semaglutide

Am I doing Healthcare wrong? Background: $235k HHI, 42 yrs old, 1 kid 17 yrs I pay $620 a month for a gold tier PPO (BCBS) through work for my daughter and I. My company has a plan where the more you get paid, the more you pay for your share of healthcare. There are no HMO options, but a HSA and healthcare ‘light’ option. My daughter and I are fairly healthy, I have PCOS and some chronic issues but nothing serious. This isn’t so much a complaint about how much I pay a month - healthcare and piece of mind is worth it and it’s a small price compare to my take home and it’s pretax. It’s just that I’m not sure if I’m getting the right value or even using it correctly. Previously I had Kaiser for all my adult life, I paid 220$ and had none of the issues below. For those in California, I know Kaiser is either love or hate but I LOVED it. My doc was amazing, it was convenient, I never got denied anything etc. they took care of my daughter since she was born. Here are 3 issues that have me puzzled: 1. When I had to switch my pcp after moving off Kaiser, it was a 6 month wait for a new PcP. This was after the initial PcP I picked was not in network any longer. This had me overdue for physical, mammogram, pap etc. it was like 1 whole year without a proper doc for my daughter and I. I don’t necessarily love my new pcp but I don’t want to wait again. 2. Appointments take forever - my kiddo is dealing with some painful cystic acne and a derm is taking 5 months! I had to pay out of pocket for her sports physical because it was 6 weeks before we could get an appointment before the sports season started. I often end up using virtual services for things. She went on a school trip to another state that needed the prescriber wet signature for the doxycycline and tretenoin she’s on - couldn’t get that in time so we just took the risk and didn’t disclose the meds. 3. 1. Speaking of paying out of pocket - while I was at Kaiser , pcp prescribed low dose semaglutide for the management of my weight and PCOS. My current insurance approved my maintenance dose but my current pcp won’t prescribe it, so I pay out of pocket for a concierge type dietician/nutritionist ($79 a month) so she can basically put in my prescription and do my annual prior authorization. I’ve been at a healthy weight for 4 years, probably don’t need the meds any longer, but I still don’t get the system. I keep paying out of pocket, seeing virtual nurse practitioners etc and still pay for ‘gold tier’ insurance. Am I doing something wrong? Should I take the risk and do a higher deductible and put the money into an HSA? I’m getting married soon and putting my husband on my insurance, it will probably get more expensive (but again, peace of mind is worth it). Just don’t know if I’m using it to its full potential. Edit: sorry for the wonky formatting, I can’t edit the line breaks for whatever reason. Keeps reverting to that incorrect numbering

Help! Switch back to Reta or stay on Tirzepatide? I used to be on the semaglutide on the highest dose for 2yrs. This year I started on the reta, I made my way up to 10mg weekly .I started on 5mg a week for 2 months, I felt nothing. Then for the 3rd month i did 3 weeks on 8mg, It would work for like 2 days then I would feel the hunger again.by the 4th week, I bumped it up to 10mg. I felt it and was working great. I lost 23 pounds in like 3 months. But then, all of a sudden every time i would put it on, by like 3am i would wake up wanting to vomit. I recently made the switch to tirzepetide. i been on it for 2 months. Im doing 12.5mg but I don't feel it. I lost 2 pounds. I started with 5mg and made my way up as well. Has anyone else experience this?

Primera semana con semaglutida 0,25 mg — experiencia inicial Hola amigos! Saludo desde Argentina. Esta semana me apliqué mi primera dosis de semaglutide (0,25 mg) y quería compartir mi experiencia inicial junto con algunas fotos. El cambio más notable hasta ahora fue a nivel mental: siento una reducción muy marcada del “ruido” relacionado con la comida. Hay menos ansiedad, menos pensamiento constante en comer y una sensación general de mayor calma y control. En cuanto a la alimentación, noto saciedad más rápida y una disminución natural en el tamaño de las porciones, sin esfuerzo consciente. Simplemente llega un punto en el que ya no tengo ganas de seguir comiendo. Respecto a efectos secundarios, fueron leves hasta el momento. Percibí algo de cansancio y una sensación corporal diferente después de comer (como más relajación o leve somnolencia), pero sin náuseas intensas ni molestias significativas. Soy consciente de que esta es una dosis inicial y que todavía es muy pronto para evaluar resultados en términos de peso. Mi objetivo es registrar el proceso de forma progresiva: cambios en el apetito, energía, digestión y evolución corporal con el paso de las semanas. Comparto esto como experiencia personal, no como recomendación médica. Me interesa saber: quienes ya pasaron por esta etapa, ¿cómo fue su primera semana y en qué momento empezaron a notar cambios más visibles?

