My Four Years From Hell On Ozempic

When my doctor told me about Ozempic in 2018, it sounded like a solid option to manage my type 2 diabetes. At 33 years old, I had just been diagnosed, and my endocrinologist recommended the semaglutide injectable for diabetics—then a relatively new drug whose name wasn’t yet synonymous with celebrity weight loss—to keep my blood sugar down and potentially even put my diabetes into remission. I’d also been overweight most of my life, so the idea of losing 10 percent of my body weight while treating my diabetes was appealing.

The common side effects of Ozempic include nausea, vomiting and diarrhea. My endocrinologist said they would dissipate over time, if I experienced them at all. I didn’t give the side effects much thought; I was already sold on Ozempic.

I started on a low dose of 0.25 mg, as most Ozempic users do, injected once a week. In the first few days, I had an intense migraine that didn’t improve with over-the-counter drugs. I was also nauseated, and I vomited a few times. Eventually, the migraine went away. The nausea remained, but I figured it’d ease up soon enough. I was more focused on the results I was seeing: My blood sugar was lower, and in just a month, I’d lost 10 pounds. After years of dieting and exercising in a futile effort to lose weight, Ozempic felt like magic. I wondered: How long could I ride this out for? How much more weight could I lose?

After a month, my doctor increased my dosage, and my side effects ramped up. I was vomiting every few days, and my nausea was persistent. But the most significant change was my relationship to food. Everything tasted different—the carbonation of Diet Coke, for instance, started to taste bad, and fruits like pineapple were outrageously sweet. I’d also completely lost my appetite. I’d have to schedule reminders to eat; my husband, by comparison, would eat four times as much food as me every day. Food was no longer a reward or a joy but merely a means of gaining energy.

By the time I reached the highest dose—a weekly 1 mg injection—I was learning to live with constant vomiting and nausea. But the benefits still outweighed the side effects: I’d already lost 45 pounds, the most weight my endocrinologist had seen any of his patients lose on Ozempic. I was proud of the changes I had made to my body and that I was managing my diabetes well.

That joy wouldn’t last long. At the six-month mark, my symptoms became debilitating. I started noticing food and medication I had ingested days earlier in my vomit. My burps were sulphuric, smelling like rotten eggs. When I stood in front of my classroom at the Toronto elementary school where I taught, my students would wonder where the stench was coming from. Sometimes, my husband couldn’t even sit next to me because of the smell.

My doctors never questioned whether Ozempic was the culprit. Instead, they just treated the side effects. I was offered digestive enzymes and probiotics as a way to reduce the belching, but they only helped a bit. I was vomiting four or five times every day. I started to develop strategies: If I had to vomit while at school, I’d pull out a small bag at my desk and discreetly throw up in it, or I’d hold the vomit in my mouth until I got to a bathroom.

After a year on Ozempic, I’d dropped 80 pounds. I lost more weight than its manufacturer, Novo Nordisk, suggested was even possible, according to my endocrinologist. My diabetes did not go into remission, but doctors said that, given my successes, I’d likely be on the drug for the rest of my life to maintain my weight and blood-sugar levels. On paper, I was a shining example of what Ozempic could do for people with diabetes. But in reality, my symptoms were growing worse and worse. I developed watery diarrhea, and I began vomiting the sulphuric slurry sitting in my gut up to eight times a day. Doctors kept treating the symptoms—powders to bulk up my stools, Gravol for the nausea—but not the cause.

In online support groups, other Ozempic users told me they too had experienced the sulphur burps, the vomiting and the diarrhea, though my symptoms appeared to be more severe. BCDiabetes and a leading prescriber of Ozempic in Canada, says about 10 percent of his patients experience “debilitating symptoms” that lead to them reducing dosages or stopping the medication altogether. He adds that such extreme symptoms occur in just 1 to 2 percent of patients and may occur in conjunction with other medical causes.> Users in the support groups suggested drinking more water or ginger tea, but that offered little relief. My husband asked if I thought Ozempic was the problem. I brushed him off. If that were the case, wouldn’t my doctors have suggested it already?

One day in September 2020, I started vomiting and I couldn’t stop. I became severely dehydrated. I called an ambulance and landed at St. Michael’s Hospital in downtown Toronto. I was diagnosed with cyclic vomiting syndrome, an illness where the brain tells the body to continuously vomit without cause. Tests determined that I also had mild gastroparesis, or stomach paralysis. (Diabetes, it should be noted, is the most common known cause for gastroparesis.) In other words, my stomach wasn’t digesting the food I ate; instead, that food was fermenting inside me.

Doctors offered me medication to treat the gastroparesis, and I remained on Ozempic. I still vomited every day, but I could manage. It was 2020, and doctors were burnt out, only offering emergency or virtual appointments, so I learned to deal with my condition. Gastroparesis has no cure, but I could make do.

That was until September 2022. Two years after my first hospitalization, everything went downhill. I’d vomit more than a dozen times a day, sometimes up to 200 times a week. Unlike before, I had no warning or time to find a bathroom or garbage can; it felt like I was exploding. During one ER visit, I vomited for nearly 36 hours straight, and only an antipsychotic drug—a last resort—made it stop. I took a leave of absence from work. I was in crisis.

During these bouts of vomiting, my blood pressure would spike and I would begin sweating profusely. My husband would watch on in horror. Sometimes he would text friends and family in fear. “I think Emily is dying, and there’s nothing I can do,” he’d tell them.

That November, I was desperate, so I visited a new gastroenterologist. He performed more tests and found that my gastroparesis had worsened since 2020. But he was also starting to piece together what other doctors had missed. When he’d performed endoscopies on other Ozempic users, he’d noticed that there was often old, fermenting food in their stomachs, even when they had fasted before the procedure. Their stomach motility—the process of stomach muscles contracting to aid digestion—was always incredibly slow. Perhaps, he thought, the Ozempic had caused my gastroparesis. It was the first time a doctor had thought to take me off the drug. I was eager to give it a try.

I’ve been off Ozempic for nearly a year now, but my symptoms persist. I’m still on leave from work, and I spend many days receiving IV fluids and Gravol injections to manage my nausea. On a good day, I’ll vomit five times and recover. On a bad day, I will spend hours vomiting, exhausting myself until it finally ceases. Since my September 2022 hospitalization, I have lost 70 pounds from vomiting alone.

When my doctors told me about Ozempic, they mentioned the most common symptoms and complications, like low blood sugar and pancreatitis. But at no time did they note gastroparesis as a possible risk, nor was it mentioned in the product monograph.

This fall, researchers discovered a link between semaglutide drugs and severe stomach issues; their findings, published in The Journal of the American Medical Association, note an increased risk of gastroparesis among users. In response, Novo Nordisk says that “patient safety is a top priority. We work closely with Health Canada to continuously monitor the safety profile of our medicines.” The company “stands by the safety and efficacy” of its products.

I used to believe that I would be happier in a smaller body. But this ordeal has taught me that weight loss has nothing to do with health. I was much healthier and happier before Ozempic.

In many ways, I am grieving who I used to be. I don’t know when or if I’ll ever stop vomiting. I recently began tolerating smoothies, and I’ve gained four pounds back. My parents also hired a private medical-consulting firm to review my records and suggest further treatments. I’m still holding out hope that I’ll get better, though it’s difficult. In the meantime, I’m living my life moment to moment—it’s all I can do.

—As told to Erica Lenti