The cost to society of weight loss drugs

Obesity, Ozempic, and the end of body positivity - Is New Zealand losing its balance in its pursuit of thinness?

New Zealand is struggling with a growing waistline.

New weight loss drugs could help to get rid of it, but there's a high price to be paid - literally, for those shelling out on Ozempic and Wegovy, and socially as well.

Officially, this country is the third most overweight nation in the OECD, with one in three adults and one in 10 children now classified as obese.

The Detail examines the fallout of this - the strain it puts on our healthcare system is enormous - and also the pros and cons of quick-fix, expensive weight loss drugs.

Ozempic and Wegovy are transforming lives, but they are also negatively impacting the fashion industry, with once-in-demand, plus-sized models finding they no longer fit in.

"You are getting hate for existing in a bigger body, which is messed up," says fashion journalist Evelyn Ebrey, who has just produced the documentary series Cutting the Curve, on plus-sized models.

"These drugs coming have meant there's a real renewed focus on thinness ... you have people openly talking about wanting to get thinner, needing to get thinner, and it's like, why though?

"With models, the industry has definitely returned to focusing on thin. We were at London Fashion Week in February, and that whole season of shows, there were 50 percent fewer curve models on the runway, and there weren't that many curve models to begin with.

"And that's nuts ... this teeny tiny number is crazy. And for curve models, that means less work ... and so there is that pressure of 'well, maybe I should take this thing, if I want to keep my career'."

Auckland University Professor Wayne Cutfield, who has done a breakthrough study on obesity and the link to the gut, warns that the weight loss drugs aren't a miracle cure, they are expensive, long-term, and there are side effects.

Diet and exercise are also required to shrink the excess fat, while taking the drugs.

"There are no easy fixes," he tells The Detail. "Ozempic is associated with quite appreciable weight loss, but you still need to eat a healthy diet; you can't just absolutely free range and hope that Ozempic will fix the obesity problem, and at great cost."

He says obesity is costing the country billions of dollars, with obese Kiwis at risk of heart attacks, diabetes, cancers, neurological disorders, and digestive disorders ... the list goes on.

And obesity, he says, starts young.

"If you look at five-year-old children, our five-year-olds are about the second most obese children on the planet," he says.

"So why is this happening? It's a combination of things; it's a combination of genetics, and we have a greater predisposition amongst Pasifika and Māori, there's also lifestyle choices ... and when I say lifestyle choices, everybody knows they should eat a healthy diet - and it should be limited in calories, not excessive - and we should exercise regularly.

"But humans are hedonists, and we love what isn't necessarily good for us, so we like to free range and eat lots of foods that contain fats, salt, and sugar, which are not so good for us, and we have an aversion to exercise."

So, he's been working on a groundbreaking gut health study and a probiotic that could change the future of obesity treatment.

"It's a designer probiotic - is it a miracle? Let's see ... but it shows lots of promise."

He says eight years ago, 87 obese adolescents took part in the study to see whether faecal transfer (taking 'good' gut bacteria from healthy donors and giving them in capsule form to people with a less healthy microbiome) would make a difference to their health and weight.

A follow-up study suggests some significant health benefits from that single gut bugs transfer, with the original overweight teens having reduced risk for a bunch of metabolic changes which can lead to heart disease, stroke, and diabetes.

The treatment group was also on average 11kg lighter than those who had a placebo capsule.

"What is impressive is that just a single treatment produced a dramatic reduction in metabolic syndrome ... this means they are at much lower risk of developing diabetes and heart disease over the long term."

Evelyn Ebrey says while weight loss drugs are good for those who need them for, say, medical reasons, she's alarmed at their growing popularity with already slim people, celebrities in particular.

"It is quite concerning when we see so many celebrities shrinking because they have huge influence ... it is a problem."

She says it's time Kiwis addressed their fat phobia and be kinder to themselves and others.

And to deal with an uncomfortable truth: we're chasing thinness at any cost - even when the price is our health, our diversity, and our sense of self-worth.

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