Health News

As an editor, I have always steered clear of promoting diets or writing about weight loss. Instead, BeautyEQ celebrates a healthy body image, regardless of size. However, when a text alert arrived in my inbox last week, "Trudi weight management injection now available at Clinic 42," from a top Auckland cosmetic medicine destination, it was the third time in that week I had read about the so-called wonder drug Saxenda.  

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Dr Joanna Romanowska, co-founder of Clinic 42, is always cautious about the cosmetic treatments she and her team offer. They prefer those that are backed by science and clinical trials. So back to Saxenda, why was Clinic42 offering it? "We are all about increasing awareness and offering our patients options for health and well-being. This medication has been available since 2014, aimed at overweight diabetics; it's not new; the only thing that has changed is that it is now aimed at illness and wellness. 

Saxenda is Med-Safe approved, not new, and not the first diet drug available in New Zealand. Currently, four are on offer for the treatment of obesity, including liraglutide 3 mg (Saxenda®), orlistat (Xenical®), phentermine (Duromine®), and naltrexone hydrochloride/bupropion hydrochloride (Contrave®). However, each comes with side effects, and all need to be prescribed by a doctor. 

John Baker, an endocrinologist and chairman of the Diabetes Foundation Aotearoa, believes, "The world has been starved - so to speak - of good weight loss medicine." Why is that? Anyone wanting to lose weight will know how hard it can be. Yes, it's all about diet and daily exercise, but that takes commitment, willpower, and work - even though being healthy lowers the risk of heart disease and diabetes. 

It's no secret that New Zealand has an obesity epidemic. But it could not be more frustrating for health providers when healthy food is astronomically expensive. It's common knowledge that inflation is at an all-time high. However, Stats New Zealand recently reported that the food price index rose 12.5 per cent in April, and fresh fruit and vegetables were up 22.5 per cent. The highest annual rate rise since late 1987. A recent New Zealand Health Survey reported that 32 per cent of adults (aged 15 years and over) were obese, with the prevalence of obesity differing by ethnicity. This upward trend in weight gain and obesity burdens individuals, society, and the economy. Romanowska says, "The way the body responds to satiety (feeling satisfied or full after eating) changes as we age, as does weight gain. Unfortunately, the media's focus on thinness perpetuates that bad body image, which is not what Saxenda is for. It's recommended for adults with excess weight, a BMI of 27 or more, who also have weight-related medical problems, or with a BMI of 30 or more (classed as obese). The patient will need blood work to check liver function before taking the medication," says Romanowska. Who adds, "People with low BMI are no ideal candidates; Saxenda is not a quick-fix weight loss plan."

So, what is Saxenda (pronounced sak-sehn-duh)?

Saxenda, or Liraglutide 3 mg, is a glucagon-like peptide-1 analogue, a class of medications commonly used to treat type 2 diabetes. Used together with a healthy, balanced diet and regular exercise, it's part of an overall weight loss plan. 

How does it work?

Saxenda makes your stomach slower to empty after eating, encourages the pancreas to produce more insulin, and prevents the liver from producing too much blood sugar. It also acts on the central nervous system to stop the feeling of hunger. The combined effect is that you feel full faster and have less appetite, causing you to eat less. The goal is that it leads to eating fewer calories and losing weight over time. However, Romanwoska says, "It should not be considered a one-hit-wonder. It takes time to lose weight, and expectations need to be set so that the outcome is a change in a patient's health and well-being, not just the weight loss. The goal is to gradually withdraw the medication and improve and change lifestyle habits, such as eating less and exercising daily." She adds, "Modest weight loss can significantly improve your overall health, including lower blood pressure, and reducing the risk of taking diabetic medication is the end goal." Saxenda is injected daily, anytime, with or without food and drinks. The medication comes in a prefilled, dial-a-dose pen injected under the skin, in the stomach, thigh or upper arm. It can deliver 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg and 3 mg, depending on your prescribed dose. 

What are the side effects?

Romanowska says there are side effects, "Including nausea, diarrhoea, vomiting, headaches and constipation. The treatment starts with low doses, so the side effects are minimised, but as the dose increases, week by week, these side effects can increase, and you don't get the full impact of the treatment for five weeks." Romaowska also recommends increasing the fibre content in your diet and drinking two litres of water daily. 

How much weight should you expect to lose?

"The ideal is five per cent weight loss over 16 weeks. However, the weight loss should be gradual; for example, it can take three months to get five per cent weight loss, says Romanowska, who adds, "It is then you can reduce the dose as maintenance while establishing new habits, so when you come off the medication, you will be used to eating less and exercising more, which is the goal of healthy weight loss." 

What does it cost?

Cost does vary, but you can expect to pay for a doctor's consultation. Then, from $500 for three months' supply. Doctors will educate on administration and managing expectations and any side effects.

Patient interview

For Abbey Grayson, 52 years old, from Auckland, Saxenda was a good option for her weight loss journey after discussing Saxenda with her GP. Here she shares her insights on the drug she has been taking for a month.

 How did you hear about Saxenda?

Through a friend, they had great results, which piqued my interest. So my husband and I decided to take it together, as we both needed to lose weight, and we could support each other through the journey.

Why do you want to take it?

Being post-menopausal, I had a tummy I couldn't shift. If there was a way that I could reduce it, approved by my doctor, then I was up for it.

What were the criteria for the medication?

We had to have a BMI of above 27. I am Pre-diabetic and was told I had to lose weight over the last few years; when I discovered this option was available, I jumped at the chance.

Is it hard to inject yourself every day?

As a needle-phobic, it's surprisingly easy. My doctor guided us through how and where to inject, and as it's such a tiny needle, you don't even notice. So I inject in my midriff (where the fat is).

How do you feel?

I feel great! You get supplied with all the tools to record your details weekly. Inside the book, there are also pieces of information, and you must exercise regularly, plus drink lots of water.

Have you had any side effects?

Initially nausea. But on reflection, it was because instead of three big meals, you reprogramme yourself to eat little and often. So it's remembering to have snacks on board. Also, constipation, but clearly, I wasn't drinking enough water.

Have you lost weight?

I have lost four kilos and am starting to fit into clothes I couldn't. It's a great confidence booster.

What are your weight-loss goals?

10-12 kilos.

How long are you allowed to take it?

The doctor supplied three months of Saxenda. That is until you have lost at least four per cent of your BMI after 12 weeks. Then we will review with the doctor after a blood test to discuss the next steps.