Weight-loss drug costs $1,300 a month — or hunger comes back

Beth Rubin liked being skinny. And for some 14 years, after losing 40 pounds, she enjoyed a slender physique.

“My happiest day,” the recently retired Wall Street executive told The Post,“was when I gave away my ‘big’ clothing.”

Then the pandemic hit. Her caloric intake increased and the weight piled back on. After gaining 10 pounds, Rubin knew that something had to be done — and traditional dieting had ceased to work.

“In December I told my weight-loss doctor that I needed help,” Rubin, 59, said. “I knew what I had to do [to lose weight] but I always felt hungry. My doctor told me that my body was looking for calories.”

At the advice of her physician, Dr. Katherine H. Saunders, Rubin turned to a new strategy — the diabetes drug Ozempic. It includes a a compound, semaglutide, that is intended for the obese and those with Type 2 diabetes — but is being used more and more by people who need to lose just 5 or 10 pounds. It’s found in both the weight-loss drug Wegovy and injectable Ozempic ; the former has been shown to help reduce body weight by 15 percent and the latter, by around 10 percent.

Semaglutide “is a hormone that is produced while we eat; it tells the brain that we are full,” Dr. Saunders, cofounder of Intellihealth, a company focused on medicated management of obesity, told The Post. “It helps people to feel less hungry, to feel full faster and to stay full longer. But it does so when we actually are less full” than would be the norm.

And it can be costly. Dr. Abe Malkin, founder of Concierge MD in Los Angeles, has seen people paying $1,300 per month for Wegovy. He understands the appeal.

“Certain patients in LA want to look good and feel good, and this is a way to maximize the gains when you start a weight-loss program,” he told The Post. On the other end of it, Dr. Malkin added, “Getting the last few pounds off can be difficult. It is effective for people, regardless of the weight, whether you need to lose five pounds or 50.”

Officially, Wegovy is recommended for patients who have a body mass index of 27 or higher, with at least one weight-related medical condition.

But there is a catch: Once you stop, the hunger pangs return. So for those who want to stay slender, it can be a lifetime of $1,300 dole-outs each month, which Dr. Saunders describes as “prohibitive for most people.”

Fortunately for Rubin, who has a family history of diabetes, her insurance provider covers Ozempic. Its efficacy, via self-injection “into my tummy” every week, exceeded her wildest dreams.

“I wanted to lose 10 pounds — and I wound up losing 19,” said Rubin, who began taking the medication last December. “I have not been this light since I was in my early 20s. People are calling me ‘skinny,’ and I had not been called ‘skinny’ in a long time. That in itself is positive reinforcement.”

But taking the drug can come with complications. Rubin reports that, for the first five or six weeks, she was newly plagued by acid reflux and heartburn.. Plus food did not taste as good. At the start, when the effects are most pronounced, Rubin told The Post, “I had to push myself to eat. I was not hungry at all. I had to eat slowly and watch my meals. If I ate too much, my doctor told me, I would get sick.

“There were times I ate a little too much, and I did not feel well.”

Testament to the effectiveness of what some call “a miracle drug” is the fact that Rubin managed to not gain weight even under conditions when she normally would. Five weeks after she started taking Ozempic, Rubin and her husband traveled to Egypt. Rubin said that she always gains weight while on vacation, and mentioned it to the nurse practitioner in Dr. Saunders’ office. “Not this time,” the nurse predicted.

She was right. Rubin’s weight remained stable. Maybe, she figured, it had to do with Egypt not exactly being a foodie destination. More recently, however, she went to what ranks among the most food-intense locales in the world.

“I was in Paris just two weeks ago,” Rubin said. “I ate bread every day and still did not gain weight.”

But she ate less bread than normal: “If there was food on my plate and I had enough, I stopped. I actually lost half-a-pound in Paris.”

But there are people who wish that the non-obese would lay off of Wegovy. Due to a supply chain issue and popularity of the medication, it reportedly has been in limited access for new users. The manufacturer Novo Nordisk (which manufactures both Wegovy and Ozempic) acknowledged as much on its website: “There will be minimal to no supply of the 1 mg strength dose [which is the starter dose] beginning as early as May and continuing into the second half of 2022 when we expect to stabilize supply.”

This has stoked concern in some who are on Wegovy. “It should only be for people who need the medication for health reasons,” Kelli Deavers Charpentier, who stands five-foot-two and now weighs 170 pounds, told The Post. “My body is insulin resistant and I would immediately gain the weight back if I can’t get a hold of it. I was morbidly obese.” Having shed 12 pounds in seven weeks, she added, “Now I am obese.”

Dr. Scott Kahan, director at National Center for Weight and Wellness in Washington DC, described Wegovy as “a great medicine,” but, he told The Post, “It is not a miracle drug … And using it for thin people who want to lose a few pounds for a wedding would be inappropriate. Obesity is a medical condition. For people who are 100 pounds overweight, this is an appropriate medication. Over-treating with medication is not medically prudent.”

Rubin and other patients qualify for their medications not by suffering from obesity now, but by having been there in the past and having the potential to get there in the near future. It is a form of treatment that Dr. Kahan generally agrees with.

“We look at someone’s body mass,” said Dr. Saunders. “If they were [a BMI of ] 40 and are now 26, we may want to prescribe it because there would be a high likelihood of gaining back the weight that they lost. It’s not only where they are now, but where they were before they lost the weight. Our bodies have evolved to not starve. That is why people lose and gain, lose and gain. Seventy-four percent of this country is overweight or obese. Our bodies sabotage our best efforts. Medication can help.”

Even if it means taking Ozempic for the rest of her life, the battle of the bulge is not a war that Rubin will lose easily.

“I have no intention of stopping,” she said. “If I stop I will get hungry again.”