September 15, 2025 • 10 mins
Semaglutide drug Wegovy has been available in New Zealand for a couple of months now, and more Kiwis are learning about the effects.
The drug has transformed our ability to manage obesity and type 2 diabetes, and has shown potential for a wide range of conditions such as Alzheimer’s, addiction and depression.
General Practice NZ chair Dr Bryan Betty joined the Afternoons team to discuss further - and highlight some potential drawbacks.
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Speaker 1 (00:09):
You're listening to a podcast from News Talk zed B.
Follow this and our wide range of podcasts now on iHeartRadio.
Speaker 2 (00:16):
If you've noticed the bars around we go vie the
new weight loss injection promising quick results. You're not alone,
many many people undertaking that treatment, including former Ukraine correspondent
Lizette Rama. She wrote a story about it. So this
drug mimics a hormone in your gut which makes you
feel fall and it also interacts with your reward pathways,
so you're less likely to reach of things like chocolate
(00:37):
and ice cream.
Speaker 3 (00:38):
Yeah. Look, we've seen it everywhere. The Hollywood stars are
sucking it back like their tic TACs.
Speaker 2 (00:45):
They love it, ash.
Speaker 3 (00:46):
Hanim, it's an injection I keep getting for used in
that one strike that. But it's been incredibly popular and
it's been around for a while now, so lots of
you are either on it, I imagine, or thinking seriously
about it. So we want to talk about does it work,
how hard is it to get? And look, if it
is the panacea that some people claim it is, why
(01:06):
wouldn't you why wouldn't you just fire some of that
into your veins and lose the weight. Because we all
know how bad obesity is for people?
Speaker 2 (01:13):
Yeah, oh hundred not great for the old heart. No,
certainly not great for the heart. Oh one hundred and eighty.
Ten eighty is the number to call. Andrew is standing by,
but right now we're joined by doctor Brian Betty. He
is Chair of General Practice in z And. He's a
specialist GP based in Potty or doctor Betty. Very good
afternoon to you.
Speaker 4 (01:32):
Oh, good afternoon. It nice to be here.
Speaker 3 (01:34):
So how popular are these weight loss drugs in New
Zealand and who can get them and how hard is
it to access them?
Speaker 4 (01:41):
Oh, look, they got to prove a few months ago,
so they're relatively new to New Zealand, though they've been
around the world for a period of time. There's been
quite a large uptake in them. I've got to say.
I think there's over ten thousand patients who are probably
taking it at this point with a New Zealand. What
problems is are not subsidized by the government. So the injection,
(02:05):
which is a weekly injection, is expensive. It's about jenually
about five hundred to six hundred dollars per month, so
there's no subsidy on them. So it is an expensive medication.
But Yeah, big uptake in this particular medication since it arrived.
Speaker 3 (02:22):
So I didn't actually know that. I've been hearing so
much about it. I thought it had been available for
a bit longer than that. So you have to go
to the doctor. Do you have to prove anything to
get it or just ask for it?
Speaker 4 (02:32):
Well, look, I mean, look, there's a couple of issues
with it. I mean, you know, you need to have
a talk to your GP and to see whether it's
the right medication for you. It's not a panacea for
everyone with obesity. You know, there are some side effects
with it, so you do need to have a proper
assessment to work out whether it's the right medication. Yeah.
Then it's available on script, so you do have to
(02:53):
have a script for it to pick it up from
the chemist. And there's a couple of things about it.
You have to start at a lower dose for a month,
then you work the dose up over a month and
another month till you get to the maximum dose. So
it takes about four or five months to get to
the maximum dose. To see the weight loss, it's estimated
that many patients will lose about probably about fifteen percent
(03:13):
of their weight on it, So it is considered effective,
but it does have side effects and that's one of
the things that we need to be aware of.
Speaker 3 (03:23):
Now, how much you know, so I could go in
there maybe on five kg overweight? Is that if I
went into a doctor and something that I could fix
with just a reasonable, reasonably slight change in my diet
and exercise, would the doctor sign that off or does
it have to be an actual problem?
