1 00:00:09,093 --> 00:00:11,972 Speaker 1: You're listening to a podcast from News Talk zed B. 2 00:00:12,373 --> 00:00:16,133 Speaker 1: Follow this and our wide range of podcasts now on iHeartRadio. 3 00:00:16,613 --> 00:00:18,772 Speaker 2: If you've noticed the bars around we go vie the 4 00:00:18,813 --> 00:00:22,172 Speaker 2: new weight loss injection promising quick results. You're not alone, 5 00:00:22,213 --> 00:00:26,733 Speaker 2: many many people undertaking that treatment, including former Ukraine correspondent 6 00:00:26,732 --> 00:00:29,013 Speaker 2: Lizette Rama. She wrote a story about it. So this 7 00:00:29,493 --> 00:00:31,772 Speaker 2: drug mimics a hormone in your gut which makes you 8 00:00:31,813 --> 00:00:35,253 Speaker 2: feel fall and it also interacts with your reward pathways, 9 00:00:35,293 --> 00:00:37,933 Speaker 2: so you're less likely to reach of things like chocolate 10 00:00:37,973 --> 00:00:38,533 Speaker 2: and ice cream. 11 00:00:38,653 --> 00:00:41,493 Speaker 3: Yeah. Look, we've seen it everywhere. The Hollywood stars are 12 00:00:41,732 --> 00:00:44,053 Speaker 3: sucking it back like their tic TACs. 13 00:00:45,293 --> 00:00:46,092 Speaker 2: They love it, ash. 14 00:00:46,013 --> 00:00:47,812 Speaker 3: Hanim, it's an injection I keep getting for used in 15 00:00:47,812 --> 00:00:51,492 Speaker 3: that one strike that. But it's been incredibly popular and 16 00:00:51,533 --> 00:00:54,493 Speaker 3: it's been around for a while now, so lots of 17 00:00:54,533 --> 00:00:58,093 Speaker 3: you are either on it, I imagine, or thinking seriously 18 00:00:58,173 --> 00:01:00,173 Speaker 3: about it. So we want to talk about does it work, 19 00:01:00,733 --> 00:01:03,533 Speaker 3: how hard is it to get? And look, if it 20 00:01:03,613 --> 00:01:06,693 Speaker 3: is the panacea that some people claim it is, why 21 00:01:06,693 --> 00:01:09,333 Speaker 3: wouldn't you why wouldn't you just fire some of that 22 00:01:09,333 --> 00:01:11,693 Speaker 3: into your veins and lose the weight. Because we all 23 00:01:11,733 --> 00:01:13,452 Speaker 3: know how bad obesity is for people? 24 00:01:13,572 --> 00:01:17,013 Speaker 2: Yeah, oh hundred not great for the old heart. No, 25 00:01:17,173 --> 00:01:19,012 Speaker 2: certainly not great for the heart. Oh one hundred and eighty. 26 00:01:19,053 --> 00:01:21,773 Speaker 2: Ten eighty is the number to call. Andrew is standing by, 27 00:01:21,893 --> 00:01:24,093 Speaker 2: but right now we're joined by doctor Brian Betty. He 28 00:01:24,253 --> 00:01:26,853 Speaker 2: is Chair of General Practice in z And. He's a 29 00:01:26,893 --> 00:01:30,333 Speaker 2: specialist GP based in Potty or doctor Betty. Very good 30 00:01:30,333 --> 00:01:30,933 Speaker 2: afternoon to you. 31 00:01:32,572 --> 00:01:34,092 Speaker 4: Oh, good afternoon. It nice to be here. 32 00:01:34,652 --> 00:01:36,893 Speaker 3: So how popular are these weight loss drugs in New 33 00:01:36,973 --> 00:01:39,053 Speaker 3: Zealand and who can get them and how hard is 34 00:01:39,093 --> 00:01:41,453 Speaker 3: it to access them? 35 00:01:41,773 --> 00:01:46,453 Speaker 4: Oh, look, they got to prove a few months ago, 36 00:01:46,932 --> 00:01:49,533 Speaker 4: so they're relatively new to New Zealand, though they've been 37 00:01:49,613 --> 00:01:53,573 Speaker 4: around the world for a period of time. There's been 38 00:01:53,653 --> 00:01:55,493 Speaker 4: quite a large uptake in them. I've got to say. 39 00:01:56,013 --> 00:01:58,533 Speaker 4: I think there's over ten thousand patients who are probably 40 00:01:58,573 --> 00:02:01,453 Speaker 4: taking it at this point with a New Zealand. What 41 00:02:01,613 --> 00:02:05,093 Speaker 4: problems is are not subsidized by the government. So the injection, 42 00:02:05,253 --> 00:02:09,053 Speaker 4: which is a weekly injection, is expensive. It's about jenually 43 00:02:09,093 --> 00:02:12,213 Speaker 4: about five hundred to six hundred dollars per month, so 44 00:02:12,253 --> 00:02:15,293 Speaker 4: there's no subsidy on them. So it is an expensive medication. 