Wegovy and nausea

I wish i could find something about Expound.I might would do a trade off now that i lost 45 lbs.

I've had bariatric surgery, which led to severe nausea (called "dumping" if you decide to do a search for it); started tirzepatide last summer to get rid of the weight I had gained (to improve my knee arthritis), which led to a slew of GI side effects; and moved to semaglutide this year, largely to deal with the side effects.

One of the key reasons the weight went back on was that I eventually fell back on comfort food to assuage the dumping syndrome, so yeah, part of this is behavioral. However, I also devoted a lot of attention to figuring out my list of trigger foods, and that's what worked in the end.

This was a very useful experience when I started the GLP-1 RAs. I titrated up more slowly than they recommend, paused and stuck at a lower dosage than the maximum, and titrated down slowly. During this experience, I did make use of the controlled nausea as a tool to help manage my eating, but I also did a lot of tracking to figure out what made a difference, and also got a prescription for anti-nausea medication that I used sparingly. I found that the symptoms were worse with some foods than others, if I didn't stop eating immediately when I started to feel the first edge of nausea, and at meals later in the day (I used the medication to help me be able to go out to dinner for social occasions, since otherwise dinners were difficult for me). This may or may not be the same for you, but it's an example of sleuthing the issue out.

It's really important to prioritize protein and fiber when we eat so much less. Unfortunately, this has meant that I haven't been able to rely on plant proteins, where the protein requires eating more volume. In my case, vegetables are more triggering than fruit, especially cruciferous vegetables, so I'm skewing toward fruit.

My GI symptoms are only partially dose-related, meaning that dropping down to a lower dose helped a little but not a lot. That's why I switched to another drug in the family, which helped (as did the fact that I could get it as a multi-pen, which let me fine-tune dosages). Switching definitely helped, although it took a couple of months for my system to calm down.

This was not the only side effect I had, and I've systematically been going after each one. I don't think this is normal -- someone has to be a statistical outlier, and I guess I was elected -- and it really is normal for the nausea to be dose-dependent and to go away over time. But it does appear that the weight loss is not just a reaction to the nausea, and does not depend on that symptom. So if you can get the nausea under control, you may well see the weight loss still happen.

@larry68
Go to their web site. Very helpful information there. They offer some cost savings for those with insurance and thos without but not federal ones like Medicare Part D and other federal programs.

My Mayo PCP was really up on Expound. He said had two receptor for appetite reduction where Wegovy only had one.

He also mentioned not so many side affects but I read on MCC posters having side affects to it.

WOW that is great you lost 45 lbs. You should be very proud of yourself!

Sorry about your problems. I had gastric bypass surgery 20 years ago. Even to this day, if I eat things I shouldn’t, I will dump. If I don’t chew my food completely, I’ll dump. Sugary foods will make me dump. Like I said, 20 years later. Sooner or later you need to realize that it’s what we put into our mouths we are responsible for. The doctors were certain that I understood the complications if I didn’t change my eating habits. Once you dump a couple of times, you know how to avoid it. I have kept off 100 pounds since then. Good luck.

@lisalucier
The short answer to the question is yes both nausea and stomachace with the 2.4 dosage.

I started per my Mayo PCP with lowest dose of Wegovy I think was .25 but those levels did not reduct my appetite. From .25 to before starting 2.4 I had very limited stomach upset. It was more bowel movement slow down that I noticed. I did not feel nausea. I did get a slight reduction at dinner in eating feeling a little full but only at that meal.

My wife got sick and I did not start the 2.4 level dose right away. When I did within 2 hours (was prior to bedtime) I could feel nausea and stomach discomfort.

When I woke up the next morning was quite frankly severe. I was really nauseated and had stomach pain. I vomited. I struggled and sent a message to my PCP about my symptoms. At lunch time I vomited again. I was given an acute visit to Mayo.

The doctor who saw me said no way to counter the drug it has to take is time to go through system and would take about 4-5 weeks to completely leave. I was told to eat very light and clear food. My doctor said I would normally prescribed a nausea pill for you but it would interfere with other medication you take.

