Weight loss medications like Wegovy are effective, but not without risks. Healthy Food Guide investigates some of the plusses and pitfalls of these drugs.
For some, the idea of being able to take medication to lose weight might seem like a dream come true. Living with obesity and under the looming shadow of a long list of potential chronic health problems (and the accompanying stigma) is a reality for around one in three adults in New Zealand and just shy of that number in Australia. Weight loss isn’t straightforward and many people who want to reach and maintain a healthy weight range struggle, for a variety of valid yet often poorly understood reasons.
When celebrity tales of rapid weight loss linked to diabetes drugs started infiltrating our screens and social media feeds we all naturally – albeit a little skeptically – took notice. Diabetes drug Ozempic we learned, was a medication belonging to a class called GLP-1 receptor agonists in the form of something called semaglutide. Glucagon-like peptide-1 (GLP-1) is a metabolic hormone that helps lower blood glucose levels in our body, and affects areas of the brain that signal hunger and fullness.
GLP-1 receptor agonists, like semaglutide, work by mimicking this hormone. Semaglutide first entered the US market in 2017 as diabetes medication Ozempic. In August last year drug manufacturer Novo Nordisk launched Wegovy to the Australian market, and from 1 July 2025 it became available to buy on prescription in New Zealand. Like Ozempic, Wegovy is an injectable semaglutide medication, but is a higher dose and approved as an adjunct to diet and exercise for weight loss, whereas Ozempic was meant for type 2 diabetes, but used off-label for weight loss. Now that these weight loss medications are more widely available Down Under, it’s important to be informed about their potential benefits and risks.
1. Effectiveness for weight loss
Studies show semaglutides can help with long-term weight loss in people with obesity, especially when combined with a healthy diet and regular exercise. Clinical trials have demonstrated significant weight loss, with participants shedding an average of 15 per cent of their body weight. In an interview for Johns Hopkins news centre Hub, gastroenterologist Sameer Khan said it wasn’t completely clear the mechanism by which these medicines worked for weight loss, but they did slow digestion, and appeared to affect the brain to regulate appetite.
Wegovy and Ozempic are self-injected once a week and activate the GLP-1 receptors that are responsible for insulin production, regulating blood sugar levels, appetite and gastric emptying. People eat less as they don’t feel as hungry and crave food less.
2. Shutting down food noise
Some people who use semaglutide report that it quietens ‘food noise’. Their thoughts are no longer occupied by what they’ll eat next, and the associated feelings and behaviours stop. Evidence around food noise is largely anecdotal, but it’s growing in relation to GLP-1 RA use, and could be a helpful area to explore for better understanding of factors that affect food cue reactivity and its outcomes on human eating behavior and health, according to researchers in a 2023 paper in the journal Nutrients.
3. Rebound weight gain
Wegovy and other GLP-1 RAs can help with weight loss, but they don’t treat all the underlying causes of overweight and obesity, which are multiple and complex. So once the medication is discontinued, weight is often regained. A recent meta-analysis for anti-obesity medications, including GLP-1 RAs, found they were associated with significant weight loss while being used, but followed by weight regain starting eight weeks after discontinuation and continuing for an average of 20 weeks before plateauing. This means drugs like Wegovy could be a lifetime commitment for some patients.
4. Side effects
Like any medication, semaglutides come with a list of potential side effects. Side effects and their severity will vary from person to person.