Speaker 2 (03:42):
Yeah?
Speaker 4 (03:43):
Look, look, I think five kilos overweight, you're looking at
diet and exercise in that situation, I don't think medication
or a weekly injection with potential side effects is the
way to go. It's generally the degree to which you
do have a weight problem. So we go on something
called a BMI, which is your height to weight ratio. Generally,
you know, over thirty to about thirty five you can
(04:05):
start to consider medication. Over thirty five medication it does
have an absolute role to play, and over forty it does.
We know we have bariatric surgery as an option for
if you do have a real weight problem and you
bemiz up around that forty mark, but certainly that thirty
thirty five as it goes up, there is a role
for it to play, But if you're just over the
(04:26):
normal weight, it's certainly something I wouldn't recommend.
Speaker 2 (04:29):
Would it be a better option than bariatric surgery for
those people who are sort of you know and just
in the obese camp doctor that you know? By all accounts,
it sounds like bariatric surgery offer obviously carries concerns and
dangers and risks. Would it be less risky than that?
Speaker 1 (04:46):
Well?
Speaker 4 (04:47):
Look, look, I mean, yeah, it's all swings and roundabouts,
isn't it. So certainly bariatric surgery does is surgery that
has inherent risks in terms of what happens, and it
can have complications. So yeah, if barrack surgery is not
an option, weight you know, weight management with diet and
exercise because that always underpins what actually goes on. So
(05:07):
so diet and excit this is incredibly important. Yeah, look,
it has a role to play, There's no doubt about it.
But I suppose one of the things to be aware
of that if you do lose the weight maybe over
one to two years that you're on the medication, what
all the studies show that if you come off the medication,
then the majority of people, ninety percent of people over
(05:28):
two years will put the weight back on. So the
body is very very good at reprogramming. It's reprogramming itself
and putting the weight back on. So there is a
line of thought now that is saying, look, these medications,
they can be effective, they do have a role to play,
but in fact they may be lifelong treatment, much like
we talk about with blood pressure medication and cholesterol medication
(05:53):
their lifetime treatments. It maybe we're in the space where
these types of medication actually are required for life. And
there's certainly a body of opinion that is starting to
think that.
Speaker 3 (06:04):
Well, they come down in price, because right now, if
it was a lifelong treatment, looking at what roughly you know,
over ten well and five hundred dollars a month, you know,
five hundred times twelve, you're looking at six thousand dollars
a year, aren't you. Yeah, So that's a lot to
spend over a lifetime. So it is a big investment,
isn't it.
Speaker 4 (06:23):
So will they come down in price? You're quite likely
over time that will happen. They'll become more available. Maybe
at some point they'll be subsidized by the government for
certain patients, maybe with certain conditions that really do need
treatment with weight loss medication. So yeah, that's possibly going
to happen over time. But yeah, you're right. I mean
that you're looking at five to six thousand dollars per year,
(06:44):
so it is a big commitment and it is something
that you know you need to think about and you
do need to discuss with your doctor about whether it's
the right choice for you to do that.
Speaker 3 (06:56):
Just to circle back a little bit, you were saying
that there were side effects and downsides, what exactly are those?
Speaker 4 (07:02):
Yeah, so look, the commonest side effect is actually gastro intestinal,
so that is a stomach things like nausea, which is
actually very very common. It can cause diarrhea occasionally constipation
if you don't drink enough water, and abdominal pain and
bloating are sort of the things that can be seen.
Often that's modified by advising that you have low fat
(07:23):
diet and don't eat large meals. There are more, more
less common but very important ones. So gall bladder issues
or gallstones can actually be a problem, and that's due
to rapid weight loss. So if you lose weight quickly,
we know that you can develop gallstones very quickly and
get a gall bladder problem. Pancreatitis is a rare complication
(07:44):
which can occur sometimes. And you know there's some other
other really really rare ones, but those are probably the sea.
