My year on Wegovy: How semaglutide changed my perimenopausal life

The author chose to share her story anonymously.

I’ve spent the last year in a pretty exclusive club. In February 2024, I began weekly doses of Wegovy (semaglutide), which I injected into my belly. As a Gen X gal a few years into perimenopause, I’ve gained a ton of weight — to the point that my labs were screaming at me in all caps: YOU IN DANGER, GIRL.

How it started: On the struggle bus

I received the prescription from my regular doctor in November 2023, after asking if she would prescribe it to help me lower my skyrocketing A1C levels. I’d been over 200 pounds (around 233) for a few years, without any luck of shaking it through exercise or diet changes. My blood pressure was high, along with my A1C which was at the top of the “pre-diabetes” range. She agreed, but it wasn’t that easy. I still had to navigate the wild waters to obtain the drug, which was unavailable anywhere. 

I spent months calling a handful of local pharmacies — ranging from national chains as well as a few mom-and-pop options. I’d hear the same thing over and over: they didn’t have Wegovy in stock but they could attempt to get some for me if I went through the process of transferring over my prescription to their pharmacy. But there were no guarantees. 

At one pharmacy, the pharmacist legit laughed at me over the phone when I asked how possible it was to get the drug. I was heartbroken. I even called the pharmacy benefit manager associated with my insurance to see if they could recommend any other options — like running for the border in Canada. But they said neither was a viable solution for me.

The weighting game

I waited and even considered joining one of the growing number of “medical spas” in my city, which offered their own cocktail of GLP-1 drugs with a hefty “membership fee” tacked on each month. But what would cost just a few hundred dollars with my insurance at a normal pharmacy would cost thousands through a med spa — with no guarantee that their elixir (called “compounding” in pharmacy speak) would do the trick. 

I hemmed and hawed and waited it out a little longer. At the end of 2023, Novo Nordisk, the company that makes Wegovy as well as Ozempic, promised that they would be ramping up production in early 2024. I had hope.

But January came and went. My doctor was out on maternity leave, so I met with her fill-in for a check-up — and my labs were even worse from the holidays. But this time, the substitute doctor had new ideas for sourcing my prescription: mail order. Low-and-behold, CVS Mail Order Pharmacy had the injections, and I was able to get my first “starter” doses of Wegovy in February 2024.

I continued with CVS as I ramped up my dosing, and now I get Wegovy at my local pharmacy. (Since last spring, CVS Mail Order Pharmacy stopped carrying Wegovy completely, citing costs.) Finding doses locally has now become easier, partly due to increased production — partly as initial Wegovy users discontinued their medication.

Scaling down: How Wegovy works and feels

Because Wegovy (like other GLP-1 inhibitor drugs) works to make your stomach empty slower, it can be a bit of a shock to your system. Patients start on a very low dose — just .25 mg each week for the first month, administered via epi-pen injection. It’s then increased (if you’re tolerating it well) to a .50 mg dose.​​ Then 1 mg, 1.7 mg, and finally 2.4 mg as the final dosage. In normal circumstances, this takes five months, but sometimes patients repeat a month or go slower per doctors’ instructions on individual tolerance.

First, almost immediately, I felt a physical fullness creep into meals. Especially when eating later in the day. I wouldn’t say that I had cues to stop eating all the time, but if I took it slowly and served myself less, I would hit the end of a meal having eaten less than I used to. In fact, that was the one overarching tip my doctor gave me: put half of what you’d normally eat on your plate. It was the best advice I received on managing the effects so I wouldn’t feel like I had to throw up. This worked well to make me feel satisfied and “normal,” even while suddenly consuming less food.

The silence of “food noise”

The problem with eating habits are, well, they’re habits! And by the time you hit your 40s, you’ve definitely gone on autopilot with food. Food was and still is pretty tied to emotions. The biggest change I experienced at the start of taking Wegovy was a turning down of the “food noise” in my head. 

I never heard a name for this emotional eating that fit so well as this phrase. It’s almost like I didn’t realize how loud or constant it was until it was gone. (Like tinnitus suddenly lifting.) No more did I feel like I had to go and raid the pantry for something salty or sweet at certain times of the day. And I didn’t even want dessert now? (Who was this person?)

I found myself skipping whole meals because I wasn’t hungry — I didn’t even notice. Previously, I might have gotten shaky or light-headed if I skipped lunch, and now there was nothing to even remind me to eat.

How Wegovy changed how I saw food

Slowly, as I edged towards a “full” dose of 2.4 mg of Wegovy, everything started to even out. The food noise was pretty quiet and I just tried to eat to eat — without judgments. What a concept!

For example, I had a coffee date with a friend one afternoon and found her eating a “protein bowl” of guac and hummus with baby carrots. She had swapped out the chips in the dish for a “healthy” option (and looked miserable as a result). While I had a chai and started a pumpkin bar from the shop’s bakery, I found the sweetness almost overwhelming and less than halfway through, asked for a box so I could take the rest home. She remarked, “Oh you’re being so good!” and I realized internally that I hadn’t planned anything other than eating something yummy and didn’t want to waste half of it by throwing it away. Meanwhile, she had planned her whole day of what she “could” and “couldn’t” eat around our hour hangout. I remembered those days of my own dieting so well — and I realized how diet-charged our existences had become. And how toxic diet culture permeated everything.