45 00:02:16,253 --> 00:02:21,853 Speaker 4: But Yeah, big uptake in this particular medication since it arrived. 46 00:02:22,293 --> 00:02:24,053 Speaker 3: So I didn't actually know that. I've been hearing so 47 00:02:24,133 --> 00:02:25,693 Speaker 3: much about it. I thought it had been available for 48 00:02:25,733 --> 00:02:27,333 Speaker 3: a bit longer than that. So you have to go 49 00:02:27,373 --> 00:02:29,933 Speaker 3: to the doctor. Do you have to prove anything to 50 00:02:30,013 --> 00:02:31,213 Speaker 3: get it or just ask for it? 51 00:02:32,853 --> 00:02:35,013 Speaker 4: Well, look, I mean, look, there's a couple of issues 52 00:02:35,053 --> 00:02:36,453 Speaker 4: with it. I mean, you know, you need to have 53 00:02:36,453 --> 00:02:38,373 Speaker 4: a talk to your GP and to see whether it's 54 00:02:38,373 --> 00:02:40,933 Speaker 4: the right medication for you. It's not a panacea for 55 00:02:41,133 --> 00:02:45,013 Speaker 4: everyone with obesity. You know, there are some side effects 56 00:02:45,093 --> 00:02:46,852 Speaker 4: with it, so you do need to have a proper 57 00:02:46,893 --> 00:02:50,692 Speaker 4: assessment to work out whether it's the right medication. Yeah. 58 00:02:50,773 --> 00:02:53,213 Speaker 4: Then it's available on script, so you do have to 59 00:02:53,252 --> 00:02:54,972 Speaker 4: have a script for it to pick it up from 60 00:02:54,972 --> 00:02:57,413 Speaker 4: the chemist. And there's a couple of things about it. 61 00:02:57,453 --> 00:02:59,773 Speaker 4: You have to start at a lower dose for a month, 62 00:03:00,093 --> 00:03:02,053 Speaker 4: then you work the dose up over a month and 63 00:03:02,093 --> 00:03:04,333 Speaker 4: another month till you get to the maximum dose. So 64 00:03:04,373 --> 00:03:06,252 Speaker 4: it takes about four or five months to get to 65 00:03:06,293 --> 00:03:10,013 Speaker 4: the maximum dose. To see the weight loss, it's estimated 66 00:03:10,093 --> 00:03:13,893 Speaker 4: that many patients will lose about probably about fifteen percent 67 00:03:13,933 --> 00:03:16,893 Speaker 4: of their weight on it, So it is considered effective, 68 00:03:18,093 --> 00:03:20,773 Speaker 4: but it does have side effects and that's one of 69 00:03:20,813 --> 00:03:22,373 Speaker 4: the things that we need to be aware of. 70 00:03:23,373 --> 00:03:25,653 Speaker 3: Now, how much you know, so I could go in 71 00:03:25,693 --> 00:03:29,133 Speaker 3: there maybe on five kg overweight? Is that if I 72 00:03:29,133 --> 00:03:32,573 Speaker 3: went into a doctor and something that I could fix 73 00:03:32,653 --> 00:03:36,053 Speaker 3: with just a reasonable, reasonably slight change in my diet 74 00:03:36,133 --> 00:03:39,653 Speaker 3: and exercise, would the doctor sign that off or does 75 00:03:39,653 --> 00:03:42,213 Speaker 3: it have to be an actual problem? 76 00:03:42,813 --> 00:03:43,053 Speaker 2: Yeah? 77 00:03:43,093 --> 00:03:45,693 Speaker 4: Look, look, I think five kilos overweight, you're looking at 78 00:03:45,733 --> 00:03:49,053 Speaker 4: diet and exercise in that situation, I don't think medication 79 00:03:49,253 --> 00:03:52,413 Speaker 4: or a weekly injection with potential side effects is the 80 00:03:52,453 --> 00:03:55,493 Speaker 4: way to go. It's generally the degree to which you 81 00:03:55,533 --> 00:03:58,053 Speaker 4: do have a weight problem. So we go on something 82 00:03:58,093 --> 00:04:01,893 Speaker 4: called a BMI, which is your height to weight ratio. Generally, 83 00:04:02,133 --> 00:04:05,373 Speaker 4: you know, over thirty to about thirty five you can 84 