So certainly that abdominal pain, bloating, diarrhea, nausea can be
quite common. Then the gall bladder and pancreatitis the two
of the other ones that we start to worry about a.
Speaker 3 (08:04):
Lot of time when I hear about diets, people say,
I just want to shock to the system. I want
to lose the twenty cage or whatever. I'm just making
up that number that I need to lose, and then
I need to make the lifestyle changes to stay there.
Is that a realistic thing? How many people actually pull
that on?
Speaker 4 (08:19):
Yeah, well, again, all the studies show that within two
years I've been on a weight loss treatment, often if
you come off it within two years, the weight goes
back on, and so.
Speaker 3 (08:29):
There is a lot of you often hear that the
weight and more goes on. And then some people are
talking about your reward pathways being changed because whatever discipline
you had is sort of turned off for the time
that you're on it, So when you come off, you
don't even have whatever discipline you did have. If discipline
is the right word I'm looking for.
Speaker 4 (08:47):
Yeah, so it's the body. Tabler's is really common thought
that the body starts to reset its metabolism at a
lower rate. If you lose weight like that, and as
you put the weight and take the medication away, start
to eat more calories and you'll go back to your
normal diet. Your metabolism set slightly lie and you tend
(09:11):
to put on the weight quite rapidly. So there's a
whole lot of interaction stuff that's going on that's only
just been starting to be understood. It's been really really
poorly understood. So the body is very very good at
allowing the weight to come back on often, so regardless
of diet and exercise. Yeah, yeah, yeah, so it tends
to predetermine where it sits and that can be a problem.
(09:33):
The other the other thing that people need to be
aware of is rapid weight loss is yeah, not a
great great thing to have happened. So if you lose
weight quickly, then put it on quickly, then lose weight again,
that's not a very very good thing for the body
at all.
Speaker 2 (09:48):
Yeah, doctor, really great to get your thoughts on this,
and really appreciate your time this afternoon.
Speaker 4 (09:53):
Great, no lovely to be here. Thank you.
Speaker 2 (09:56):
That is doctor Brian Betty's Chair of General Practice, New Zealand.
He's a specialist GP based in Partty Do
Speaker 1 (10:02):
For more from news Talks b listen live on air
or online, and keep our shows with you wherever you
go with our podcasts on iHeartRadio
You're listening to a podcast from News Talk zed B.
Follow this and our wide range of podcasts now on iHeartRadio.
Speaker 2 (00:16):
If you've noticed the bars around we go vie the
new weight loss injection promising quick results. You're not alone,
many many people undertaking that treatment, including former Ukraine correspondent
Lizette Rama. She wrote a story about it. So this
drug mimics a hormone in your gut which makes you
feel fall and it also interacts with your reward pathways,
so you're less likely to reach of things like chocolate
(00:37):
and ice cream.
Speaker 3 (00:38):
Yeah. Look, we've seen it everywhere. The Hollywood stars are
sucking it back like their tic TACs.
Speaker 2 (00:45):
They love it, ash.
Speaker 3 (00:46):
Hanim, it's an injection I keep getting for used in
that one strike that. But it's been incredibly popular and
it's been around for a while now, so lots of
you are either on it, I imagine, or thinking seriously
about it. So we want to talk about does it work,
how hard is it to get? And look, if it
is the panacea that some people claim it is, why
(01:06):
wouldn't you why wouldn't you just fire some of that
into your veins and lose the weight. Because we all
know how bad obesity is for people?
Speaker 2 (01:13):
Yeah, oh hundred not great for the old heart. No,
certainly not great for the heart. Oh one hundred and eighty.
Ten eighty is the number to call. Andrew is standing by,
but right now we're joined by doctor Brian Betty. He
is Chair of General Practice in z And. He's a
specialist GP based in Potty or doctor Betty. Very good
afternoon to you.
Speaker 4 (01:32):
Oh, good afternoon. It nice to be here.
Speaker 3 (01:34):
So how popular are these weight loss drugs in New
Zealand and who can get them and how hard is
it to access them?
