Rosie, a 43-year-old mother of five from Nelson, has struggled with her weight since her 20s.
“Every time I would go to the doctor, I would say ‘Hey, I don’t think it is normal. I’m quite overweight. Is there something that can help me?
“And the answer is always ‘diet and exercise, diet and exercise’, but I’ve always eaten well. I’ve always exercised, like, I lift weights at the gym.”
A diagnosis at 29 for Polycystic Ovary Syndrome, which could impact weight due to insulin resistance and hormone imbalances, alluded to a possible cause.
Finally, in 2024, Rosie’s GP prescribed her two weight loss medications over the last nine months. She lost 15kg but her progress on the current medication Saxenda plateaued and Rosie was still 15kg from her goal.
That’s why in July she is planning to transition to Wegovy. It is a weekly injectable weight loss medication with a celebrity aura that is available from July 1 in New Zealand after years of overseas success. It is also known as the diabetes medication Ozempic and reduces appetite while silencing food noise.
But Rosie, who works in retail with a side hustle to pay for her current weight loss medication, doesn’t know if she can afford the potentially $500 monthly cost for Wegovy. While the medication is approved for use by Medsafe, it is not funded by Pharmac.
For those who are already using weight loss medication, Wegovy’s availability is highly anticipated to decrease their weight further with fewer side effects. The fervent coverage on social media will no doubt attract more attention — and new converts — to medical weight loss.
Yet, Wegovy’s high monthly cost and lack of government funding in New Zealand puts it out of reach for most people. The notion of funding weight loss drugs is stuck in a political tug-of-war between those who see obesity as a chronic health condition and those who blame obesity on a lack of personal responsibility. One in three New Zealanders over the age of 15 and one in 10 children are considered obese, the third highest amongst OECD countries.
“…We haven’t had really effective weight loss medications [in New Zealand] ever really so this is a real boost and it does change the dynamics a lot of obesity management,” says Boyd Swinburn, a professor of population nutrition and global health at the University of Auckland.
Initially, the drug won’t have a big impact because of its lack of affordability, but as other drug makers rush to make similar drugs, the cost will come down, he says.
The challenge with getting funding for costly weight loss drugs like Wegovy is often shackled by “weight bias, the view that people’s excess weight is their own silly fault…,” says Swinburn.
“That kind of thinking, which really goes against the evidence of what’s driving obesity here, that does carry into wider views about the deservedness of people with obesity having taxpayer-funded medications.”
Swinburn pointed to our general acceptance of funding for other ongoing medications used to reduce blood pressure and high cholesterol as a model for how we should view weight loss medication.
The UK government has begun funding for Wegovy and the similar medication Mounjaro for some people and only for a two-year cycle for each patient, according to the BBC. The medication is costing the UK taxpayer close to US$7000 per person annually and there are concerns a fast roll-out could overwhelm the UK’s National Health Service due to need. However, rising obesity rates could also “bankrupt” the NHS with the high cost of treating obesity-related diseases such as type 2 diabetes and cancer.
Novo Nordisk confirmed Wegovy’s entry into the New Zealand market and said in a statement that it is in discussions with the New Zealand government to “explore options for broader, more equitable access for patients”. The drug maker declined a request for an interview with one of its representatives.
Even without government funding in New Zealand, the cost of weight loss medications is essentially subsidised by the reduced grocery bills for patients, according to Dr Gerard McQuinlan, a Wellington-based GP specialising in weight loss. He is planning to transition most of his medical weight loss patients from Saxenda to Wegovy in the coming weeks.
“When they worked out how much they were spending on snacks and the foods they were used to — like high calorie, high carb foods and alcohol — it actually balances out the medication’s cost.
“They hardly go to a cafe because they’re just not interested.”
Long-term lifestyle change needed — Dave Letele
If Wegovy was quickly funded in New Zealand, former professional boxer and community health advocate Dave Letele would be irritated. He founded From the Couch, a 12-week programme that supports mostly Māori and Pasifika people towards a healthy lifestyle. Massey University’s research on the programme showed participants lost on average 7kg during the programme with a significant reduction in signs of severe depression. The research suggested the programme was effective in “the holy grail” of weight loss programmes: long-term lifestyle change.
“It would be annoying if they funded [Wegovy] and not fund programmes like ours. We have a programme that breaks cycles for generations and we don’t get much,” says Letele, adding there is a waitlist to enter the From the Couch programme in some areas. A new location kicks off in Northland this week with funding from the Department of Internal Affairs.
“I’m not against the drug, like I’m not against the gastric sleeve [weight loss surgery]. Everything has its place, but there is so much more to it that you need to address.”
Letele stressed the need for wrap-around services including help with nutrition and fitness as well as psychological support.
Wegovy might be a forever drug for some patients. Numerous studies show that many who stop taking it or similar medications regain much of their weight.
Dr Lara Courtenay, a weight loss physician at the MacMurray Centre in Auckland, has prepared many of her patients to transition from Saxenda to Wegovy throughout July. While Wegovy doesn’t work for all patients, the weight loss is typically greater, the side effects are reduced and it requires one weekly injection whereas Saxender is injected daily.
Courtenay was a GP for seven years before transitioning to the medical weight loss field, describing it as “a very rewarding job”. Along with weight loss medication, MacMurray Centre patients get the support of dieticians and psychologists to promote lifestyle change. This increases the possibility that they one day won’t need regular weight loss medication, or require a reduced dose, says Courtenay.
However, whatever weight loss medication patients are on, once they stop, they face an uphill battle to prevent their body from returning to their set weight, which is their heaviest weight.
“What I say to patients is, ‘you’re a cave person, your cave person is trying to get you back to your set weight’,” says Courtenay, “and our bodies are really good at doing that.”
By Serena Solomon of rnz.co.nz