00:04:05,413 --> 00:04:08,813 Speaker 4: start to consider medication. Over thirty five medication it does 85 00:04:08,853 --> 00:04:11,853 Speaker 4: have an absolute role to play, and over forty it does. 86 00:04:12,213 --> 00:04:14,493 Speaker 4: We know we have bariatric surgery as an option for 87 00:04:14,533 --> 00:04:16,413 Speaker 4: if you do have a real weight problem and you 88 00:04:16,493 --> 00:04:20,053 Speaker 4: bemiz up around that forty mark, but certainly that thirty 89 00:04:20,173 --> 00:04:23,453 Speaker 4: thirty five as it goes up, there is a role 90 00:04:23,573 --> 00:04:26,173 Speaker 4: for it to play, But if you're just over the 91 00:04:26,213 --> 00:04:28,773 Speaker 4: normal weight, it's certainly something I wouldn't recommend. 92 00:04:29,173 --> 00:04:32,813 Speaker 2: Would it be a better option than bariatric surgery for 93 00:04:32,853 --> 00:04:35,333 Speaker 2: those people who are sort of you know and just 94 00:04:35,453 --> 00:04:38,613 Speaker 2: in the obese camp doctor that you know? By all accounts, 95 00:04:38,653 --> 00:04:42,853 Speaker 2: it sounds like bariatric surgery offer obviously carries concerns and 96 00:04:42,933 --> 00:04:45,413 Speaker 2: dangers and risks. Would it be less risky than that? 97 00:04:46,893 --> 00:04:47,133 Speaker 1: Well? 98 00:04:47,133 --> 00:04:49,653 Speaker 4: Look, look, I mean, yeah, it's all swings and roundabouts, 99 00:04:49,733 --> 00:04:53,053 Speaker 4: isn't it. So certainly bariatric surgery does is surgery that 100 00:04:53,133 --> 00:04:55,733 Speaker 4: has inherent risks in terms of what happens, and it 101 00:04:55,773 --> 00:04:59,613 Speaker 4: can have complications. So yeah, if barrack surgery is not 102 00:04:59,653 --> 00:05:03,613 Speaker 4: an option, weight you know, weight management with diet and 103 00:05:03,653 --> 00:05:07,413 Speaker 4: exercise because that always underpins what actually goes on. So 104 00:05:07,413 --> 00:05:10,613 Speaker 4: so diet and excit this is incredibly important. Yeah, look, 105 00:05:10,653 --> 00:05:13,413 Speaker 4: it has a role to play, There's no doubt about it. 106 00:05:13,733 --> 00:05:15,813 Speaker 4: But I suppose one of the things to be aware 107 00:05:15,853 --> 00:05:18,653 Speaker 4: of that if you do lose the weight maybe over 108 00:05:18,693 --> 00:05:21,613 Speaker 4: one to two years that you're on the medication, what 109 00:05:21,773 --> 00:05:24,733 Speaker 4: all the studies show that if you come off the medication, 110 00:05:25,693 --> 00:05:28,573 Speaker 4: then the majority of people, ninety percent of people over 111 00:05:28,613 --> 00:05:31,133 Speaker 4: two years will put the weight back on. So the 112 00:05:31,173 --> 00:05:35,573 Speaker 4: body is very very good at reprogramming. It's reprogramming itself 113 00:05:35,893 --> 00:05:38,453 Speaker 4: and putting the weight back on. So there is a 114 00:05:38,533 --> 00:05:41,573 Speaker 4: line of thought now that is saying, look, these medications, 115 00:05:41,693 --> 00:05:44,773 Speaker 4: they can be effective, they do have a role to play, 116 00:05:45,413 --> 00:05:48,333 Speaker 4: but in fact they may be lifelong treatment, much like 117 00:05:48,413 --> 00:05:52,973 Speaker 4: we talk about with blood pressure medication and cholesterol medication 118 00:05:53,013 --> 00:05:56,853 Speaker 4: their lifetime treatments. It maybe we're in the space where 119 00:05:56,893 --> 00:06:01,093 Speaker 4: these types of medication actually are required for life. And 120 00:06:01,133 --> 00:06:04,133 Speaker 4: there's certainly a body of opinion that is starting to 121 00:06:04,173 --> 00:06:04,573 Speaker 4: think that. 122 00:06:04,973 --> 00:06:07,093 Speaker 3: Well, they come down in price, because right now, if 123 00:06:07,093 --> 00:06:10,653 Speaker 3: it was a lifelong treatment, looking