A New Era in Weight Management and Chronic Disease Treatment

Earlier this week, semaglutide-based drugs Ozempic and Wegovy became available for prescription in New Zealand. Originally approved in the United States in 2017 for managing type 2 diabetes, these medications have rapidly gained attention for their remarkable ability to induce weight loss. Their arrival in New Zealand has ignited a national conversation about obesity, health, and the potential risks and benefits of these powerful drugs.

A Breakthrough in Chronic Disease Management

Developed to treat type 2 diabetes, Ozempic and Wegovy function by mimicking a hormone that regulates appetite and glucose levels in the body. Their side effect—significant weight loss—has led to their growing use in weight management, despite not being officially approved for that purpose in many countries. These drugs have shown promise beyond weight loss, with preliminary studies suggesting potential benefits in treating conditions such as Alzheimer’s, addiction, and depression.

Grace Wade, a health reporter based in the U.S., highlighted the potential of semaglutide to reduce cravings for addictive substances like alcohol and nicotine. This effect is attributed to the drug’s influence on brain regions responsible for reward and craving, offering hope for individuals struggling with substance use disorders.

The Risks and Side Effects

Despite their benefits, semaglutide drugs are not without risks. One of the most concerning side effects is the risk of non-arteritic anterior ischemic optic neuropathy (NAION), a condition linked to reduced blood flow to the optic nerve. This can lead to sudden, often permanent vision loss in one eye. While not total blindness, the damage can cause cloudiness and visual impairment.

According to a 2024 study, individuals taking semaglutide for diabetes were 4.3 times more likely to develop this condition, and those using it for weight loss were 7.6 times more likely. This has raised alarms among health professionals who caution about the long-term safety of widespread use.

Other common side effects include gastrointestinal issues such as constipation, bloating, heartburn, and frequent trips to the bathroom. Additionally, users may experience an overall weight loss that includes the breakdown of muscle and even bone, which can lead to a loss of lean body mass. This has prompted experts to emphasize the importance of physical activity when using these drugs to preserve muscle and prevent rapid weight regain after discontinuation.

The "Ozempic Face" Phenomenon

Another emerging concern is the so-called "Ozempic face," a term that has gained traction on social media. Users have reported a hollowed or sunken facial appearance, likely due to the significant fat loss in the face. While not a medical condition per se, this aesthetic change has raised questions about the broader implications of rapid, untargeted weight loss and its impact on skin elasticity and facial structure.

Cost and Accessibility Challenges

With an estimated monthly cost of $500, Wegovy is out of reach for many New Zealanders, particularly those who are overweight or obese. Approximately 65% of the population falls into these categories, yet access to the drug remains limited due to its high price and lack of widespread insurance coverage. This has sparked a debate about whether such medications should be subsidized or made more accessible to those in need.

The Future of Semaglutide Research

Scientists are actively exploring new drugs that mimic the beneficial effects of semaglutide without the weight loss component, particularly for older or frail patients who may not benefit from rapid weight reduction. Researchers are also investigating the mechanisms behind semaglutide’s wide-ranging effects, including its potential to reduce heart attacks and strokes, improve fertility, and slow cognitive decline.

Grace Wade emphasized the uniqueness of semaglutide drugs, noting that they are among the few medications with the potential to treat a wide array of conditions. However, she also stressed the need for caution and further research before these drugs are recommended for widespread use.

"Let’s unravel how they can treat all of these conditions before we jump the gun and start suggesting we, you know, maybe put it in everyone’s water or something," Wade said, highlighting the importance of evidence-based medicine and responsible drug use.

As the debate continues, one thing is clear: Ozempic and Wegovy are reshaping the landscape of chronic disease and weight management. Their benefits are undeniable, but so are the risks. The challenge now lies in balancing innovation with safety to ensure that these drugs are used responsibly and to the greatest benefit of patients.