What I Know About Ozempic That the Headlines Don't

Thirty years in, not thirty weeks.

I have been on Ozempic for three years. I have not lost dramatic amounts of weight. And I am using it for a reason that barely features in anything written about the drug.

Let me back up.

I was diagnosed with Type 2 diabetes in 1994, aged thirty-five. The diagnosis arrived at the end of a day when I had fallen asleep on the office sofa and woken six hours later to my wife’s increasingly non-negotiable phone calls. I went from the GP’s surgery directly to hospital. That was the beginning of a management relationship with the disease that has now lasted more than thirty years — through insulin injections, through a lap band procedure, through karate, through six years off all medication, followed by the slow, humbling return of the disease in its progressive form. I know this disease. I know its rhythms, its responses, its particular habit of ignoring things you try on it.

Three years ago, my endocrinologist added Ozempic to my regimen. Not for weight loss. For blood glucose management. It works on a hormone pathway that stimulates insulin production in response to meals, among other things, and for someone managing advanced, long-standing Type 2 diabetes, it is genuinely effective for that purpose. That is why I am on it. Weight loss was never the goal.

Good. Now let me tell you what the coverage doesn’t.

Ozempic has side effects. The medical literature acknowledges this in careful, measured language — “gastrointestinal effects,” “abdominal discomfort” — as though it were describing mild inconveniences. What the literature does not convey, and what no celebrity profile of the drug has mentioned, is the particular social texture of those effects. The flatulence is persistent, loud, and largely indifferent to social context. The belching is similarly uninvited. The stomach noises — a deep, rolling interior gurgling — have announced themselves in meetings. They have interrupted conversations. They have no sense of occasion whatsoever.

I say this not to be indelicate but because people deserve accurate information before they start. I have had to become strategic about positioning in rooms. That is a sentence I never expected to write.

There is also fatigue, particularly in the days immediately after injection. Not incapacitating, but present — a heaviness I have learned to plan around. And injection site reactions: the occasional lump, the lingering tenderness. For someone who already administers a nightly insulin injection, a weekly subcutaneous shot is not an unfamiliar experience — but it adds to the accounting. This is the pharmacological management of a chronic disease. It is not glamorous. Nobody is writing long profiles of what that part feels like.

Now. The weight.

Over three years on Ozempic, I have lost approximately five kilograms. I am not entirely convinced the drug deserves credit for all of it. Here is why. My wife and I spend three months of every year in Greece. In Greece, I reliably lose around two kilograms — better food, more walking, lower stress, Mediterranean everything. In Australia, on the same drug, same dose, same treatment regimen, I do not lose weight. Or not anything measurable beyond ordinary fluctuation.

My endocrinologist has views about this — olive oil and insulin sensitivity feature prominently — and I find the explanations plausible. But I cannot fully explain it, and I am wary of anyone who claims they can. What I know is that the drug the headlines have called transformative has, in my experience, not produced the transformation the headlines describe. It is doing something useful. Weight loss is not the primary thing it is doing.

Perhaps the pharmaceutical companies should stop trying to synthesise the molecule and start trying to synthesise a month in a Greek village. It is, in my experience, the only thing that actually moves the needle for me.

Now. The supply shortage.

For roughly two years — and the memory is still fresh enough to sting — obtaining Ozempic required persistence. Multiple calls to multiple pharmacies. Occasional failure. Occasional expensive workarounds. The supply had been overwhelmed by off-label demand: people without diabetes, prescribed it for weight loss.

I want to be careful here, because I believe obesity is a real disease. Not a character flaw, not a failure of willpower, not something that better choices would simply fix. A genuine medical condition with complex metabolic, genetic, and environmental drivers, and one that deserves to be treated with the same seriousness we extend to any other chronic illness. That is not a pro forma disclaimer. I mean it.

But there is a prioritisation question that nobody seemed particularly interested in asking. When patients using a drug for glycaemic control — patients for whom it is not a lifestyle intervention but a component of managing a serious, progressive condition — cannot reliably obtain it, something has gone wrong with how we’ve allocated access. The market found its equilibrium eventually. The supply situation has largely resolved. But the conversation about who bore the cost during those two years, and whether that was acceptable, has never really happened.

That is the story you do not read. Not because it is hidden. Because the people writing about Ozempic are not the people who were on it before it became famous, and the patients for whom it is simply the latest chapter in a very long story have not been given much column space.

I keep reading the coverage looking for something that resembles my experience. I am still looking.

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I write about my own experience managing Type 2 diabetes — thirty-plus years of it. None of this is medical advice. Your situation is not my situation, and nothing here should be a reason to change your treatment without talking to your doctor first.