ACCORDING TO MEDSAFE, VERY COMMON SIDE EFFECTS INCLUDE:
❉ Headache
❉ Vomiting
❉ Diarrhoea
❉ Constipation
❉ Nausea
❉ Abdominal pain
❉ Fatigue
COMMON SIDE EFFECTS:
❉ Hypoglycaemia in people with type 2 diabetes
❉ Dizziness
❉ Dysgeusia (taste disorder)
❉ Eructation (belching)
❉ Flatulence
❉ Abdominal distension
❉ Dry mouth
❉ Cholelithiasis (gallstones)
❉ Hair loss
❉ Injection site reactions
UNCOMMON ADVERSE REACTIONS:
❉ Increased heart rate
❉ Acute pancreatitis
❉ Delayed gastric emptying
❉ Increased amylase (an enzyme that helps digest
carbs and elevates in blood when pancreas is
diseased or inflamed)
❉ Increased lipase (an enzyme that helps break
down fat and may signal pancreatic disorders)
RARE ADVERSE REACTIONS:
❉ Anaphylaxis
5. Overall disease risk improvement
A recent analysis of 215,970 GLP-1 RA users for type 2 diabetes found both positive and negative health effects, including a decreased risk of 42 health outcomes but an increased risk of 19, compared with usual treatments. Lowered disease risk included Alzheimer’s disease and dementia, infectious illnesses, seizures and disorders that lead to cardiovascular disease. But increased risk was seen for gastrointestinal conditions, hypotension, syncope and arthritis. Further investigation is needed though, because the study cohort comprised mostly older white males, and all were living with diabetes.
6. Pregnancy and contraception
Wegovy and Ozempic are not recommended during pregnancy, and animal trials have found that they may be linked to birth defects. If you’re pregnant or planning to have a baby it’s vital to ask your GP for advice. If you have had fertility issues related to overweight or obesity, your fertility may increase with weight loss, so it’s very important to use an effective contraception to avoid unplanned pregnancy while you’re taking either of these medications.
7. Staying nourished and hydrated
Because semaglutide use is associated with reduced appetite and gastrointestinal issues like diarrhoea and vomiting, you may be more at risk of nutrient deficiencies and dehydration. It’s important to focus on nutrient-dense foods to get the most out of your smaller portions. Accredited practising dietitian Jess Burvill says to prioritise protein to preserve muscle. Think fish, eggs, tofu, legumes, lean meats, Greek yoghurt and cheese. Jess also says fibre-rich foods like whole grains, fruit and veg, legumes, nuts and seeds help stabilise blood sugar levels and promote digestive health. Smoothies (ideally high in protein), soups and meal replacement bars are good snack options if larger meals are difficult. Aim to drink two to three litres of water daily to prevent constipation, help manage nausea and prevent dehydration. If you’re concerned about deficiencies, your doctor can provide a blood test to see if you need supplements to fill in any nutrient gaps.
8. High costs
Wegovy for weight loss isn’t subsidised in New Zealand or Australia, so it comes with a hefty price tag that is simply unaffordable for many people. Kiwis can expect to pay about NZ$500 a month for Wegovy, while Australians need to fork out around AU$450-500. Given many people who take the medication will need to commit to it for life, the cost limits who can access the treatment.
9. Eating disorders
Restrictive eating and pro weight loss messaging can be triggers for eating disorders like anorexia nervosa and bulimia. Case studies of eating disorder patients misusing GLP-1 RA medications have been highlighted in the US. It’s important doctors screen patients for eating disorders and other mental health conditions before prescribing medicines such as Wegovy. In The Conversation, psychology academics Lindsay Bodell and Samantha Withnell warn that the combination of appetite signal interference, potential for weight regain after stopping use, weight suppression and stigmatising conversations around body weight and image is a recipe for disaster when it comes to eating disorder risk.
The bottom line
For people with obesity, or overweight with related health conditions, GLP-1 RAs like Wegovy can offer an effective way to lose weight when lifestyle changes like healthy diet and exercise haven’t worked on their own. But their use requires careful consideration. These drugs work well (alongside healthy eating and regular physical activity), but they cost a lot of money and can have ranging side effects, which make them unsuitable for some people. And if you do take weight loss medications like Wegovy, following a nutrient-dense eating pattern and drinking plenty of water is essential to avoid potential deficiencies and dehydration. Finally, eating disorder experts warn that the effects of and discussion around weight loss drugs can be triggering for some people, with very serious consequences. If you have concerns about eating disorders, contact EDANZ in New Zealand (ed.org.nz) or EDFA in Australia (edfa.org.au).
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