at what roughly you know, 124 00:06:10,693 --> 00:06:13,493 Speaker 3: over ten well and five hundred dollars a month, you know, 125 00:06:13,573 --> 00:06:16,853 Speaker 3: five hundred times twelve, you're looking at six thousand dollars 126 00:06:16,853 --> 00:06:19,453 Speaker 3: a year, aren't you. Yeah, So that's a lot to 127 00:06:19,493 --> 00:06:23,013 Speaker 3: spend over a lifetime. So it is a big investment, 128 00:06:23,093 --> 00:06:23,413 Speaker 3: isn't it. 129 00:06:23,493 --> 00:06:26,133 Speaker 4: So will they come down in price? You're quite likely 130 00:06:26,253 --> 00:06:29,573 Speaker 4: over time that will happen. They'll become more available. Maybe 131 00:06:29,613 --> 00:06:32,613 Speaker 4: at some point they'll be subsidized by the government for 132 00:06:32,773 --> 00:06:36,533 Speaker 4: certain patients, maybe with certain conditions that really do need 133 00:06:36,613 --> 00:06:39,453 Speaker 4: treatment with weight loss medication. So yeah, that's possibly going 134 00:06:39,533 --> 00:06:42,293 Speaker 4: to happen over time. But yeah, you're right. I mean 135 00:06:42,373 --> 00:06:44,853 Speaker 4: that you're looking at five to six thousand dollars per year, 136 00:06:44,933 --> 00:06:49,173 Speaker 4: so it is a big commitment and it is something 137 00:06:49,213 --> 00:06:51,813 Speaker 4: that you know you need to think about and you 138 00:06:51,853 --> 00:06:54,093 Speaker 4: do need to discuss with your doctor about whether it's 139 00:06:54,093 --> 00:06:56,293 Speaker 4: the right choice for you to do that. 140 00:06:56,693 --> 00:06:58,333 Speaker 3: Just to circle back a little bit, you were saying 141 00:06:58,373 --> 00:07:01,253 Speaker 3: that there were side effects and downsides, what exactly are those? 142 00:07:02,733 --> 00:07:06,933 Speaker 4: Yeah, so look, the commonest side effect is actually gastro intestinal, 143 00:07:06,973 --> 00:07:09,653 Speaker 4: so that is a stomach things like nausea, which is 144 00:07:09,693 --> 00:07:13,933 Speaker 4: actually very very common. It can cause diarrhea occasionally constipation 145 00:07:14,013 --> 00:07:16,653 Speaker 4: if you don't drink enough water, and abdominal pain and 146 00:07:16,693 --> 00:07:18,933 Speaker 4: bloating are sort of the things that can be seen. 147 00:07:19,613 --> 00:07:22,933 Speaker 4: Often that's modified by advising that you have low fat 148 00:07:23,053 --> 00:07:27,693 Speaker 4: diet and don't eat large meals. There are more, more 149 00:07:28,613 --> 00:07:31,573 Speaker 4: less common but very important ones. So gall bladder issues 150 00:07:31,653 --> 00:07:34,013 Speaker 4: or gallstones can actually be a problem, and that's due 151 00:07:34,013 --> 00:07:36,493 Speaker 4: to rapid weight loss. So if you lose weight quickly, 152 00:07:37,093 --> 00:07:39,693 Speaker 4: we know that you can develop gallstones very quickly and 153 00:07:39,773 --> 00:07:44,773 Speaker 4: get a gall bladder problem. Pancreatitis is a rare complication 154 00:07:44,853 --> 00:07:49,773 Speaker 4: which can occur sometimes. And you know there's some other 155 00:07:50,013 --> 00:07:53,813 Speaker 4: other really really rare ones, but those are probably the sea. 156 00:07:53,973 --> 00:07:59,453 Speaker 4: So certainly that abdominal pain, bloating, diarrhea, nausea can be 157 00:07:59,533 --> 00:08:02,093 Speaker 4: quite common. Then the gall bladder and pancreatitis the two 158 00:08:02,133 --> 00:08:04,253 Speaker 4: of the other ones that we start to worry about a. 159 00:08:04,173 --> 00:08:05,933 Speaker 3: Lot of time when I hear about diets, people say, 160 00:08:05,933 --> 00:08:07,453 Speaker 3: I just want to shock to the system. I want 161 00:08:07,453 --> 00:08:10,533 Speaker 3: to lose the twenty cage or whatever. I'm just making 162 00:08:10,573 --> 00:08:12,293 Speaker 3: up that number that I need to lose, and then 163 00:08:12,333 --> 00:08:14,653 Speaker 3: I need to make the lifestyle changes to stay there. 