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I've been writing for a few days about GLP-1 medications— today is my Day 4 using one myself— and writing about effects and side-effects as if my audience was already at least sorta familiar with them. That may not be far off the truth, as an increasing number of people in my age bracket are already on GLP-1s or have a partner who is. For everyone else, let me back up a bit and explain what these drugs are and what they do.

First, a bit of terminology. GLP-1 is short for Glucagon-like Peptide-1. It's the name of a natural hormone in the small intestine that helps manage insulin secretion, among other things. This class of medications are actually GLP-1 receptor agonists, a technical term that means they bind to the same receptors in the body as the GLP-1 hormone. So taking a GLP-1 pill or shot is like having extra GLP-1 hormone in your body.

Taking a GLP-1 drug, which triggers the same effects as the GLP-1 hormone, does several things:

• Triggers the release of insulin, promoting the conversion of food into energy and lowering the amount of glucose (sugar) in the bloodstream. Elevated blood-sugar levels over time cause diabetes.


• Blocks the secretion of Glucagon, another natural hormone that raises blood sugar levels.


• Slows digestion in the stomach, reducing the amount of sugar available to release into the bloodstream and helping signal to your brain the sense that you are "full" and don't need to eat.


• Directly affects areas of your brain that regulate appetite and food cravings.

It's the third one that causes a lot of the side effects everyone on a GLP-1 drug struggles to manage. Food sitting in your stomach longer can lead to discomfort, gas, indigestion, and upset stomach. When food you've eaten previously is still in your stomach because it takes longer to digest, eating your next meal— or exercising, or even just lying down— may cause you to barf. This is one of the biggest side-effects of the medicine virtually everyone who's on it has warned me about it. Thus it's also the one I've been most concerned about as I've started a GLP-1.

So have I barfed? No, but notice how I titled yesterday's blog "Day 3: Trying not to Barf'. 🤣 There have been times over these 4 days I've felt like I might be about to get sick to my stomach. Thankfully I haven't actually gotten sick to my stomach. Yet. 😟

What I feel is happening to me is that I'm getting that effect #3 without effect #4 yet. My stomach fills up faster and takes longer to clear, but my brain isn't yet getting stronger signals to stop eating. Thus I'm at risk of overeating my stomach's reduced capacity for digestion when all I do is "eat until I feel full".

So far I'm compensating for this by consciously reducing my portion sizes and stopping eating before I feel full. I hope that effect #4 kicks in soon, because otherwise what I'm doing is basically an austerity diet— the kind that has been shown not to work long-term for most people, including me.

Sunday's D&D game wasn't finished after the epic chase scene where Leoghnie and Otonio caught the fleeing spy/ringleader. For one, there was also action happening in the other ring. Back at the scene of the ambush, the hobgoblins had fled but the worgs (bigger, stronger, evil wolves) had not. The worgs had already killed two of the caravan's horses and were about to kill two more. Ryuu-Han the mage moved around from behind his wagon to confront the worgs.



Ryuu-Han's move was a good one... initially. He gained clear line-of-effect on the worgs with his spells while remaining 20' away from the melee. He struck one worg with a burst of magical flame that singed its hide. But in the heat of battle he forgot that worgs, like their wolf cousins, move fast. The worgs disengaged from the horses and moved to attack the foe they perceived as the biggest threat. Ryuu-Han was flanked.

The mage wasn't done. He still had fight in him. The magical protections he'd cast gave him some defense against the worgs' snapping jaws— much better than the worgs expected for a city-ape clad only in rags. His strongest spells were depleted, though. The risk was very real that the worgs, even both injured badly already, would kill him before he killed them.

His companions rallied to his side.

Herran, already on the ground with her bow in her hands, spotted the trouble first. Employing a tactic of "walking fire"— move, shoot, move, shoot— she closed on the worgs, each shot becoming more deadly as she shortened the distance. Before her first move, though, she banged on the side of a wagon asking Wataru for help.



Wataru, a grizzled older driver, had put up a stout fight so far. As driver of the first wagon he'd already taken a lot of arrows, though. He'd retreated into the cover the wagon to drink a healing potion. Now it was time to rejoin the fight. He leapt down from the seat, bow in hand, and followed Herran with walking fire.

