the stomach can get used to it. Nausea and vomiting are among the most common side effects and usually go away with time. The Saxenda leaflet says that if a dose increase is not tolerated for two weeks in a row, stopping the treatment should be considered.

So I ask:

Did anyone ever think about lowering the dose or switching medicine?

Did anyone take into account that she couldn't eat?

Did anyone suggest she see a nutritionist, so she could eat at least the minimum she needed to stay healthy?

I don't know the answers. I only know what she told me.

Responsibility

I often talk here about personal responsibility. And seeing situations like this one, I'm even more convinced that we need to take charge of our lives and our health.

But, for crying out loud, in this case the responsibility can't be hers alone.

Anyone looking for help to lose weight, with or without medication, needs someone who looks beyond the scale. Someone who checks whether they are eating enough, whether they are losing muscle and whether they are learning something that will stay with them when the treatment ends.

These medicines can help a lot of people. But without eating the minimum, without strength training and without learning how to eat, the weight will most likely come back.

Thank you, Bárbara, for sharing.