Weight loss drugs

Bariatric surgeon Richard Barbor recently spoke to TVNZ’s Breakfast show about the surge in popularity of weight loss drugs, Ozempic and Wegovy. Here is a condensed version of the interview.

Ozempic and Wegovy have gained fame for helping celebrities lose weight. However, the active ingredient in these medications, semaglutide, is primarily intended to treat type 2 diabetes. Their popularity as weight loss drugs has led to a global shortage, making them inaccessible to those who need them most and unavailable in New Zealand.

How does Ozempic work?

Ozempic is a “GLP-1 receptor agonist” that targets receptors in the brain, pancreas, and gut. GLP-1 receptor agonists mimic the GLP-1 hormone, helping to lower blood sugar levels and reduce appetite. This slows down the gut’s activity and makes the brain think you’re not hungry. Many patients report that they “just stopped thinking about food,” and if they did eat, they felt full almost immediately.

Are they miracle weight loss drugs?

No, they are not miracle drugs, but they are highly effective for treating type 2 diabetes. These medications are game-changers and do promote weight loss. They represent an important new class of medications that many people will use in the future. However, the associated weight loss is relatively modest, and weight can be regained once the medication is stopped. The hype surrounding these drugs, especially in Hollywood and media outlets like Oprah, is somewhat exaggerated.

Is that the reason for the shortage?

Yes, Ozempic must be one of the most Googled terms right now! The high demand has contributed to the global shortage.

Do we have Ozempic & Wegovy in New Zealand?

Currently, these medications are not available in New Zealand due to the global shortage. Manufacturers are working to increase production, so we expect to have them here eventually.

What are the alternatives?

In New Zealand, similar drugs like Saxenda are available. Saxenda works in a similar way but requires daily injections instead of the weekly injections that Ozempic requires. It is used for both type 2 diabetes and weight loss in New Zealand.

Learn more

Ozempic for Weight Loss: Richard Babor on Balancing the Promise and Perils

In recent years, several new medications have emerged to aid in weight loss, including Ozempic (semaglutide), Wegovy, Saxenda, and Trulicity. These medications have shown promising results in helping individuals achieve significant weight reduction. However, alongside their benefits, there are potential risks that users should be aware of, including the development of gallstones.

More about the pros and cons of Ozempic

The connection between Ozempic and gallstones

Ozempic, a popular weight loss and type 2 diabetes mellitus (T2DM) medication, has been associated with an increased risk of gallstones (cholelithiasis) in clinical studies. Here’s what the research tells us:

• Ozempic use in type 2 diabetes patients 
  In clinical studies, 1.5% of people using Ozempic at a 0.5 mg dose developed gallstones, while 0.4% of those using a 1 mg dose experienced this issue.
• Children vs adults
  Children aged 12 and older taking Ozempic for weight loss were found to have a higher incidence of gallstones compared to adults on the same treatment.
• Incidence in adults
  When adults used Ozempic for weight management, 1.6% reported developing gallstones. This is higher than the 0.7% occurrence in those taking a placebo.
• Impact of rapid weight loss
  Substantial or rapid weight loss can lead to a higher risk of gallstones. Even after considering weight loss, patients on Ozempic had a higher rate of acute gallbladder disease compared to those on a placebo.
• Ongoing monitoring
  After Ozempic was made available to the public, there have been instances of patients needing gallbladder removal surgery (cholecystectomy).

These findings underscore the importance of monitoring gallbladder health in patients using Ozempic and similar medications.

Addressing gallstone risks

For individuals on these medications, it’s crucial to be aware of the symptoms of gallstones, which can include severe abdominal pain, nausea, vomiting, and jaundice. Early detection and treatment are vital to prevent complications.

New service for gallstone diagnosis and treatment

Understanding the growing need for specialised care in this area, we are pleased to announce a new service offering fast access to gallstone diagnosis and treatment. Our dedicated team at Auckland Gallbladder Surgery is equipped with the latest diagnostic tools and treatment options to ensure you receive timely and effective care.

Stay informed

While weight loss medications like Ozempic, Wegovy, Saxenda, and Trulicity offer significant benefits, it’s important to be mindful of potential side effects, including the risk of gallstones. By staying informed and proactive about your health, and by taking advantage of specialised services like ours, you can safely manage your weight and overall well-being.

For more information on gallstones and our new diagnostic and treatment services, visit Auckland Gallbladder Surgery.

References

• Semaglutide Drug Monograph – Elsevier.com
• Ozempic Label – DailyMed (FDA)

A new weight loss solution named Ozempic is the latest buzz on TikTok, capturing the attention of celebrities such as Jeremy Clarkson and Kim Kardashian. This ‘miracle’ drug, administered through injections in the stomach, thigh, or upper arm, has ignited intrigue and discussions surrounding its effectiveness in weight loss.

Ozempic operates by replicating an appetite-regulating hormone, a mechanism that helps curb hunger and extends the feeling of fullness among its users. While the allure of a potential game-changer in the battle against obesity is undeniable, cautionary notes from obesity experts emphasise that Ozempic is no magic bullet. Users should be wary of potential side effects ranging from nausea and diarrhoea to more serious complications like pancreatitis and gallbladder issues.

Seeking clarity on this groundbreaking drug, Simon Barnett and James Daniels of NewstalkZB radio talked to one of the country’s top bariatric surgeons, Richard Babor, to explore its role within the complex landscape of weight loss.

Here’s a condensed extract from the interview.

Are there just a lot of fat, lazy people out there?

I know from the biology of obesity, and my experience from my patients, is that if it was that simple, we wouldn’t have an obesity epidemic. The people that I see do diets and exercise over and over again. They might move moderate amounts of weight but the hormonal and biological drivers that increase weight are not able to be overcome by combinations of diet and exercise. The science has disproven the notion that all you have to do is cut down what you eat and exercise more and obesity will go away.

Is bariatric surgery the cheats way out?

Most of the patients I see have tried diets and exercise and they haven’t worked. Perhaps they can lose weight for six to nine months and then they put that weight back on. The biological drivers of their obesity are not able to be overcome by just willpower. These people are not stupid, they might be well educated, affluent and well-resourced and are usually highly motivated.

In the 80s, obesity wasn’t a thing. Is it because of the high calorific, high sugar content in food, coupled with a sedentary lifestyle?

Yes, we are a product of our ‘obesogenic environment’. 

The solution to population obesity is not bariatric surgery and it’s not Ozempic either. It’s modifying our food ecology. Our food environment is toxic. It’s a very thorny political problem and outside of my area of expertise. There are people in public health working on that problem.

What I can do is offer individuals who are not able to overcome obesity in their own lives, bariatric surgery as powerful tool to bring weight down.

Do you endorse Ozempic and other similar medications?

Ozempic has been shown to reduce weight by 10 or 15%. The problem is there is a world wide shortage because it’s been promoted by celebrities on social media. There are Ozempic clinics popping up in the US. 

It does have an effect but it also has strong side effects like nausea, vomiting, diarrhoea, abdominal pain, bloating and some can’t tolerate the treatment.

Currently in New Zealand Ozempic is only approved as a prescription for people with diabetes. Ozempic is not available in New Zealand as a weight loss drug, because there is a worldwide shortage.

Final thoughts

The allure of Ozempic as a weight loss miracle should be balanced against the understanding of its limitations and potential risks. Dr Babor’s expertise emphasises the need to adopt a holistic approach to tackle obesity, recognising that individual solutions, whether pharmaceutical or surgical, must be complemented by broader efforts to reshape our obesogenic environment for lasting change.

Listen to the full interview here: