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Speaker 1: Welcome back to our special summer series. I hope you're

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Speaker 1: having an amazing break and taking some time out to

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Speaker 1: rest and recover from a huge year. This week, we

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Speaker 1: wanted to bring you some of our favorite episodes from

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Speaker 1: twenty twenty five, the ones we loved putting together for you,

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Speaker 1: or the ones you told us meant something to you.

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Speaker 1: We are kicking things off with part one of our

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Speaker 1: three part series investigating ozen Pic. This episode contains distressing themes,

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Speaker 1: including suicide and disordered eating. For twenty four to seven support,

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Speaker 1: please contact Lifeline on thirteen eleven fourteen. You'll find some

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Speaker 1: links to more resources in today's episode description.

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Speaker 2: Welcome to the eighty second Golden Gloves, Ozempich's Biggest night.

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Speaker 1: We think of this o Zembic takeover in Hollywood. Excuse me,

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Speaker 1: Jennie's No, it's Azempic. From viral weight loss drug to

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Speaker 1: Hollywood punchline. What percent shouldn't be the only one? Ones

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Speaker 1: whose body fat is one possess?

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Speaker 3: When I look around this throom, I can't help but

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Speaker 3: wonder is Ozembic right for me?

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Speaker 1: Before Ozepic took social media by storm, it was touted

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Speaker 1: as the miracle drug that could end type two diabetes.

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Speaker 1: Medications are changing the way that we think about diabetes

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Speaker 1: and weight management, but also cardiovascular risk management. Once lauded

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Speaker 1: as the silver bullet to the stars, ozempic and other

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Speaker 1: similar medications have slowly but surely crossed into the mainstream,

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Speaker 1: bringing with them new conversations about body image, ethics, health

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Speaker 1: and accessibility.

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Speaker 4: There is so much demand, you know, there is demand

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Speaker 4: for this that outstrips anything we've ever seen.

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Speaker 1: But what does the exploding global popularity of azempic mean

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Speaker 1: for young people?

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Speaker 3: The entire body neutrality movement has almost had this regression

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Speaker 3: where it's like, I don't know, we're actually back to

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Speaker 3: those sizes that we're trying to get away from, and

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Speaker 3: here's a drug that's going to fix everything.

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Speaker 1: Over the next three episodes, we'll explore the new world

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Speaker 1: of weight loss medication, its long term implications, the medical

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Speaker 1: and social ramifications of its growing popularity, and how it's

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Speaker 1: being prescribed and used in Australia today.

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Speaker 5: Medicine and marketing should not be disconnected.

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Speaker 6: In this way, we'll.

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Speaker 1: Speak to experts, advocates, and the people whose lives have

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Speaker 1: been changed by ozepic, for better or for worse. From

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Speaker 1: the Daily Os. I'm Emma Gillespie and this is investigating

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Speaker 1: Ozenpic part one. Ozepic was first approved by health authorities

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Speaker 1: in the US in twenty seventeen as a medication to

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Speaker 1: treat type two diabetes, approved for use in Australia the

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Speaker 1: following year. The drug now generates billions of dollars annually

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Speaker 1: for its manufacturer, Novo Nordisk, which has become one of

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Speaker 1: the world's richest pharmaceutical companies. But what is ozeenpic and

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Speaker 1: how does it actually work?

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Speaker 4: So, Azempic's a drug name, and it's a drug name

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Speaker 4: for what is otherwise known as semaglue tide. Semi glue

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Speaker 4: tide falls into this family of drugs called glp ones.

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Speaker 1: That's doctor Michael Bonning. He is the Australian Medical Association

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Speaker 1: Chair of Public Health and a Sydney GP.

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Speaker 4: Ozempic is the one that has been talked about so

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Speaker 4: much in the media, but actually there are two others

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Speaker 4: that get a lot of coverage as well. One is

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Speaker 4: called Weigovi, which is just a higher dose version of ozempic,

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Speaker 4: and another one that is called Munjaro. They act on

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Speaker 4: hormones in our body and generally they were developed for

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Speaker 4: diabetes patients. What they did for them was making sure

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Speaker 4: that the cells work better with insulin, but also then

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Speaker 4: that gastric emptying is slowed down so you feel fuller faster.

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Speaker 4: You ended up with people losing significant amounts of weight,

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Speaker 4: which for many people with diabetes is also a significant

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Speaker 4: benefit to improving their diabetic control. But for those who

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Speaker 4: don't have diabetes, that side effect has meant that these

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Speaker 4: drugs have become increasingly popular for an indication that they

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Speaker 4: weren't originally put on the market for.

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Speaker 7: With those Zeenpig's popularity for dramatic weight loss, it's been

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Speaker 7: hard to get, but a new similar drug has the

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Speaker 7: same active ingredient as ozepig.

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Speaker 2: WHEREGOV helped people lose on average fifteen percent of their

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Speaker 2: body weight. That's compared with the nearly twenty three percent

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Speaker 2: achieved by Manjaro. The battle of the weight loss drugs continues.

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Speaker 1: Taken as an injection usually once a week, doctor Bonning

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Speaker 1: says ozeenpic and other GLP one medications start working almost immediately,

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Speaker 1: within a few hours. For twenty six year old Grace,

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Speaker 1: the overall experience of weight loss medication gave her a

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Speaker 1: confidence that she had never felt before. Grace wrote to

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Speaker 1: us from Brisbane to tell us about her experience. Here's

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Speaker 1: a bit of her story, voiced by someone else.

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Speaker 4: My entire life.

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Speaker 7: I have been slightly overweight since becoming an adult, working

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Speaker 7: an office job, no longer doing sports, the weight started

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Speaker 7: to climb slightly. It wasn't until I moved away from

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Speaker 7: home and experienced a really rough time that I ended

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Speaker 7: up putting on significant weight in a short period. This

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Speaker 7: was the start of a number of health problems for me.

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Speaker 7: I had kidney stones, I had gallstones. I was generally

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Speaker 7: unhappy and lacking a lot of self love.

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Speaker 1: Grace has used both Ozenpic and Munjaro at different times

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Speaker 1: since June twenty twenty three.

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Speaker 7: Munjaro was significantly more expensive, but it gave me almost

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Speaker 7: no side effects. Because of that, I was able to

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Speaker 7: consistently stay on the medication for about six months.

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Speaker 1: She lost over seventeen kilos during that time, and since then,

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Speaker 1: Grace says her life has changed. Her confidence has transformed.

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Speaker 1: Pain she used to feel daily has disappeared.

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Speaker 7: I'm not embarrassed to walk up the stairs with someone.

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Speaker 7: I feel confident that I could physically get myself out

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Speaker 7: of danger if I had to. The mobility is insane.

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Speaker 7: The change of perspective is enormous.

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Speaker 1: Grace said she feels in control of her food choices

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Speaker 1: for the first time in her life. She details experiencing

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Speaker 1: a shift in how she thinks about food, what Grace

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Speaker 1: describes as previous compulsions and food noise all day, every day.

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Speaker 1: She told us, it's a difficult thing to explain to

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Speaker 1: someone who's never experienced issues with food noise, but Grace

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Speaker 1: likens it to listening to a loud song on repeat

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Speaker 1: and you've got no ability to change the song, or

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Speaker 1: turn down the volume or take a break. For her,

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Speaker 1: both glp won medications, Ozebic and Munjaro were like finally

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Speaker 1: someone had given her a remote to listen to something else.

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Speaker 7: It was so healing to know that I wasn't just

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Speaker 7: worse than skinny people, or I wasn't just weak. My

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Speaker 7: brain wasn't working against me anymore.

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Speaker 1: Grace's story is just one of the hundreds of positive

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Speaker 1: anecdotes we received when we asked our audience about their

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Speaker 1: experiences using Ozepic and similar medications. Dozens of TDA followers

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Speaker 1: told us that these drugs have changed their life that

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Speaker 1: they've never been happier or healthier. Some of you told

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Speaker 1: us it's saved your life. We could go on for

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Speaker 1: hours talking through all the many glowing reviews we received

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Speaker 1: about ozepic, Munjaro, and wegovi. But while so many of

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Speaker 1: you did have a positive experience with these medications, hundreds

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Speaker 1: of you also told us the exact opposite. Several TDA

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Speaker 1: followers told us they've ended up in hospital after taking ozenpic,

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Speaker 1: with gallbladder removal being the most commonly reported issue.

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Speaker 4: As with most drugs, most side effects are dose dependent.

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Speaker 4: They often are worse at higher doses.

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Speaker 1: We'll be back with more of today's episode right after this. Ultimately,

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Speaker 1: GLP one medications like ozepic are still relatively new, and

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Speaker 1: that means the full list of side effects associated with

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Speaker 1: their long term use remains somewhat unknown. GPS and healthcare

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Speaker 1: providers can report adverse side effects relating to these medications

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Speaker 1: to the federal government's Department of Health. These reports are

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Speaker 1: tracked on the Therapeutic Goods Administration's Database of Adverse Event Notifications.

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Speaker 1: The online tracker includes negative symptoms associated with the use

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Speaker 1: of any medication but you can filter down by type.

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Speaker 1: So that's what we did to look at ozenpic. We

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Speaker 1: go v and compounded products or pharmacy made versions of

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Speaker 1: these drugs, as well as semaglue tide products where the

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Speaker 1: brand name was not specified. Remembering that semigluetides a type

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Speaker 1: of GLP one. Golp ones are these weight loss medications

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Speaker 1: that we are talking about. On the database, gastro Intestinal disorders,

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Speaker 1: including pancreatitis made up around half of the adverse events

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Speaker 1: reported between January twenty twenty three and January twenty twenty five.

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Speaker 1: But there's another particularly sinister side effect associated with ozepic

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Speaker 1: use that's becoming increasingly prominent. I, for no reason whatsoever,

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Speaker 1: and I hadn't felt like this for a very long time,

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Speaker 1: became suicidal, unable to work.

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Speaker 6: It was really quite unexplained.

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Speaker 1: Mackenzie is a twenty six year old woman who sought

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Speaker 1: out a zenpic for weight management.

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Speaker 6: I've tried diet exercise and haven't been able to get

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Speaker 6: that to work for the long term.

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Speaker 1: But taking ozempic would lead her down one of the

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Speaker 1: most frightening periods of her life.

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Speaker 6: I was really really concerned, and I chatted with my

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Speaker 6: partner about it, and he was like, well, the only

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Speaker 6: thing that has changed in your life is you going

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Speaker 6: on this particular medication.

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Speaker 1: Suicidal ideation makes up one in every twenty adverse GLP

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Speaker 1: one reactions reported to the TGA database. Since January twenty

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Speaker 1: twenty three, there have been three reports of attempted suicide

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Speaker 1: and separately, two deaths by suicide associated with the use

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Speaker 1: of these medications. Ozenpic was the only product suspected to

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Speaker 1: be related to both of those deaths. The TGA website

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Speaker 1: stresses that the reports included in the database doesn't mean

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Speaker 1: the details of the event have been confirmed or that

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Speaker 1: the event has been determined to be related to that

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Speaker 1: specific medication that it's listed alongside. The TGA says it

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Speaker 1: uses adverse event reports to quote identify when a safety

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Speaker 1: issue may be present, but it says assessing the safety

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Speaker 1: of a medication cannot be made using the tracker alone.

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Speaker 6: Saw Juniper advertised and decided to go through the questionnaire

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Speaker 6: that they've got online, put in all accurate information and

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Speaker 6: it gave me a prescription for Ozenpic.

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Speaker 1: Juniper is one of a growing number of online platforms

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Speaker 1: that privately prescribed weight loss medications without requiring face to

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Speaker 1: face consults. It's a virtual or telehealth service, and while

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Speaker 1: individual practitioners must comply with compulsory standards, there is no

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Speaker 1: current mandatory safety and quality standards framework for these platforms.

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Speaker 1: Mackenzie disclosed to Juniper that she'd been taking antidepressants since

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Speaker 1: her early teens before she received a prescription for ozeenpic.