Now what did I do to manage it. I tried eating mashed potatoes and let them dissolve in my mouth. This light and easy digetible food did not upset my stomach and I was able to keep it down. I chew a long time and ate very slow. I need to have protein but was not going to eat any meat. So I bought protein shakes. They were tasty and did not have an issue with them.

I drank gingerale. It seemed to quell stomach. I constantly felt nausea and was burping. I stayed with the mashed potatoes and protein drinks and did not vomit again. I watch not to lay down to soon after eating as would seem cause more nausea.

I don't want to put a negative on these medications. For some they have great success with them and minor side affects. For me none of the lower doses were working to reduce appetite and the highest one I got a severe reaction.

I wish it would have worked for me but I and others need to know once you stop them your appetite and stomach will eventually return to the way it was before. So you have to try to change you lifestyle and eating habits and not just count on being on a medication like Wegovy.

My PCP wanted me to consider Expound (spell?). He said it contained 2 recptors to lower appetite not just the one in Wegovy. But I have read on MCC others having issues with Expound as well. I was told we he would not even consider it for at least three months after I had the reaction to Wegovy.

@jc76 - confirming you mean tirzepatide (Zepbound)?

@lisalucier
In my old age my remembering spelling is not part of mine better side.

WEGOVY offers programs to offset cost of their products except for federal insurance.

Yes I meant ZEPBOUND. My Mayo PCP wanted me to start on it to replace WEGOVY which did nothing on all the lower doses and then severe reactin on the highest does 2.4.

PCP stated Zepbound had to receptors to reduce appetite where Wegovy only had one.

I take a medication called Xhance and sometimes I find myself putting the X on Zepbound by mistake. Again, old man, terrible remembering and hoped spell check programs would help us old guys.

Not to worry at all, @jc76. Just wanted to be sure other members here understood what you meant.

I recall you said if you changed to tirzepatide (Zepbound) you'd have to wait a bit first. What are your thoughts right now about changing to tirzepatide (Zepbound), jc76?

I feel like my situation is weird. I started out by taking one .25 shot in the doctor's office. Then my doctor gave me a .5 prescription for three or four months.

So I started about 2 1/2 months ago and was absolutely rocking it out, just amazing, on .5. Zero side effects, and the most wonderful results was the no sweet tooth, that things tasted differently and I didn't even realize that I had food noise but all of that food noise was blessedly silent. I did not spend all day thinking about food.

I was watching my macros and of course constipation is always an issue but things were amazing and I got greedy. So I talked to my doctor into sending me a 1 mg script after one month.

Here's where it gets weird. I was on this 1mg with just slight stomach upset and nausea every once in a while for 3 weeks. But after the third week, I have since had two weeks of horrible side effects. First, neuropathy issues. I found out through research on Reddit that your skin hurts. It's weird but it's like if you take prednisone at a high dose and then don't taper off, your skin will hurt to the touch. It's highly sensitive and sometimes burns. So only very specific spots on my sides and back would burn or hurt whenever my clothes would rub against my skin or I would sit back or next to something. It was so crazy but definitely something I could've tolerated.

But at the same time, overwhelming nausea and fatigue hit me. I thought I had a bug and then maybe Covid and I have been so sick, probably a scale of seven for the nausea, most every day for two weeks and it has drastically affected my life. I barely worked last week. I just don't understand why it took that long but then I imagine that maybe I got gastritis from it. It is horrible nausea but a bite of anything or even taking my morning medication meant extreme indigestion, constant burping and overwhelmingly violent hiccups over and over every day. I dreaded taking my meds in the morning or my supplements and sometimes I wouldn't even be able to eat and sometimes I could and that would help the nausea a little but that's if I could even get it down.

I did lose over 10 pounds in that two months but most of that was the first month on .5 because even worse than all these ridiculous side effects, is I've only lost 3 pounds all month. So I requested that my doctor move me back down to .5 again and I'm praying that the side effects go away or lessen. Especially considering I have had to pay $1000 for both medications when I only dosed once from the 1 mg box. So I've paid 1000 bucks for two prescriptions in the last two weeks. Wish me luck!

Just the food noise being absent is life-changing for me..