Ozempic restrictions for weight loss ‘unfair’, obesity expert says

A diabetes drug proven to help with weight loss has been limited for use in diabetics only — but an obesity expert has called on the health regulator to remove the “unfair” restrictions.

A world obesity expert has called for the current restrictions on the diabetes drug Ozempic to be lifted for those suffering obesity.

In the face of a global shortage, the Therapeutic Goods Administration has recommended Ozempic be prioritised for Type 2 diabetics only, but Professor Joseph Proietto, chair of the Clinical Care Committee of World Obesity, has written to the TGA arguing “the situation is unfair” on obese patients.

“It should not be just restricted to diabetes, I’ve complained about their directive to favour diabetics, a lot of my obese patients are now being shamed by pharmacists to go away and eat less,” Prof Proietto said.

Novo Nordisk Pharmaceuticals, the makers of Ozempic notified the Therapeutic Goods Administration (TGA) of a shortage due to an increase in consumer demand from extensive off-label prescribing for obesity management, for which Ozempic is not indicated.

Prof Proietto, an endocrinologist specialising in both diabetes and obesity, pointed out to the TGA that Ozempic was one of the few drugs that worked for obese patients while diabetics had a range of 11 separate drugs they could use. Claims that diabetics needed Ozempic exclusively for their survival were wrong, he said.

Obesity expert Prof Joseph Proietto has urged the TGA to drop Ozempic restrictions.

“That’s complete rubbish, it’s not true because there are plenty of agents that lower blood sugar.

“I pointed out to the TGA diabetics already have the other analogs of this hormone, Byeta and Bydureon, Trulicity, they have insulin, sulfonylureas, DPP4 inhibitors, metformin, acarbose, thiazolidenediones and the list goes on.

“Obesity is basically genetic, you cannot develop it without a gene,” Prof Proietto said, adding these genes conspire to defend weight and increase hunger after weight loss leading to patients regaining losses.

Ozempic is successful for weight loss because it mimics a human hormone, glucagon-like peptide 1GLP-1, that slows the emptying of the stomach and also suppresses hunger, he said.

“If you don’t have a medication to suppress hunger, you gain weight, this is why current public health measures never work for obesity,” he said.

People with obesity have access to only three drugs, Contrave, an old drug, Duromine, which has many contraindications, and Ozempic which is currently prescribed off label.

Diabetes medicine semaglutide called Ozempic . Picture: Supplied

An alternative to Ozempic is Saxenda, a daily injection that costs three times as much as Ozempic which is a weekly injection - $378 a month as opposed to around $140 for Ozempic.

Prof Proietto also said the restrictions were leading to “fat shaming” of patients.

“We’ve have hundreds of distressed patients calling saying they are regaining weight and I can’t get Ozempic and the chemists are shaming people with obesity and saying, ‘Why are you coming to get this for weight, when you don’t have diabetes?’”

Prof Proietta also urged the TGA to consider the health impacts of obesity which include cancer, cardiovascular disease, metabolic disease and a host of other complications.

“Obesity has a lot more complications than diabetes, no system is spared from obesity and top of the list it causes is diabetes,” he said,

The shortage in Australia has been blamed on TikTok influencers sharing their weight loss journey, but the shortage is global and bit hard after Elon Musk tweeted to his 103,000 followers in March “Ozempic…appears to be effective in appetite control.

Sue Tremlett, 60, from Llandilo in Western Sydney said she had been booked to have gastric sleeve surgery earlier this year when her surgeon suggested she try Ozempic.

Sue Tremlett has been shamed at the pharmacy for trying to fill an Ozempic script. Picture: Supplied

“The surgeon, instead of cutting me open, had the ethics to say ‘let’s try Ozempic’. So from April to now, I have lost 19kg and am delighted. Then with the shortages, I’ve been treated like I’m a fat greedy old lady by pharmacy staff,” Ms Tremlett said.

“My biggest issue is just the treatment by pharmacy staff and inaccessibility. One staff member at one pharmacy reduced me to tears with her behaviour.

“I would challenge the government to make this available for people like me, who are in the morbidly obese category with the prospects of diabetes looming, the opportunity to get this a bit more freely.

“If we don’t treat the weight issue and we become diabetic, the costs to the government ongoing would surpass the costs of having the Ozempic.”

Earlier this year, Kristen Hayes from Brisbane was pre-diabetic and insulin resistant with a family history of diabetes.

Kirsten Hayes has not been able to get Ozempic. Picture: Supplied

She also had high blood pressure after a 30kg weight gain due to a hormone imbalance.

“I’d tried every diet, then my doctor suggested Ozempic and I finally started losing weight. I’ve lost 14kg, I was on blood pressure tablets, I don’t have that anymore, and I’m off them.”

“Other issues corrected also, but now I can‘t get it. It’s been out for five weeks and I’m too scared to check my weight.

“There are so many diabetic medications out there and there is only this for people like me. I feel discriminated against, more by those making the rules, like the TGA,” she said.

A spokesman for Novo Nordisk said the company was: “expanding its global capacity at our production sites in Denmark to ensure we meet the strong global demand for Ozempic in Australia, and we anticipate being able to support an increase in local supply availability in 2023.”