Speaker 4 (01:41):
Oh, look, they got to prove a few months ago,
so they're relatively new to New Zealand, though they've been
around the world for a period of time. There's been
quite a large uptake in them. I've got to say.
I think there's over ten thousand patients who are probably
taking it at this point with a New Zealand. What
problems is are not subsidized by the government. So the injection,
(02:05):
which is a weekly injection, is expensive. It's about jenually
about five hundred to six hundred dollars per month, so
there's no subsidy on them. So it is an expensive medication.
But Yeah, big uptake in this particular medication since it arrived.
Speaker 3 (02:22):
So I didn't actually know that. I've been hearing so
much about it. I thought it had been available for
a bit longer than that. So you have to go
to the doctor. Do you have to prove anything to
get it or just ask for it?
Speaker 4 (02:32):
Well, look, I mean, look, there's a couple of issues
with it. I mean, you know, you need to have
a talk to your GP and to see whether it's
the right medication for you. It's not a panacea for
everyone with obesity. You know, there are some side effects
with it, so you do need to have a proper
assessment to work out whether it's the right medication. Yeah.
Then it's available on script, so you do have to
(02:53):
have a script for it to pick it up from
the chemist. And there's a couple of things about it.
You have to start at a lower dose for a month,
then you work the dose up over a month and
another month till you get to the maximum dose. So
it takes about four or five months to get to
the maximum dose. To see the weight loss, it's estimated
that many patients will lose about probably about fifteen percent
(03:13):
of their weight on it, So it is considered effective,
but it does have side effects and that's one of
the things that we need to be aware of.
Speaker 3 (03:23):
Now, how much you know, so I could go in
there maybe on five kg overweight? Is that if I
went into a doctor and something that I could fix
with just a reasonable, reasonably slight change in my diet
and exercise, would the doctor sign that off or does
it have to be an actual problem?
Speaker 2 (03:42):
Yeah?
Speaker 4 (03:43):
Look, look, I think five kilos overweight, you're looking at
diet and exercise in that situation, I don't think medication
or a weekly injection with potential side effects is the
way to go. It's generally the degree to which you
do have a weight problem. So we go on something
called a BMI, which is your height to weight ratio. Generally,
you know, over thirty to about thirty five you can
(04:05):
start to consider medication. Over thirty five medication it does
have an absolute role to play, and over forty it does.
We know we have bariatric surgery as an option for
if you do have a real weight problem and you
bemiz up around that forty mark, but certainly that thirty
thirty five as it goes up, there is a role
for it to play, But if you're just over the
(04:26):
normal weight, it's certainly something I wouldn't recommend.
Speaker 2 (04:29):
Would it be a better option than bariatric surgery for
those people who are sort of you know and just
in the obese camp doctor that you know? By all accounts,
it sounds like bariatric surgery offer obviously carries concerns and
dangers and risks. Would it be less risky than that?
Speaker 1 (04:46):
Well?
Speaker 4 (04:47):
Look, look, I mean, yeah, it's all swings and roundabouts,
isn't it. So certainly bariatric surgery does is surgery that
has inherent risks in terms of what happens, and it
can have complications. So yeah, if barrack surgery is not
an option, weight you know, weight management with diet and
exercise because that always underpins what actually goes on. So
(05:07):
so diet and excit this is incredibly important. Yeah, look,
it has a role to play, There's no doubt about it.
But I suppose one of the things to be aware
of that if you do lose the weight maybe over
one to two years that you're on the medication, what
all the studies show that if you come off the medication,
then the majority of people, ninety percent of people over
(05:28):
two years will put the weight back on. So the
body is very very good at reprogramming. It's reprogramming itself
and putting the weight back on. So there is a
line of thought now that is saying, look, these medications,
they can be effective, they do have a role to play,
but in fact they may be lifelong treatment, much like
we talk about with blood pressure medication and cholesterol medication
(05:53):
their lifetime treatments. It maybe we're in the space where
these types of medication actually are required for life. And
there's certainly a body of opinion that is starting to
think that.