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Speaker 6: So I started receiving that in the mail and injecting

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Speaker 6: that as per kind of the recommended guidelines, I kind

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Speaker 6: of had peace of mind that it would cover everything

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Speaker 6: that was in my medical history.

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Speaker 1: Mackenzie started on what she said was quite a low

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Speaker 1: dose of ozmpic, but a month later she ramped up

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Speaker 1: to a higher dose, and that's when she says things

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Speaker 1: started feeling off, essentially out of nowhere. She describes experiencing

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Speaker 1: suicidal ideations. Mackenzie shared her concerns with her regular GP,

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Speaker 1: but that GP is not the person who prescribed her

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Speaker 1: this medication. She got the drugs through Juniper.

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Speaker 6: He said that he'd seen this in a number of patients.

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Speaker 6: He explained to me how it kind of worked, and

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Speaker 6: one of the things is that it slows the digestive system,

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Speaker 6: which then can have negative effects on absorption.

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Speaker 1: The medication Mackenzie was taking had stopped her body from

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Speaker 1: absorbing the antidepressants that she'd been used to taking for

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Speaker 1: more than a decade.

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Speaker 6: I was in such a bad place that he suggested

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Speaker 6: I go to hospital, stopped taking it, and contact Juniper

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Speaker 6: to let them know that I was no longer taking

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Speaker 6: it and explain what the side effects of that had

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Speaker 6: been for me.

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Speaker 1: Mackenzie followed the advice of her regular GP and stopped

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Speaker 1: taking Ozeenbic immediately, but due to the slow release nature

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Speaker 1: of the drug, it took over a month for her

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Speaker 1: to start feeling like herself again. The twenty six year

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Speaker 1: old said she was surrounded by the right people and

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Speaker 1: the right support to get herself back to feeling safe

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Speaker 1: and happy. She considers herself one of the lucky ones,

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Speaker 1: but Mackenzie holds broader concerns about what these prescribing practices

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Speaker 1: could mean that at risk young people.

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Speaker 6: The fact that this is so freely available without even

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Speaker 6: so much as a zoom call or a face to

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Speaker 6: face check in is really really concerning to me, and

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Speaker 6: I think something needs to be done regarding the access

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Speaker 6: people have to this medication. I'm not saying that we

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Speaker 6: should never use it and that it should be totally

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Speaker 6: out of the question, but I think some kind of

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Speaker 6: regulation needs to be put in place.

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Speaker 1: So how are these medications regulated and how many people

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Speaker 1: are taking them in Australia. The short answer to the

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Speaker 1: second part of that question is really, we have no idea,

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Speaker 1: and that's because of the way that these drugs are

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Speaker 1: classified by health regulators and something called the Pharmaceutical Benefit

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Speaker 1: Scheme the PBS.

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Speaker 4: O Zembic is funded by the Australian government, so on

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Speaker 4: the PBS for those people who meet certain parameters around

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Speaker 4: their type two diabetes, so those people need to be

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Speaker 4: the ones who are prioritized to get access to it.

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Speaker 1: Let's break that down. Ozepic is a PBS listed drug

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Speaker 1: for type two diabetes treatment, so because of that, it'll

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Speaker 1: cost a diabetic around forty dollars a month to access.

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Speaker 1: That doesn't mean it's illegal to use ozepic for other reasons,

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Speaker 1: but it does mean prescriptions issued for a purpose other

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Speaker 1: than diabetes, what's called off label uses, aren't subsidized by

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Speaker 1: the PBS and therefore aren't tracked by it either. These

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Speaker 1: private scripts also cost patients upwards of four hundred dollars

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Speaker 1: a month.

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Speaker 4: The other two medications are not on the PBS for

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Speaker 4: that indication.

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Speaker 1: Doctor Michael Bonning is talking about Munjaro and wegovy, but

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Speaker 1: we Govy could soon become cheaper for some people who

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Speaker 1: take it after the TGA recently approved this drug as

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Speaker 1: a treatment for heart disease in overweight patients. This means

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Speaker 1: the medicine regulator has determined there is SATIS factory evidence

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Speaker 1: that we go v is an effective complementary therapy for

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Speaker 1: adults with both cardiovascular disease and high body mass index

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Speaker 1: to reduce the related risk of heart attack, stroke or death.