I didn’t even want the big dessert because food had no intrinsic value past just being food. It wasn’t charged with categorical goodness or evil. It simply was there to be enjoyed.

I’ve been on diets since I was in fourth grade. That was the first time I had a doctor say I was about 10 pounds heavier than where I should be for my height, and I just needed to hold it there for a year or so. Instead, I was perpetually aware of my “overweightness” and how large I felt, compared to my smaller classmates. I had a “spare tire” around my belly (as my mom put it) and I joined her for jogs or weird stints of sacrifice to the diet gods by way of Slim Fast drinks, snacks of plain crackers, or other torture devices. It was that year that I also had my first “diet fail” when I couldn’t hold my weight at the appointed limit.

Flash forward forty-some years and I’m now in a place where if I want to eat the thing, I eat the thing. I had ice cream most nights this summer because I absolutely craved it. But I also didn’t feel the temptation and naughtiness of the “cheat meal” or the wish to get the biggest slice of cake because I wouldn’t be “allowed” to have it for a while. I simply ate. I didn’t even want the big dessert because food had no intrinsic value past just being food. It wasn’t charged with categorical goodness or evil. It simply was there to be enjoyed. I had a small ice cream scoop and I was fine. No big whoop. I absolutely couldn’t believe it.

And now, it’s my normal

Believe me, I know how lucky I am: I have an insurance plan that covers Wegovy. I’m waiting to see how my plan, which paid for most of my monthly doses this year, will react to my one-year anniversary on the drug when I imagine I need a new pre-authorization from my doctor, now that my bloodwork is better and my weight is down. 

Even if I now have to pay out-of-pocket, I will likely try to spread out my injection schedule and continue with “maintenance” injections. Only time (and the fickle nature of insurance company plans) will tell how long this journey will last for me. But for now, it’s been a bit of a miracle.

So far, I’ve lost almost 70 lbs. on Wegovy in just under a year. It hasn’t felt “hard” except as I navigated the insurance and medication sourcing since GLP-1s became so popular.

And it’s not all fun. There have been odd problems with losing weight so fast. Like I have to constantly find new pants that fit — and that’s confusing. I’d forgotten how crazy sizing can be from brand to brand. I’m obsessed with adjustable belts that I can use to keep things from falling off my (lack of a) butt. Even my shoes are loose (I think I’ve gone down half a size). You might roll your eyes or even laugh, but it’s a range of problems I never thought I’d have again. If I order a pair of jeans online, by the time I get them, they’re already too big.

And since you’re likely also reading this for the tl;dr version, here are measurements from my first year on Wegovy. These are my weight loss stats according to my Renpho “smart scale,” which gives me my weight as well as some metrics and an app to track them:

Start (2/16/24):

• Starting weight: 230.8 lbs.
• Starting BMI: 35.0
• Starting Blood Pressure: 122/78 mmHg
• Starting A1C: 6.4%
• Starting Body Fat: 44.9% (as calculated by my scale)
• Starting waist circumference: 42.5 inches
• Starting women’s clothing size: 20W/2X

Current (1/30/25):

• Current weight: 161 lbs.
• Current BMI: 24.5
• (December 2024) Blood Pressure: 119 / 79 mmHg
• (October 2024) A1C: 5.5%
• Current Body Fat: 28.7%
• Current waist circumference: 36 inches
• Current women’s clothing size: 12

Come for the community, stay for the stool softeners

If you’re thinking about starting the semaglutide journey, one of the most helpful things you can do is join a community where you can share experiences and get support. 

One night, I started to Google some weird symptoms I was having and I stumbled into the “Wegovy Weight Loss” Reddit group — a great way for me to just have a quick “Is this typical?” sanity check. 

As you ramp up, almost every change in dosage can bring new side effects that can be hurdles. Some people (like me) get crazy acid reflux, called the “egg burps” or “sulfur burps” by Redditors. Some people can’t get past a queasy feeling and don’t progress much past a month or two. Your body is going through some changes in its normal digestion process (something you hope it has figured out by your 40s!), and I had weeks where my guts were swinging for the extremes of diarrhea or constipation. 

I found that increasing my water intake, keeping up with foods that were mellow on my system, and the occasional stool softener worked best for me. Folks on the forums who had tried blasting their bound-up pipes with lots of fiber found themselves in a bad way when they hadn’t pooped in a week. Just keeping up with your body’s new language was the trick — not ignoring and not swinging for the fences either.

Starting semaglutide is a journey with challenges, but a supportive community can make all the difference. Listening to your body, making gradual adjustments, and staying informed will help you navigate side effects. With patience and self-care, you can set yourself up for success.