Speaker 3 (06:04):
Well, they come down in price, because right now, if
it was a lifelong treatment, looking at what roughly you know,
over ten well and five hundred dollars a month, you know,
five hundred times twelve, you're looking at six thousand dollars
a year, aren't you. Yeah, So that's a lot to
spend over a lifetime. So it is a big investment,
isn't it.
Speaker 4 (06:23):
So will they come down in price? You're quite likely
over time that will happen. They'll become more available. Maybe
at some point they'll be subsidized by the government for
certain patients, maybe with certain conditions that really do need
treatment with weight loss medication. So yeah, that's possibly going
to happen over time. But yeah, you're right. I mean
that you're looking at five to six thousand dollars per year,
(06:44):
so it is a big commitment and it is something
that you know you need to think about and you
do need to discuss with your doctor about whether it's
the right choice for you to do that.
Speaker 3 (06:56):
Just to circle back a little bit, you were saying
that there were side effects and downsides, what exactly are those?
Speaker 4 (07:02):
Yeah, so look, the commonest side effect is actually gastro intestinal,
so that is a stomach things like nausea, which is
actually very very common. It can cause diarrhea occasionally constipation
if you don't drink enough water, and abdominal pain and
bloating are sort of the things that can be seen.
Often that's modified by advising that you have low fat
(07:23):
diet and don't eat large meals. There are more, more
less common but very important ones. So gall bladder issues
or gallstones can actually be a problem, and that's due
to rapid weight loss. So if you lose weight quickly,
we know that you can develop gallstones very quickly and
get a gall bladder problem. Pancreatitis is a rare complication
(07:44):
which can occur sometimes. And you know there's some other
other really really rare ones, but those are probably the sea.
So certainly that abdominal pain, bloating, diarrhea, nausea can be
quite common. Then the gall bladder and pancreatitis the two
of the other ones that we start to worry about a.
Speaker 3 (08:04):
Lot of time when I hear about diets, people say,
I just want to shock to the system. I want
to lose the twenty cage or whatever. I'm just making
up that number that I need to lose, and then
I need to make the lifestyle changes to stay there.
Is that a realistic thing? How many people actually pull
that on?
Speaker 4 (08:19):
Yeah, well, again, all the studies show that within two
years I've been on a weight loss treatment, often if
you come off it within two years, the weight goes
back on, and so.
Speaker 3 (08:29):
There is a lot of you often hear that the
weight and more goes on. And then some people are
talking about your reward pathways being changed because whatever discipline
you had is sort of turned off for the time
that you're on it, So when you come off, you
don't even have whatever discipline you did have. If discipline
is the right word I'm looking for.
Speaker 4 (08:47):
Yeah, so it's the body. Tabler's is really common thought
that the body starts to reset its metabolism at a
lower rate. If you lose weight like that, and as
you put the weight and take the medication away, start
to eat more calories and you'll go back to your
normal diet. Your metabolism set slightly lie and you tend
(09:11):
to put on the weight quite rapidly. So there's a
whole lot of interaction stuff that's going on that's only
just been starting to be understood. It's been really really
poorly understood. So the body is very very good at
allowing the weight to come back on often, so regardless
of diet and exercise. Yeah, yeah, yeah, so it tends
to predetermine where it sits and that can be a problem.
(09:33):
The other the other thing that people need to be
aware of is rapid weight loss is yeah, not a
great great thing to have happened. So if you lose
weight quickly, then put it on quickly, then lose weight again,
that's not a very very good thing for the body
at all.
Speaker 2 (09:48):
Yeah, doctor, really great to get your thoughts on this,
and really appreciate your time this afternoon.
Speaker 4 (09:53):
Great, no lovely to be here. Thank you.
Speaker 2 (09:56):
That is doctor Brian Betty's Chair of General Practice, New Zealand.
He's a specialist GP based in Partty Do
Speaker 1 (10:02):
For more from news Talks b listen live on air
or online, and keep our shows with you wherever you
go with our podcasts on iHeartRadio
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