CW: weight loss, weight gain, weight loss medications, obesogenic medications, medication side effects

Wegovy. It could alleviate the cognitive dysfunction of the post-viral condition I have been dealing with for decades, the bonus amount I acquired free with Covid, or both (reports return the I could brain with some reduced level of difficulty, which is rather exciting). It could cause thyroid cancer (but maybe only if I were a mouse). I might lose the 35-odd extra pounds I gained thanks to a prescribed antidepressant (if I were among the small percentage who lose 20% of their bodyweight). I might lose a goodly deal of my hair. It may be a godsend. It may make me end up looking like a Simpsons alien, and give me some pretty severe pancreatitis as well. Thanks to insurance and a manufacturer’s discount card, it would cost me $25 a month to find out first hand.

As Hunter S. Thompson would say (about much more exciting things than this), “Buy the ticket, take the ride.” Will I take on this body project? Apparently I am lacking in gonzo or this would be a field report from the GLP-1 agonist trenches rather than my ambivalence regarding entering them. The Maintenance Phase podcast episode on Ozempic has helped me get a better idea of the matter, but at the time of writing this paragraph, I still haven’t decided. Read on to find out if I do by the end of this post.

Though I have started losing a little after discontinuing escitalopram, I recently massed 20 pounds more than the heaviest I have ever otherwise been: nine months pregnant with a soon-to-be entire independent person. That may not sound like a lot, but I’m only a little over 5’2″ and am not currently gestating anyone. Thanks to dysmorphia I hadn’t known I had plus a very forgiving wardrobe, I was able to mostly not notice the difference until the scale at the doctor’s office let me know that no, I wasn’t just retaining a little fluid in my ankles and that when I found not-sweatpants that fit, they would be my spouse’s old jeans.

Since then, I’ve been vacillating about GLP-1 agonists. Will I? Won’t I? I consider myself as vain as the next person, but am I “vain enough” to risk my thyroid (a pre-Maintenance Phase worry) on something that I ‘should be able to do on my own with enough willpower’, as the discourse goes? (These are things I would never consider saying to anyone else. But some of our minds are prisons of our own makings just as much as bodies can be.) And in my case, heavy exercise that would illustrate ‘willpower’ is not an option. Willpower would include willingness to power through to post-exertional malaise and system overwhelm the likes of which could send me to the hospital with a sprained brain. Which is how I ended up with a Lexapro scrip in the first place.

Luckily I was able to wean off of it, and if my luck holds, I might not have to make a permanent commitment to the choice of Sane vs Svelte. I’m aware it’s not a choice that many chronically ill and disabled people get to make. The vicious cycle of medications to mitigate the side effects of the medications you take because of the side effects of your medication is one that I know, and many others do as well. This is a part of the fat discussion that goes unsaid by the general population: medication-induced weight gain is overlooked in favor of the single story of obesity, that of self-discipline and the individuated Calvinist work ethic. A HHS report on “obesogenic medications” states, “Many prescription medications have weight gain as an adverse and unintentional effect… and the use of these medications has been recognized as a preventable cause of obesity” and that use of them lowers weight loss with programs and laprascopic surgery , but that the rate at which these drugs are used has not been determined(Obesity (Silver Spring). 2022 January ; 30(1): 229–239. doi:10.1002/oby.23299). It also states that my anti-POTS beta blockers are “obesogenic”. So there’s another thing to address. (I’m learning a lot from writing this post.)

When used vs. long Covid, it’s the anti-inflammatory effects that are the main attraction as they seem to be reducing neuroinflammation. I am not a doctor, nor a lawyer, nor your real dad, but I am intrigued about this above the reason I first looked into the medication. Maintenance Phase talked me down from the hyperbole regarding side effects. What remains is that the benefits of GLP-1 agonists are temporary. I’m Buddhist. (Ish.) What isn’t? Do I want to sign up for yet another maintenance medication? I already have a daily handful; what’s one more thing?

Do I want to line up for this ride? It seems, for me, the possibility of cognitive benefits is the headliner and possible weight loss a side attraction, and that being able to brain is worth the price of admission. Whether or not it’s the opposite of obesogenic, I think I am going to ride this ride for its auxiliary effects and see what it and I can make of this bodymind of mine with thanks to the non-hyped, non-discourse conversation and perhaps a smidge to Uncle Hunter.