I Started Ozempic Because of My Illness

And yes, I'm one of the few who actually needs to take it.

Felix and I are both on a health journey.

TW: disordered eating, eating disorders

It was as if I’d been asleep all these years and finally woke up.

For much of my life, I’ve waged a war with my body. As a child, food was a luxury—one summer we subsisted on bags of potatoes cooked over a hot pot. Our fridge was anemic, bone-thin, too bright for daylight. When we were flush—when my mother held fistfuls of tips—we filled a cart with food and gorged on the spoils. Frozen boxes of Stouffer’s macaroni and cheese, slim braciole steaks and chicken cutlets that would be breaded and fried in butter, and boxes of sugary cereal that stained our milk pink, brown, and blue—we held onto our food for as long as we could. We traded stories about the meals we ate when there were fewer meals to have.

As a teenager, I hoarded food. Frightened of its disappearance even though my mother kept our cabinets stocked from the fancy diner she worked across from the racetrack.

Little Debbie Cakes, cinnamon rolls, soft pretzels drenched in butter, and Otis Spunkmeyer chocolate chip cookies—I ate until I was sick. And when I’d leave the bathroom, I’d eat some more.

As an adult, I traded bathroom trips for miles on a treadmill, on pavement, on sand when the rain came down in sheets and my Walkman kept skipping. The art of eating became surgical, every plate worthy of vivisection. And I whittled down to size 0 and when I asked a sales associate—do these pants come in a smaller size—she replied we don’t make clothes in negative numbers. I was proud of my smallness and I’d live this way for much of my twenties and thirties even when doctors hailed me as healthy amidst a cocaine and alcohol addiction. Healthy even with burst capillaries all over my face. Healthy even when I started to lose memory, lose time because while I never had a problem holding my drink, I had a problem letting it go.

But I was thin, and that was all that seemed to matter.

When I worked as an equity partner in a New York digital agency, I spent sixteen hours a day shackled to a laptop and my longest relationship was with Seamless Web and the pancakes and burgers and pizzas I had delivered because I craved comfort.

And when I left that company, when I shivered and shook in a shower, I paid a “nutritionist” who taught me to count calories and vilify food. Although I’d whittled away all the weight I’d gained, it would take me years to calculate the costs.

When I moved to Los Angeles, I decided to fuck that chump change and not diet, not obsessively exercise, but I veered to the other extreme because I’m nothing if not consistent. There was no balance or middle ground. It was either counting the calories in a handful of almonds or eating pizzas whole.

All the while I kept telling myself it’s okay if I’m not thin. I paid psychiatrists to remind me that it’s okay I’m not thin. Food can never fill a hole within you that is bottomless.

Last year, I moved to Bakersfield, temporarily, to work on a new book. It was possibly the worst decision I’ve ever made because in those four months I rarely left my home because of the brutal heat, my cat was diagnosed with diabetes by an incompetent money-hungry vet and I fell down the stairs, dislocated my kneecap, and tore every single muscle in my knee except my ACL and when the full results of my MRI surfaced, my orthopedist was shocked. Apparently, I managed to tear my thigh muscle too.

It’s been nine months and I still walk with a limp—even though I’m back in Los Angeles, home of competent doctors. I’ve endured grueling physical therapy and steroid shots and the realization that it’s not a matter of if I need surgery, it’s a matter of when.

Because apparently I’ve been wearing down my knees since I was an over-exercising adult.

Six months ago, it wasn’t my therapist who delivered the come to Jesus, it wasn’t even my primary care doctor — it was my orthopedist. I have Kaiser insurance and all my doctors can see my entire medical record in one portal, and my ortho, after injecting my knee with a long needle and hearing me scream in pain, told me I need to get it together.

He said, Felicia, you need to get it together. You haven’t had a pap in two years? I can’t even find your last bloodwork. I prattled on about hating doctors, hating medication, hating hospitals and the American healthcare system — and I again regaled him with stories about the horrific treatment I experienced in a Bakersfield ER, where I cried more in seven hours than the past seven years — but he was having none of it.

He went through my entire medical record like a fucking archeologist, rattling off all the appointments I needed to make. All the doctors I needed to see.

I’m grateful for this:

Millennial doctors who practice empathy like the gospel. Doctors who don’t push calories in and calories out, doctors who are sensitive to my lifetime of disordered eating. Doctors who ask how I’d like to be treated.

In January, I scheduled all the appointments and took all the tests and got all the vaccines, and my primary care doctor sat me down for THE TALK.