164 00:08:14,733 --> 00:08:17,533 Speaker 3: Is that a realistic thing? How many people actually pull 165 00:08:17,573 --> 00:08:17,813 Speaker 3: that on? 166 00:08:19,133 --> 00:08:22,373 Speaker 4: Yeah, well, again, all the studies show that within two 167 00:08:22,493 --> 00:08:25,453 Speaker 4: years I've been on a weight loss treatment, often if 168 00:08:25,453 --> 00:08:27,933 Speaker 4: you come off it within two years, the weight goes 169 00:08:27,973 --> 00:08:29,253 Speaker 4: back on, and so. 170 00:08:29,253 --> 00:08:30,893 Speaker 3: There is a lot of you often hear that the 171 00:08:30,933 --> 00:08:33,253 Speaker 3: weight and more goes on. And then some people are 172 00:08:33,253 --> 00:08:37,693 Speaker 3: talking about your reward pathways being changed because whatever discipline 173 00:08:37,693 --> 00:08:40,613 Speaker 3: you had is sort of turned off for the time 174 00:08:40,653 --> 00:08:42,173 Speaker 3: that you're on it, So when you come off, you 175 00:08:42,213 --> 00:08:44,492 Speaker 3: don't even have whatever discipline you did have. If discipline 176 00:08:44,573 --> 00:08:45,612 Speaker 3: is the right word I'm looking for. 177 00:08:47,773 --> 00:08:53,253 Speaker 4: Yeah, so it's the body. Tabler's is really common thought 178 00:08:53,293 --> 00:08:56,413 Speaker 4: that the body starts to reset its metabolism at a 179 00:08:56,453 --> 00:09:00,012 Speaker 4: lower rate. If you lose weight like that, and as 180 00:09:00,053 --> 00:09:05,093 Speaker 4: you put the weight and take the medication away, start 181 00:09:05,132 --> 00:09:07,612 Speaker 4: to eat more calories and you'll go back to your 182 00:09:07,612 --> 00:09:10,973 Speaker 4: normal diet. Your metabolism set slightly lie and you tend 183 00:09:11,012 --> 00:09:14,373 Speaker 4: to put on the weight quite rapidly. So there's a 184 00:09:14,372 --> 00:09:17,252 Speaker 4: whole lot of interaction stuff that's going on that's only 185 00:09:17,453 --> 00:09:20,453 Speaker 4: just been starting to be understood. It's been really really 186 00:09:20,453 --> 00:09:23,412 Speaker 4: poorly understood. So the body is very very good at 187 00:09:23,773 --> 00:09:27,012 Speaker 4: allowing the weight to come back on often, so regardless 188 00:09:27,012 --> 00:09:30,333 Speaker 4: of diet and exercise. Yeah, yeah, yeah, so it tends 189 00:09:30,333 --> 00:09:33,533 Speaker 4: to predetermine where it sits and that can be a problem. 190 00:09:33,612 --> 00:09:35,333 Speaker 4: The other the other thing that people need to be 191 00:09:35,333 --> 00:09:39,093 Speaker 4: aware of is rapid weight loss is yeah, not a 192 00:09:39,132 --> 00:09:42,093 Speaker 4: great great thing to have happened. So if you lose 193 00:09:42,093 --> 00:09:45,612 Speaker 4: weight quickly, then put it on quickly, then lose weight again, 194 00:09:46,053 --> 00:09:48,013 Speaker 4: that's not a very very good thing for the body 195 00:09:48,093 --> 00:09:48,412 Speaker 4: at all. 196 00:09:48,612 --> 00:09:51,333 Speaker 2: Yeah, doctor, really great to get your thoughts on this, 197 00:09:51,413 --> 00:09:53,653 Speaker 2: and really appreciate your time this afternoon. 198 00:09:53,813 --> 00:09:55,693 Speaker 4: Great, no lovely to be here. Thank you. 199 00:09:56,173 --> 00:09:59,252 Speaker 2: That is doctor Brian Betty's Chair of General Practice, New Zealand. 200 00:09:59,252 --> 00:10:01,772 Speaker 2: He's a specialist GP based in Partty Do 201 00:10:02,533 --> 00:10:05,453 Speaker 1: For more from news Talks b listen live on air 202 00:10:05,653 --> 00:10:08,293 Speaker 1: or online, and keep our shows with you wherever you 203 00:10:08,453 --> 00:10:10,852 Speaker 1: go with our podcasts on iHeartRadio