The Rise of Prescription Weight-Loss Medications in Australia
A wave of prescription weight-loss medications has transformed the way obesity is managed in Australia, with doctors increasingly turning to drugs like Ozempic for treatment. Originally developed as a diabetes medication, these drugs—specifically GLP-1 receptor agonists—are now being used off-label for weight loss, creating a new landscape in healthcare.
These medications have become a mainstream option for managing obesity, with hundreds of thousands of Australians using them each month. This shift has raised important questions about safety, access, and long-term health impacts. While they were initially designed to improve blood sugar control in people with type 2 diabetes, their use has expanded significantly, with approximately 500,000 Australians estimated to be taking them.
Changing Prescribing Patterns
Research has highlighted a rapid shift in prescribing patterns, particularly among younger individuals, women, and patients without diabetes. A study based in New South Wales analyzing over 5.5 million patients found a sharp increase in the use of semaglutide between 2020 and 2023. Non-diabetic patients made up 8% of new users in 2020, but this rose to 34% by 2023. Women accounted for nearly two-thirds of new prescriptions, while patients without diabetes were more likely to be younger and living in more advantaged areas.
Much of this uptake has occurred outside of subsidised access, with patients paying between $350 and $600 per month privately when they don’t meet Pharmaceutical Benefits Scheme (PBS) criteria. Researchers estimate that a significant portion of prescribing is happening outside of intended clinical guidelines.
Shortages, Counterfeits and Safety Concerns
The surge in demand has led to shortages in 2022 and 2023, resulting in the emergence of compounded “replica” versions of semaglutide. These unapproved products have not been assessed for safety or quality by the Therapeutic Goods Administration (TGA). By mid-2024, it was believed that around 20,000 Australians were using these compounded versions before the Federal Government moved to ban the practice from October 2024. Regulators have also warned about counterfeit products being illegally imported.
As use expands, so do concerns about safety. The TGA has received reports of suicidal ideation linked to the drug class, while warnings have been issued about potential contraceptive failure with tirzepatide and surgical risks linked to delayed gastric emptying. Anaesthetists have raised concerns after cases of pulmonary aspiration during surgery in patients who had followed standard fasting guidelines but still had food in their stomachs. New guidance now recommends stricter pre-operative dietary preparation for patients on the medications.
Experts have also warned about muscle and bone loss during rapid weight reduction, with a significant portion of weight lost potentially coming from lean tissue rather than fat. Health professionals are increasingly recommending resistance training and higher protein intake to counter these effects.
Calls for “Wraparound” Support
AUSactive chief executive Ken Griffin has called for a national framework requiring structured exercise, nutrition, and multidisciplinary care alongside prescriptions for GLP-1 medications. He emphasized that if taxpayers are funding these medications, exercise must be built into prescriptions. “To get the full value of these medications, funded wraparound support is needed to protect muscle and bone health from day one,” Mr Griffin said. He added that all GLP-1 users should be working with an exercise professional.
“Exercise isn’t optional. It’s the safety net that protects muscle, protects bones, supports metabolism and prevents future hospitalisations.” He warned that critical safeguards risked being overlooked as use expands.
Not a “Magic Fix”
In Australia, Ozempic is approved for the treatment of type 2 diabetes, although some doctors may prescribe it off-label in certain circumstances. Medicines specifically registered for chronic weight management include Wegovy and Mounjaro.
Among those navigating the treatment is 46-year-old Melbourne account manager Samantha Wearing, who began taking Ozempic about 16 months ago while managing type 2 diabetes and bipolar disorder. Before starting treatment, she said her blood sugar levels remained high despite insulin and tablets, leaving her at risk of heart disease, blurred eyesight, and poor sleep.
“The main goal was to get my blood sugars down, as they were in the craziness of 20-plus range, even with insulin and tablets. They should be between six and 10,” Ms Wearing said. She said the medication, combined with regular exercise at The Bootcamp Co, helped her lose more than 30 kilograms, dropping from 125kg to 94kg and moving from a size 24 to a size 16.
Ms Wearing now trains four to five times a week and said the changes had improved her mobility, energy, and confidence. “Before Ozempic, the encouragement was there, but I was overweight and puffy, and I don’t really want to do things if I’m not going to succeed,” she said. “Once I started on it and exercising, I saw the results physically, mentally and my general health overall.”
But she said the experience also highlighted some of the challenges surrounding the drugs, including side effects, ongoing costs, and inconsistent medical support. Ms Wearing experienced nausea and exhaustion when she first started treatment, although her side effects were short-lived. However, she said she knew others who stopped taking GLP-1 medications because the effects became too difficult.
She also warned the medication was not a “magic fix”, explaining exercise had been critical to maintaining muscle and preventing rapid weight regain. “Without exercise and strength training to build muscle, your body turns to jelly, and you need to maintain exercise to keep that muscle because otherwise it deteriorates,” she said. “If you stop exercising … it all comes back fast.”
Long-Term Challenge
Despite positive results, Ms Wearing said support around GLP-1 use remained inconsistent. “My endocrinologist appointments cost a few hundred dollars each time and I pay to go to The Bootcamp Co,” she said. She also said greater involvement from GPs was needed in managing treatment. “It should come from the GPs, they need more education around GLP-1s. Mine pretty much just rewrites my script.”
Ms Wearing said long wait times for specialists and the cost of exercise and wraparound care could make long-term success difficult for many Australians. Her experience reflects a broader tension in Australia’s healthcare system between strong demand and rapid uptake, and evolving evidence, uneven access, and limited long-term guidance. While studies continue to show the medications can be highly effective for weight loss and diabetes management, experts caution they are not a stand-alone solution, with weight regain common once treatment stops and sustained lifestyle changes critical.
