University of Otago Prof Jim Mann, co-director of the Edgar Diabetes and Obesity Research Centre, advises caution on widely funding Wegovy (semaglutide), a GLP-1 medication for weight loss. With one-third of New Zealand adults obese, he argues for a targeted approach amid the nation's obesity epidemic.
Targeted Use for High-Risk Patients
Prof Mann believes certain groups would benefit most from Wegovy.
- People with heart disease or heart failure.
- Specific diabetes patients.
Pharmac should prioritize these, he says, but only within a comprehensive national obesity strategy.
GLP-1 Drugs Need Nutritional Support
While Wegovy and similar drugs promise dramatic weight loss, long-term success requires lifestyle changes. Prof Mann stresses:
- Nutritional counseling must accompany prescriptions.
- Weight regain is common upon stopping without better eating habits.
- No "magic bullet" exists for obesity.
"The minute you stop taking them, you'll gain weight if you haven't learned to have better eating habits," he warns.
Side Effects and Limited Experience
Despite hype as "miracles," these GLP-1 agonists are new. Potential side effects remain under study, unlike established drugs for blood pressure, diabetes, or cholesterol.
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Prof Mann calls for updated obesity treatment guidelines with Ministry of Health input, dormant for over a decade.
Access and Counseling Challenges in New Zealand
Wegovy costs $459.99 monthly in New Zealand, with Pharmac guidance expected soon. Counseling shortages hinder rollout:
- Inadequate in primary care.
- Limited even in hospitals.
"Nobody should be put on these drugs without detailed dietary counselling," Prof Mann insists.
International Context
In Australia, subsidies target patients with cardiovascular disease and BMI ≥35. Prof Mann supports limited high-risk prescribing but urges skepticism for broader use.
Apps like Shotlee can help track GLP-1 doses and nutrition, supporting Prof Mann's integrated approach.