I started Zepbound on June 28th and have lost 22 pounds so far. I had it sitting in my fridge for months because I was too scared to start and now I’m so happy with how my journey is going so far. I originally had to pay out of pocket for Semaglutide a few years ago and it made me extremely sick. My insurance covers Zepbound now. The only side effects I’ve had are bloating and very minimal nausea. It also seems to be helping with my very frequent chronic migraines. Starting weight: 200lb Current weight: 178lb Goal weight: 130lb I plan on starting on lowest dose as long as it keeps working.

Compounded Semaglutide to Zepbound. My KwikPen just arrived today and I’m starting on 2.5mg. I’m coming from Ivim’s Compunded Semaglutide program and I tolerated it very well even though they were just starter doses. Last dose was 0.69mg. I started at 195 and I’m now 178.8. I do keep fluctuating a lot between 180-177 but I figured that’s normal. Though there isn’t a conversion chart from semaglutide to Trizepatide my doctor recommended 2.5mg and increase if tolerated well. I will admit I am a bit nervous but it’s just a shot haha. I don’t really exercise much I do most of my cardio at work since I walk pretty much all day. I don’t really strength train but I do eat and drink my protein. Most the weight I lost already was likely water and inflammation. I’m very curious to know how my body will react to Trizepatide. What is your guys experience in switching from compunded semaglutide to Zepbound ?

New US and Danish Data Published Today Point to a Clear Opportunity: Better Access Could Improve Semaglutide Persistence (+ New Prurigo Nodularis Case Report) Denmark A **new JAMA Network Open study followed 157,822 first-time semaglutide users for obesity treatment in Denmark.** Using a 60-day prescription-gap definition, 49% had discontinued within 12 months. However, discontinuation was not always permanent: around one in four restarted semaglutide within three months. The study also points to affordability as an important factor, since obesity treatment with semaglutide in Denmark is largely self-paid. Coincidentally, a new US study of 8,914 commercially insured adults found that higher out-of-pocket costs were strongly associated with lower adherence to semaglutide for obesity. Nonadherence increased notably once monthly costs exceeded about $75, and patients paying more than $168 per 30-day supply had an adjusted nonadherence probability of 85.2%. Together, the two studies provide additional real-world evidence on how pricing, insurance coverage, and treatment patterns influence semaglutide use. [Denmark : Discontinuation of Semaglutide Therapy for Obesity Management](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2853380) [USA : Out-of-Pocket Costs and Adherence to Semaglutide for Obesity Among Commercially Insured Adults](https://jamanetwork.com/journals/jama-health-forum/fullarticle/2852962?utm_source=chatgpt.com) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Also published today: **Semaglutide and Prurigo Nodularis** **Prurigo nodularis is a chronic inflammatory skin condition characterized by intensely itchy, firm skin nodules caused by a persistent itch–scratch cycle. It can be difficult to treat and may substantially affect sleep and quality of life.** **A separate case report described substantial improvement in severe, treatment-refractory prurigo nodularis after semaglutide was initiated for obesity, without changes to the patient's background dermatological treatment.** **After 12 months, the report noted no active PN lesions and a marked reduction in itching. The authors suggest potential anti-inflammatory and immunomodulatory effects of GLP-1 receptor agonism.** This is only a single-patient case report, so it cannot establish efficacy, but it adds another interesting signal for potential effects of semaglutide beyond its established metabolic indications. [ Dramatic Improvement of Treatment-Refractory Prurigo Nodularis Following Initiation of Semaglutide: A Case Report](https://www.dovepress.com/dramatic-improvement-of-treatment-refractory-prurigo-nodularis-followi-peer-reviewed-fulltext-article-CCID)

Help! Switch back to Reta or stay on Tirzepatide? I used to be on the semaglutide on the highest dose for 2yrs. This year I started on the reta, I made my way up to 10mg weekly .I started on 5mg a week for 2 months, I felt nothing. Then for the 3rd month i did 3 weeks on 8mg, It would work for like 2 days then I would feel the hunger again.by the 4th week, I bumped it up to 10mg. I felt it and was working great. I lost 23 pounds in like 3 months. But then, all of a sudden every time i would put it on, by like 3am i would wake up wanting to vomit. I recently made the switch to tirzepetide. i been on it for 2 months. Im doing 12.5mg but I don't feel it. I lost 2 pounds. I started with 5mg and made my way up as well. Has anyone else experience this?