Let’s talk about your test results, to which I blurted out: AT LEAST I DON’T HAVE CANCER!!! REMEMBER, MY MOTHER DIED OF CANCER! To which she responded, yes, Felicia, you don’t have cancer. But you have high blood pressure and diabetes and believe me when I say I nearly passed out.

I felt like a failure because although I’d inherited my mother’s high blood pressure, the high A1c was my fault. The pasta and bagels I wouldn’t stop eating, the sugary wine I wouldn’t stop drinking. I believe in taking responsibility and I’d done this to my body. Through tears, I laughed and said that I was already shooting up my cat with insulin twice a day, was this my fate too?

Thankfully, no. (Even though I was Googling do all diabetics need insulin in front of my doctor.) My doctor has become accustomed to my shenanigans, knows my obsessive nature in exhaustively researching a topic until I feel I have a command of it (hello, autism), so she outlined a plan. Because I do well with plans. She prescribed Metformin, Lipitor, and we talked very carefully about alterations to my diet. This wasn’t about seismic changes, which would trigger my ED, but slow and steady changes. And she consulted with my ortho to understand my knee’s limitations. I used to walk or run five miles a day, but that’s now a struggle. Until my knee is replaced, no high-impact, no intense weight lifting—my knee simply can’t handle it.

And I’m grateful for how my doctors broached the topic of weight with care, framing it more from a let’s get this A1c down, let’s take pressure off the knee to increase mobility instead of let’s get you back to a size 4. My doctors even instructed all the nurses who would see me to not tell me my weight (another trigger)—that they would track my progress. But the focus is the A1c, knee mobility.

When I tell you Metformin is a war crime in pill form, believe it. It’s a type of medication where it regulates the amount of sugar in your blood, decreasing the amount of glucose you absorb from food. And dosage is slowly increased over time because you’re altering how your GI system functions.

I will spare you the side effects, but taking the medication became debilitating. And it’s through an urgent call I put into my doctor before this month’s formal blood work and check in that we had a long discussion about options.

We talked about Ozempic. Yes, the drug glorified by starlets, name-checked in rap battles (Team Kendrick, btw), and used by millions for its weight-losing off-label use. Yes, the drug where every single armchair physician issues their hot take based on the friend who took it or the news special they watched or their general hatred of Big Pharma. For an hour, we talked through the upsides, the side effects, the clinical trials, more side effects, and other drug options.

We finally decided to start a low-dose three-month trial with no escalation (.25 for three months, which is rare since doctors have everyone scaling up). The trials that have the highest incidence of major side effects correlated to dosage, dosage mismanagement, and lack of physician oversight. Yes, there are outliers, but I feel confident about a low dose, and monthly check-ins, weigh-ins, and blood work where my doctor can monitor the drug’s effects.

I’m grateful that the medication is covered by my insurance—it’s $100 a month, not cheap, but substantially less than the $1,000 price tag for folks who use it for off-label weight loss.

My doctor’s that rare breed who believes in slow and steady progress, viewing medication as one tool in my arsenal. This isn’t a miracle drug, she reiterated, and we’ve since traded emails on studies correlating Ozempic and decreases in joint inflammation, practitioners who are testing “micro-dosing” and seeing results, and YouTube videos. Ozempic hits the A1c and the weight loss so I’ll have less joint inflammation and the ability to walk more. I also have a check-in with my ortho to track my mobility progress because his goal is to put off surgery for 15 years.

Rarely do I get emotional, it’s difficult for me to cry, but my voice cracked when I last spoke to my doctor because I felt, for the first time, I had doctors that actually listened to me. Doctors that are on my team. Doctors who deftly navigate my suitcase of issues (ED, autism, fear of doctors, etc., etc.) and nurses who hug me and say, girl, we’re going to get that A1c down to 5!!!

Since January, I felt embarrassed to share this story. I already bared the weight of the stigma surrounding mental illness and diabetes has its own set of stigmas and assumptions. People feel they can chime in on a stranger’s individual health journey with the confidence of a physician. People feel entitled to tell you how, when, and where you failed so spectacularly at life and you should’ve done this, that, and the other thing while you’re thinking no shit, Sherlock. Is the point to make me feel worse? Is the point making your voice louder than my team of healthcare and medical professionals? I worried about sharing this because people often want to comment and fix instead of simply cheering you through your journey or having basic human empathy.

I worried about sharing this because I could’ve prevented this and I know it. I say this to my doctor, feeling unbridled shame, and she’s quick to respond. Quick to tell me the objective is to look forward. Quick to tell me this can be reversed. This can be maintained and controlled—I just have to put in the work.