BTW, if you're wondering why I'm narrating that Wataru had a bow in hand, when the picture above clearly shows him ready to draw his sword: it's because this is the sort of thing I get from AI image generation. Yes, I'm providing a lot of careful prompts. No, it's not perfect; it even stubbornly refuses to change some details I'm explicit about. I consider it enough of a victory that it doesn't draw any of the female characters with exposed cleavage or bare midriffs (IYKYK).

Update: I worked on a picture of Herran rallying aid to help Ryuu-Han:



Another driver joined in the fight, too. It took some urging from Kiarana the cleric, who was seated next to him on the buckboard. Blushing with chagrin that a cleric had to tell him to get back in the fight, he loaded his crossbow, fired, and loaded and fired again.

Together, between Ryuu-Han's resilience under threat and three warriors working their bow, the group defeated both worgs.

But even there, the story of the ambush wasn't complete. There was still the captured spy to deal with!



Kiarana healed him enough to bring him to consciousness. She cast a spell to compel him to speak only truth. Otonio led the questioning while Leoghnie scowled holding her massive sword, providing the implicit "Or else".

Again re: AI image gen... Yeah, it's not accurate that the cleric has a sword. And she's over-armored. But again, that's way better than her showing off her boobs and midriff. Plus, Jill, who's athletic herself, appreciates that Leoghnie is drawn not only with appropriate gear to go fight snarling monsters toe-to-toe but is drawn stocky enough to actually wield that huge sword she's got (IYKYK).

The spy gave up almost nothing in the questioning. He couldn't lie, due to the spell, but the spell couldn't force him to elaborate. He spat and called them names.

Otonio challenged the spy that he looked familiar. "I have seen you in the city. You serve House Berenar."

"Yeah, Tashara kid, you probably have," the spy sneered. "Best you let me go or you'll join me in hell when they find out."

Otonio's eyes narrowed as he weighed the political dimensions of this. Skirmishes between ruling houses were not unheard of but had to be navigated gently. Very gently.

"Get the merchant," Kiarana barked. She was irritated by the spy's stonewalling. Plus, now it seemed the spy might actually be the ringleader. Leoghnie went and grabbed the tied-up former caravan leader, Munetoshi, dragging him ungently across the ground to add to the questioning.

"Look, here's the deal," Kiarana explained to the two captives. "One of you talks, one of you loses his tongue. Choose." Eyes widened around the gaming table that the cleric was the one making the threat. "Hey, I'm Lawful Neutral!" the player rebutted.

Munetoshi babbled that although someone else had hired him first, this man, Touichi Berenar, told him there would be an ambush and paid him extra to advocate for surrender when it came. This confirmed that Touichi was not merely a "spy" but the coordinator of the attack.

"Hmm," Otonio said aloud, making a show of thinking about the situation as he faced Touichi. "You planned and attempted my murder. I am sure that my loyal house guard would object to that, strongly."

Leoghnie was busy picking her nose, or something— but picking it fiercely— so she didn't catch the verbal handoff. Otonio repeated himself, "I said, I am SURE my house guard would object to that, strongly!" Leoghnie didn't need a third invitation; she lopped off Touichi's head.

"As for you—" Otonio said, turning to caravan leader Munetoshi and leveling his rapier at the man's throat, "Your treachery imperiled all of our lives. It killed one of the men you hired. And should we further risk our own lives spending our now-depleted resources transporting you to the next city for trial? As a member of House Tashara, ruling coalition of Durendal, I declare your life forfeit here and now."

Today's Day 3 of taking Ozempic, a GLP-1 drug. The day's less than half over, but I'm writing now because something urgent is on my mind. I'm trying not to barf.

Getting sick to your stomach is one of the common side effects of GLP-1s. They slow your digestion, so food sits there longer. That increases the risks associated with overeating— i.e., throwing up because you ate too much.

I've been concerned about this as I've started taking a GLP-1. I mean, no one likes to barf. But it's a very real and common side effect. Many friends and my oldest sister, who are all taking GLP-1s, have warned that it can happen a lot. My sister says she barfs a few times a week even after she's adjusted her eating habits to minimize the problem. 😨🤮😭

I mentioned yesterday that on Day 1 I went to bed with some mild stomach discomfort from dinner still sitting in my stomach. It happened against last night— but worse. I'd eaten a full-sized dinner last night because I was hungry. I didn't experience any "You're full now, stop eating" cues during dinner. But then a few hours later, when I was ready for bed, my stomach seemed to be telling me, "Whoa, you shouldn't have eaten all that!" I laid down carefully, worried that I might have to get up and dash to the bathroom to puke.