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Speaker 1: We can find out how many people take ozenpic for

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Speaker 1: type two diabetes treatment, and we might soon be able

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Speaker 1: to find out how many people take we go vias

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Speaker 1: a treatment for heart disease. But for everything else, it's

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Speaker 1: virtually impossible to determine the scale of the use of

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Speaker 1: these medications. Doctor Emma Beckett, a food and nutrition scientist

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Speaker 1: and an adjunct senior lecturer at UNSW, says this is

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Speaker 1: an issue that needs to shift urgently.

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Speaker 5: My suspicion is the vast number of people accessing these

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Speaker 5: medications in Australia are accessing them through telehealth and not

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Speaker 5: through their standard GP. And for me, the question is

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Speaker 5: why are they going to their standard GP, and their

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Speaker 5: standard GP is going no, no, you don't need that.

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Speaker 5: And you go to the people who are selling them

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Speaker 5: directly and that's their purpose and they go, well, of

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Speaker 5: course you can have that. And so my question is

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Speaker 5: about how do we look at that context because I

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Speaker 5: don't think we have that data.

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Speaker 1: So without that database of prescriptions, we decided to look

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Speaker 1: into this further to get a sense of how young

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Speaker 1: people are engaging with these medications. Around twenty five thousand

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Speaker 1: of you responded to a poll by The Daily Os.

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Speaker 1: Eleven percent told us they had used ozenpic or a

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Speaker 1: similar drug. We asked the eighty nine percent who hadn't

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Speaker 1: used it if they've ever wanted to try ozenpic. Forty

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Speaker 1: three percent of respondents said yes. We heard from nurses, surgeons,

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Speaker 1: GP and other health professionals who said GLP one medications

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Speaker 1: licozenpic are among the most prescribed drugs in the country,

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Speaker 1: but it's how people are accessing these drugs, or rather

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Speaker 1: where they're getting their prescriptions that has some experts concerned.

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Speaker 5: If you Google interested in these drugs. The top hits

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Speaker 5: are not results to studies, they're not informational pieces. They're

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Speaker 5: links to the companies who are selling it, and medicine

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Speaker 5: and marketing should not be disconnected in this way, because

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Speaker 5: I can't think of any other medication that happens like this.

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Speaker 1: On the next episode of Investigating Ozenpic, we take a

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Speaker 1: closer look at the online providers prescribing weight loss medication

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Speaker 1: in Australia. We'll look into their duty of care and

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Speaker 1: whether or not they're meeting those responsibilities. We'll hear from

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Speaker 1: the people who've accessed these drugs through these providers and

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Speaker 1: those who've worked for them.

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Speaker 5: If these people started these companies to deliberately sell these

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Speaker 5: weight loss drugs. There's a gap that says when people

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Speaker 5: are going to the doctor and how this conversation with

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Speaker 5: their regular GP they're not getting what they need.

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Speaker 1: We'll answer all your questions and more on part two.

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Speaker 1: Thank you so much for listening to this episode. If

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Speaker 1: it's raised any concerns for you, help is available twenty

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Speaker 1: four to seven through Lifeline on thirteen eleven fourteen. For

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Speaker 1: eating disorder support, you can contact the Butterfly Foundation on

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Speaker 1: one eight hundred eighty hope. That's one eight hundred three

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Speaker 1: three four six seven three. There are also some links

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Speaker 1: to resources in today's episode description.

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Speaker 7: My name is Lily Maddon and I'm a proud Arunda

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Speaker 7: Bungelung Cargottin woman from Gadighl country. The Daily oz acknowledges

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Speaker 7: that this podcast is recorded on the lands of the

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Speaker 7: Gadighl people and pays respect to all Aboriginal and Torres

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Speaker 7: Strait Island and nations. We pay our respects to the

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Speaker 7: first peoples of these countries, both past and present,