I'm a big semaglutide proponent after being on it for a year. I know research says it helps with inflammation, arthritis (separately from weight reduction), and all sorts of magical things.
I lost 40 pounds in a year(230 to 190) at age 50. Great! I also went from being active and fat(weightlifting with some cardio) to basically having no energy. In the last year I've had arthritis appear in several joints. I'm awake several times a night to pee(yeah, prostate is acting up but I still void completely. The semaglutide is like a diuretic for me at night.). I get waves of hypoglycemia like feelings where I feel weak and spaced out. I'm afraid to get off of it because now my joints can't handle the extra weight. My doc recommended going to every other week now that my BMI is normal but as far as I can tell that advice isn't backed up by any research. Anyway, it's a powerful drug that works well but is not without side effects.
I had similar issues on Semaglutide, but I've found Tirzepatide much more tolerable. I've lost 165lbs, A1C has gone down to 5, I have more energy at 52 than I did at 32, and I am exercising like a maniac now. Maybe you could try it?
I'm on the pill version, which allows me to adjust the dosage on a more day-to-day level. It also doesn't need a fridge, so it allows me to travel more easily. There's a level that works best for me long-term, and it's quite a bit less than typical.
I’m also active and fat. And to me being active is more important than losing weight; I’d rather continue to do those long 2000kcal bike rides on weekends than having a healthier BMI. I’ve heard stories of my own friends bonking during a ride and I decided that I wanted to err on the side of overeating. So semaglutide doesn’t interest me. You aren’t the only one I’ve heard who started to have no energy after being on semaglutide.
That said the dementia benefit mentioned in the article still intrigues me.
I'm younger than you and only loss a about 25 lbs. I've now gone to a maintenance dose and seen my energy recover substantially, I do still think (anecdotally) that when I got off for a week I got even more energy but it's hard to judge.
Is it kind of the stuff where the benefits outweigh the side effects? I'm just scared of the unknowns with the drug with such overwhelming positive research. Maybe, I'm a paranoid person but I'm unable to believe that such a powerful drug isn't without any side effect, clinically proven.
Try Tirzepatide or one of the other drugs. They each have their own side effect profile.
I have a very similar situation: on it for about a year, 220lbs to 180 at age ~40. Also very active: weight lifting / biking / swimming and - the sport that made me realize I needed to loose weight - rock climbing. I've always been very outdoorsy-adventurous, and climbing/mountaineering is the natural sort of "end game" for this lifestyle. My weight never really got in the way of anything else in my life (maybe my self esteem) but, this might offend some people, but climbing is a sport where you really cannot be even a little bit fat. It makes you painfully aware of your body weight. Most "good" climbers are built like bean-poles. I don't really need to be a "good" climber, just an "okay" and safe climber - I'm mostly interested in alpine trad below ~5.7. I still feel like I need to lose another 10lbs.
I was a fat kid growing up. I've had a BMI of 30±1 since age 12. I also have a family history of heart disease. Literally every male on my father's side for three generations has had a heart attack in their late 50s. We all have roughly the same body type. I already had hypertension in my mid 30s. Semaglutide has made me feel like there's hope.
Unfortunately, I can relate to the lower energy levels. While I'm no longer lugging an extra 40lbs around (a full pack!), I still bonk way faster. My gym sessions are way shorter. Luckily, I haven't lost much muscle mass, so I look great and it's been the "cut" I've never been able to achieve, but I'm sure if I ever wanted to "bulk" I'd have to go off it. I've found if I have a big trip or climb coming up, I have to take a way smaller dose the week, or even weeks, prior. I found this out the hard way when I puked on a climb in North Cascades. I just couldn't eat, and felt like shit the whole time.
The trick has been self managing my dose. I'm on compounded generic, so I can dose myself with my own needles. If I have a big trip coming up, I'll take like 25% of my maintenance dose for a week or two prior. This has been almost a superpower, because I'll get this massive burst of energy from the calorie intake. Im still not really sure if this is healthy, not the "taking 25%" part, but the fact that I feel like superman when I'm off it or on a low dose for a bit. Not sure what this says for someone who is basically taking semaglutide because their weight was holding them back from the activities semaglutide makes them too bonked to do anyways.