I slept fitfully last night. Each time I woke up I felt like there was a bowling ball in my stomach. Thankfully it never got past the point of stomach discomfort. And by the time I got up this morning the feelings were gone. Dinner was digested.

It seems that I need to be more proactive about reducing my meal sizes on GLP-1. It's not enough to eat slowly and be mindful of signals of fullness that arrive sooner. Those signals are not arriving sooner. Instead I need to force myself to stop eating sooner, when my body is still screaming at me, "Eat! You're hungry! Eat!" or else I'll feel sick a few hours later. 😳🤢😞

Today was Day 2 on The Pill. I started by weighing myself— something I couldn't do yesterday because the bathroom scale I've owned for 20 years just says "D'oh!" when I step on it now. I've gained a lot of weight over the past 18 months due to 1 or 2 of the many medicines I'm taking. I'm now over the weight limit for a lot of bathroom scales. That's why I ordered a new scale on Amazon yesterday. It has a higher capacity. It arrived swiftly but not in time for an inaugural morning weigh-in. So I did that today. And I forgot to do it first thing in the morning, before eating breakfast. So I did it after breakfast... and after a dump. I figured, one meal in, one meal out; it's balanced. 🤣

I feel like I'm starting to see some of the side effects of the GLP-1. It didn't start that way, though. Yesterday, Day 1, I began with my normal breakfast. Okay, I figured; the pill doesn't take effect immediately, especially at the lowest dose. For lunch I tried cutting down my normal portion by half but was still hungry afterward. I then ate more, adding up to a typical lunch amount. I tried a reduced portion again at dinner, going with 2/3 the amount I normally eat, and that's when I started to see some appetite reduction. I felt full after a modest, 2/3-sized dinner... though that feeling of fullness came partly from a mild discomfort that felt a bit like stomach gas. I had the burps for a few hours after dinner. When I went to bed 3.5 hours later it felt like the food was still siting in my stomach and trying to crawl back up my esophagus. It wasn't painful, thankfully; just a bit weird.

Today, Day 2, I downsized my breakfast and lunch to about 2/3 of what I'd normally eat for each. I was a bit hungry after breakfast and just waited until lunch. I was a bit hungry after lunch, too; I treated myself to a small dessert of two cookies. That was enough to hold me over until dinner without any mid-afternoon munchies. Come dinnertime, though, I was hungry. I ate a full portion at dinner. Now I feel bloated from that, like I overate. Part of learning to deal with this medication, and part of why doctors start everyone on the smallest dose, is becoming familiar with new signals and developing new habits. I'll see how I feel in about 2 hours when it's time for bed.

Saturday morning I ordered a new bathroom scale. Nothing fancy, just a basic scale to replace the 20-ish year old one we have. After I selected one that doesn't have bluetooth or require downloading an app to setup, Amazon offered me a delivery option I'd never seen before, a same-day option. Oh, I've seen same-day options before. But this one was crazy because it offered a time window of 10am - 3pm... when it was already 9:52am.

"Let's see if this gets here in 8 minutes!" I chuckled to myself as I pressed the Buy button.

The reality wasn't 8 minutes, of course. But it wasn't far off, compared to the "Please allow 6-8 weeks for delivery" refrain still heard in some corners of life today. The scale hit my doorstep at 1:08pm. That's a new delivery record of 3 hours 16 minutes.

Starting today I'm on the pill. A GLP-1 pill, that is. I need it for diabetes and losing weight.

I've anticipated doing this for a while now. I chose to wait on joining millions of Americans until I retired. What I'd heard about the side effects from multiple friends who take GLP-1s made me not want to deal with it while having a rigorous schedule of meetings all day every day.

Well, last week Thursday was my first visit with my GP since retiring in March, and I got the prescription. I got the first month's dosage of pills (I chose an oral medication over an injectable) Friday and took the first one this morning. So far... nothing's changed.

I've read a fair bit about side effects and ways to avoid, reduce, and manage them. I'm not looking for meal planning tips or your favorite recipes right now. If anything I am keeping in mind not to put the cart before the horse. This is only Day 1, on the minimum dose, of the oral medication (injectable generally hits harder). While it's 💯 worth knowing what I'll face in the weeks and months ahead it's also important to keep a perspective on what I need to do today and tomorrow.