Maybe it’s not for me? Hi GLP people! I’m really trying to make it work with semaglutide but I’ve started thinking maybe it really isn’t for me. Not asking for medical advice, just seeing if anyone was in the same boat and wondering how it worked for them. I was on semaglutide previously for a few weeks and ended up with horrible anxiety after one dose of .4 after starting at .25. I’m trying again now and just got my 4th .25 dose on Wednesday and am supposed to be moving up to .5 next week. Just last night I’ve started with the sulfur burps and nausea and actually had colonoscopy-prep level diarrhea all night and hardly got any sleep. I haven’t thrown up yet and only had a cup of soup and some saltines and grapes today and my nausea is starting to come back again. I’m so scared I’ll be up all night pooping again and am on the verge of giving up. I did have a bowl of sugary cereal before bed last night so I think that may have pushed me over the edge. But should the nausea be coming back again after being careful all day? I was not feeling 100% today for sure but the nausea had stopped until tonight. Anyone else experience this? Do you think maybe it just isn’t for some people?

The imaging endpoints missed. The biopsies and the transcriptomes did not (semaglutide, kidney) Semaglutide preserves kidney function in type 2 diabetes, and this trial went looking for the mechanism with kidney MRI and biopsies. All three coprimary MRI outcomes, oxygenation, perfusion and inflammation, were unchanged against placebo over 52 weeks in 106 participants. Secondary outcomes did move: resistive index fell, diffusion stabilised, and glomerular endothelial cells carried most of the transcriptomic response. What they did REMODEL (NCT04865770) randomised 106 adults with type 2 diabetes and chronic kidney disease 2:1 to subcutaneous semaglutide, titrated to 1.0 mg once weekly, or placebo, for 52 weeks at 28 sites in 8 countries. Coprimary outcomes were kidney oxygenation by R2\*, global perfusion and tissue inflammation by T1 mapping, on multiparametric MRI. Paired biopsies came from 33 participants, with single-nucleus transcriptomics in 22 and spatial in 13. What they found \- Coprimary outcomes: estimated treatment ratio 0.98 for R2\* and 1.10 for global perfusion, and no difference on T1 mapping, none significant. \- Renal artery resistive index 0.96 (95% CI 0.93 to 0.99), P = 0.008, and cortical diffusion 1.05 (95% CI 1.01 to 1.09), P = 0.005, read as fibrosis not progressing. \- Albumin to creatinine ratio 0.60 (95% CI 0.41 to 0.88), weight 4.45 kg lower, and HbA1c 0.88 points lower. \- Fractional intimal area fell 10% (95% CI -18.9 to -1.0), P = 0.032. Glomerular endothelial cells were the most responsive of 31 clusters, with fewer immune cells beside them. What's missing Peer reviewed and open access. OpenAlex holds no record for this DOI yet and the Crossref lookup was rate limited, so the screen was done at the publisher page, which carries no notice. The authors list the limits: exploratory design, no multiplicity adjustment for the coprimary outcomes, too little power for R2\*, associative links between imaging, histology and transcriptomics, and women only 23.6% of participants. Discontinuation for adverse events was 12.7% against 2.9%. Funding and competing interests were not retrievable. Why it matters for people working on this This is a trial built to explain a result rather than produce one, and it reads as a template: paired kidney biopsies in 33 randomised participants with single-nucleus and spatial transcriptomics is rare. The argument worth having is what to make of three null coprimary outcomes beside positive secondary and molecular ones in a trial the authors call underpowered, the pattern that produces mechanistic stories which later fail. What to watch is the glomerular endothelial signal in a trial powered for it. Source: Katherine R. Tuttle (first author) and Matthias Kretzler (last author), University of Michigan. Nature Medicine, 1 October 2026. [https://doi.org/10.1038/s41591-026-04674-2](https://doi.org/10.1038/s41591-026-04674-2) NCT04865770. Open access. Research summary, not medical advice.

Help- True stall Hello! I’ve been on a glp-1 for 2.5 years (one year on semaglutide, then switched to tirz) I have lost 75 pounds, and still have about 40 more until my goal. However, over the past 9 months or so, I’ve only lost about 9 pounds. I’m at the max dose of 15 mg. I keep my calories at a 1200/day average and get average of 10k steps daily. I could def work out more, but am active in my day to day life. I’m a 50+ female. Any thoughts and recommendations on what I can do to help move the scale? (Also-as an fyi- I have not yet gone through menopause and have thyroid issues and PCOS/PMOS)

have taken semaglutide before. now i'm trying to find an easy, cheaper provider

have taken semaglutide before. now i'm trying to find an easy, cheaper provider please help me lose my final chunk of weight! I have used semaglutide with great success, but it was a local healthcare company whose membership fees were quite $$$. what can I use online that will cost less than $200? help a sister out!