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Janet McCaskill might as well be the poster child for “diet du jour.” From WeightWatchers to keto, her culinary journey reads like a health magazine’s worst fears. Turns out, trying to lose weight can sometimes feel like playing a game of whack-a-mole—you squish one fad, and another pops right back up!

“I had my hopes set on these trendy eating plans,” said McCaskill, a 58-year-old grandma from Knightdale, North Carolina. The only problem? Like a bad sitcom, they worked until they didn’t. By late 2022, after losing not just the breakdown but also her family to heart disease (no pressure there, right?), McCaskill turned to the latest heavyweight contender in the pharmaceutical ring: Mounjaro, a diabetes drug slightly off-label for weight loss, with friends like Ozempic and Wegovy. Because, who doesn’t want to micromanage their daily dosage while being surrounded by a cast of medical drugs?

“It literally saved my life,” she proclaimed, because when life gives you lemons, you might as well crush them with pharmaceuticals!

Alas, reality bites! After trying a cheaper compounded version via a local pharmacy (because why should your wallet suffer while you lose those pesky pounds?), McCaskill is now facing the cruel twist of fate: the FDA declared the branded Mounjaro shortage over. This, of course, means that all those compounding miracles must pack up and go home. Who knew weight loss would come with such a side of anxiety?

In a plot thickening quicker than a late-night infomercial, this compounding pharmacy law had been a catalyst for people seeking affordable GLP-1 meds—so naturally, some doctors are sweating bullets, fearing for their patients who were happily swiping their way to wellness without FDA approval. For patients like McCaskill, however, it’s a full-on soap opera, and she’s the star.

“I’m devastated, to say the least,” she lamented. Well, that’s one way to sum up a rollercoaster of life-altering weight loss, right?

Fast forward to the present, McCaskill’s weight has dropped like the ratings of a canceled TV show—almost 100 pounds and giddily hovering at 117. Bonus? Her blood pressure and triglycerides have taken a nosedive! The grandma is finally the energetic cheerleader for her granddaughters, doing backflips (figuratively, of course) while taking her health into her own hands.

But wait! Plot twist! She managed to navigate through the health bureaucracies by relying on the not-so-glamorous coupon system for her monthly drug supply, slashing prices to half—just shy of $500 a month, a price that would make even a wealthy heiress clutch her pearls. However, when that lifeline was cut, in came the cheaper compounded versions, a hopeful new chapter for McCaskill.

You’d think a happy ending would ensue, but not in this twisted tale of weight loss and corporate profits. The FDA, ever the uninvited guest at the party, decideth that the compounding must cease! Now it’s back to the high-stakes game of pharmaceutical roulette—do you throw down a hefty amount for brand names or risk it all for the roadside version? #YOLO

“I was on the verge of pulling an all-nighter just to field questions from my worried patients,” sighed Michele Kessler, McCaskill’s beleaguered physician assistant. Fun fact: January 2024 could see a spike in people Googling “how to lose weight without pharma drugs” at 3 a.m.

The irony here is that compounding drugs allows some DIY pharmacy action whenever there’s a shortage, but once that shortage fades, you’re left high and dry—much like a cold cup of coffee left unattended on your desk. And while compound pharmacies can whip up a personalized potion as easily as flipping a pancake, when it comes to safety, they might as well be operating out of a carnival booth.

“You walk in, and we’ll make whatever drug recipe you desire—cupcakes for your health!” Jennifer Burch, a pharmacist, quips. Meanwhile, pets can have custom-flavored medications to match their idiosyncrasies—bubble gum for the cat, anyone? Because why not?

However, while pharmacies scramble to keep up with demand for compounded tirzepatide, the manufacturers charge on, stirring the pot of capitalism while people scramble to find affordable options. The ultimate cruelty? Insurers dismiss weight-loss drugs as frivolous, leaving McCaskill and many like her caught in the middle of a labyrinthine system.

As companies like Hims & Hers reinvent the wheel to introduce trendy doses beyond the FDA-approved limits, it seems there’s no end in sight. McCaskill hopes that one day, she’ll be able to afford the magic pill without the coupon-cutting anxiety. Because who needs that kind of stress? “I just don’t want to mess with anything when it’s working 100% for me,” she concluded, a hopeful vulnerability amidst a weighty dilemma.

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