We’ve all seen the rise of weight loss medications like Ozempic in Australia, the UK and US. Whether you like them or not, they’ve caused a buzz because they can help people to lose considerable amounts of weight and keep it off. Our in-house dietitian Lily ‘Lentil’ gives us the latest on weight loss medications within the New Zealand context and why your diet still matters.
The buzz
The world of weight loss got a big shake up when Ozempic came on the scene. The reason? Research has consistently shown that this class of medications, when taken consistently can achieve around 10-15% weight loss which means they are effective (1,2)!
What is Ozempic?
Ozempic, is also known by its generic name semaglutide.
It’s a medication that belongs to a class of drugs called GLP-1 receptor agonists. These medications were originally developed for lowering blood glucose levels to manage type 2 diabetes. However, versions of the medication have since been released to support weight loss.
How does Ozempic work?
Ozempic mimicks a hormone called glucagon-like peptide (GLP-1) which is naturally produced in the gut.
There are three ways that it works:
- Blood sugar regulation: it stimulates the secretion of insulin following a meal which helps to lower blood sugar levels.
- Appetite control: it slows down digestion which helps you to feel full for longer.
- Weight loss: it reduces appetite and increases the feeling of satiety which makes it easier to manage cravings, eat less and feel full for longer periods.
What’s medications are available in NZ?
Ozempic has been approved by Medsafe for the management of type 2 diabetes but is still yet to officially come into NZ and be prescribed by doctors. There is a handful of people in NZ who have been able to access it.
Ozempic hasn’t been approved (yet) for managing weight however a medication that belongs to the same class of GLP-1 drugs called Saxenda is available – although there are supply issues affecting access.
The weight loss medications currently available in NZ include (with strict criteria):
- Liraglutide (Saxenda): belongs to the same group of medications as semaglutide. Although there are currently global supply issues.
- Orlistat (Xenical): belongs to a group of medicines called lipase inhibitors which prevent the absorption of dietary fat in your body.
- Phentermine (Duromine): is an appetite suppressant that works by directly affecting the area of the brain that controls your appetite making you feel less hungry.
- Naltrexone/buproprion (Contrave): works on areas on the brain involved in the control of food intake and energy use
Of these medications, liraglutide is the most effective and achieves an average weight loss of around 5% (3). Weight loss medications that have been around for some time i.e. orlistat, phentermine may not be as effective at achieving substantial weight reduction (4).
Are these medications a magic pill?
No matter what medication you are taking they shouldn’t be thought of as a “quick fix” or magic pill for weight loss!
They are designed to be used alongside lifestyle changes and a calorie-controlled diet to promote sustainable and long-term weight loss.
In fact, the quality of your diet becomes even more important when you’re reducing your intake of food whether that’s through less food across the day or smaller portions. A balanced diet rich in whole foods such as vegetables, fruits, lean proteins, and whole grains provides the essential vitamins, minerals, and nutrients your body needs to function optimally. Adequate protein is essential to preserve lean muscle mass during weight loss, ensuring that your body burns fat rather than breaking down valuable muscle tissue.
The elephant in the room
Some weight loss medications may be funded for specific health conditions like diabetes however, most weight loss medications in NZ are only available through privately funded prescriptions which means you have to pay for them. They vary in price, costing between $100 and $500 per month.
The other thing to consider is side effects. With Ozempic there is commonly reported mild to moderate gastrointestinal issues such as nausea and diarrhea especially during the initial phase. Other weight loss medications all have varying side effects and risks to your health.
Before starting any medication, it’s important to consider whether the investment is worthwhile given your individual weight loss goals and health needs.
What about the long-term
Different people respond differently to weight loss medicines or other approaches to managing weight like bariatric surgery. Your healthcare provider is the best person to advise whether a weight loss medication is suitable for you long term.
Studies have shown that people who stop using Ozempic more often than not regain the weight they lost (5). It is estimated that around 10% of people will be able to maintain the weight they have lost when discontinuing the medication. This means, investing in diet quality and other areas of lifestyle including sleep, physical activity are important for sustaining lasting results particularly if medication is taken short-term.
A tool in the toolbox
We should be thinking of weight loss medications as one tool in the toolbox!
To truly harness their benefits, they need to be paired with a balanced diet that hero’s nutrient-rich foods. This will enhance the effectiveness of the medication and help people to achieve their weight and health-related goals. It will also ensure that nutrition needs are meet and helps to prevent fatigue and other diet-related health problems.
At the end of the day, it’s important to obtain advice from your healthcare provider on the benefits, risks, and side effects of any medication you are intending to take.
References
(1) Ryan, D.H., Lingvay, I., Deanfield, J. et al. Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial. Nat Med 30, 2049–2057 (2024).
(2) Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982.
(3) Zhang P, Liu Y, Ren Y, Bai J, Zhang G, Cui Y. The efficacy and safety of liraglutide in the obese, non-diabetic individuals: a systematic review and meta-analysis. Afr Health Sci. 2019 Sep;19(3):2591-2599. doi: 10.4314/ahs.v19i3.35.
(4) Moiz, Areesha et al. Long-Term Efficacy and Safety of Once-Weekly Semaglutide for Weight Loss in Patients Without Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. American Journal of Cardiology, Volume 222, 121 – 130
(5) Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414–1425.
