When supplies resume, should governments subsidise drugs like Ozempic for weight loss? We asked 5 experts
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
You’ve no doubt heard of Ozempic but have you heard of Wegovy? They’re both brand names of the drug semaglutide, which is currently in short supply worldwide.
Ozempic is a lower dose of semaglutide, and is approved and used to treat diabetes in Australia. Wegovovy is approved to treat obesity but is not yet available in Australia. Shortages of both drugs are expected to last throughout 2024.
Both drugs are expensive. But Ozempic is listed on Australia’s Pharmaceutical Benefits Schedule (PBS), so people with diabetes can get a three-week supply for A$31.60 ($7.70 for concession card holders) rather than the full price ($133.80).
Wegovy isn’t listed on the PBS to treat obesity, meaning when it becomes available, users will need to pay the full price. But should the government subsidise it?
Wegovy’s manufacturer will need to make the case for it to be added to the PBS to an independent advisory committee. The company will need to show Wegovy is a safe, clinically effective and cost-effective treatment for obesity compared to existing alternatives.
In the meantime, we asked five experts: when supplies resume, should governments subsidise drugs like Ozempic for weight loss?
Four out of five said yes
This is the last article in The Conversation’s Ozempic series. Read the other articles here.
Disclosure statements: Clare Collins is a National Health and Medical Research Council (NHMRC) Leadership Fellow and has received research grants from the National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC), the Medical Research Future Fund (MRFF), the Hunter Medical Research Institute, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia, the Western Australian Department of Health, Meat and Livestock Australia, and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk (for weight management resources and an obesity advisory group), Quality Bakers, the Sax Institute, Dietitians Australia and the ABC. She was a team member conducting systematic reviews to inform the 2013 Australian Dietary Guidelines update, the Heart Foundation evidence reviews on meat and dietary patterns and current co-chair of the Guidelines Development Advisory Committee for Clinical Practice Guidelines for Treatment of Obesity; Emma Beckett has received funding for research or consulting from Mars Foods, Nutrition Research Australia, NHMRC, ARC, AMP Foundation, Kellogg and the University of Newcastle. She works for FOODiQ Global and is a fat woman. She is/has been a member of committees/working groups related to nutrition or food, including for the Australian Academy of Science, the NHMRC and the Nutrition Society of Australia; Jonathan Karnon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment; Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vaihea Skincare LLC, a director of SetDose Pty Ltd (a medical device company) and a Standards Australia panel member for sunscreen agents. Nial regularly consults to industry on issues to do with medicine risk assessments, manufacturing, design and testing; Priya Sumithran has received grant funding from external organisations, including the NHMRC and MRFF. She is in the leadership group of the Obesity Collective and co-authored manuscripts with a medical writer provided by Novo Nordisk and Eli Lilly.
Fron Jackson-Webb, Deputy Editor and Senior Health Editor, The Conversation
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Samosa Spiced Surprise
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You know what’s best about samosas? It’s not actually the fried pastry; that’s just what holds it together. If you were to try eating sheets of pastry alone, it would not be much fun. But, the spiced vegetable filling? Now we’re talking! So, this recipe takes what’s best about samosas, and makes them into healthy snack-sized patties.
You will need
- Extra virgin olive oil, or coconut oil (per your preference) for cooking
- 4 medium potatoes, boiled, peeled, and mashed
- 1 medium onion, diced
- 1 cup peas
- 1 carrot, finely chopped
- ½ cup garbanzo bean flour (chickpea flour, gram flour, whatever your supermarket calls it)
- ¼ cup fresh cilantro, chopped (substitute parsley if you have the soap gene)
- ¼ bulb garlic, minced
- 1 jalapeño pepper, chopped
- 1 tbsp ground cumin
- 2 tsp garam masala
- 1 tsp ground coriander
- 1 tsp ground turmeric
- 1 tsp ground black pepper
Method
(we suggest you read everything at least once before doing anything)
1) Fry the onion until it is becoming soft and translucent (3–5 minutes).
2) Add the spices (the garlic, both kinds of pepper, cumin, coriander, turmeric, and the garam masala), stirring in well
3) Add the carrot and peas, stirring and cooking until just becoming soft (probably another 3–5 minutes, depending on the heat, how small you chopped the carrot, and whether the peas were frozen or fresh). Take it off the heat.
4) Mix the potato, chickpea flour, and cilantro in a bowl, and carefully add everything from the pan, mixing that in thoroughly too.
5) Shape into patties, and fry them on each side until browned and crispy.
6) Serve as part of a buffet, or perhaps as an appetizer—raita is a fine accompaniment option.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
Take care!
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Cherries vs Blackberries – Which is Healthier?
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Our Verdict
When comparing cherries to blackberries, we picked the blackberries.
Why?
In terms of macros, cherries have more carbs while blackberries have more protein and fiber. The protein of course is a tiny amount and an even tinier difference, and/but it’s worth noting that the fiber isn’t, and blackberries have more than 3x the fiber. So, a win for blackberries in this category.
In the category of vitamins, cherries have more of vitamins A, B1, B2, and B6, while blackberries have more of vitamins B3, B5, B9, C, E, K, and choline. Another win for blackberries.
When it comes to minerals, cherries have a tiny bit more potassium, while blackberries have considerably more calcium, copper, iron, magnesium, manganese, phosphorus, selenium, and zinc. Another easy win for blackberries.
Both fruits have abundant antioxidants, but as many are different, and comparison between them becomes more subjective than we have room for here.
In short, enjoy either or both, but we say blackberries win overall on macro- and micronutrients!
Want to learn more?
You might like to read:
Cherries’ Very Healthy Wealth Of Benefits
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Apple vs Pineapple – Which is Healthier?
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Our Verdict
When comparing apple to pineapple, we picked the pineapple.
Why?
An apple a day may keep the doctor away, but pineapples are heavier and armored and spiky and generally much more intimidating.
More seriously, apples are great but we say pineapples have the better nutritional and phytochemical properties overall:
In terms of macros, actually apples win this first round, albeit marginally; the two fruits are equal on carbs, while apple has a little more fiber and pineapple has a (very) little more protein. This makes the fiber content the deciding factor, so apples do win this one, even if by just 1g/100g difference.
When it comes to vitamins, however, apples have more of vitamins E and K, while pineapple has more of vitamins A, B1, B2, B3, B5, B6, B7, B9, C, and choline. The margins of difference are equally generous on both sides, so this is a clear and overwhelming win for pineapple (including 10x more vitamin C than apples, which are themselves considered a good source of vitamin C)
In the category of minerals, apples have slightly more phosphorus, and pineapple has a lot more calcium, copper, iron, magnesium, manganese, potassium, selenium, and zinc. Another easy win for pineapple.
Pineapples are not only also higher in polyphenols, but also contain bromelain, a powerful anti-inflammatory group of enzymes that are unique to pineapple—you can read about it in the link below!
Meanwhile, pineapple wins the day in our head-to-head here, but as ever when it comes to a plurality of healthy things, do enjoy either or both! Diversity is good.
Want to learn more?
You might like to read:
Bromelain vs Inflammation & Much More
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How To Out-Cheat “Cheat Days”
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Out-Cheating “Cheat Days” (Or Even Just “Cheat Meals”)
If you are in the habit of eating healthily, the idea of a “cheat day” probably isn’t appealing—because you simply don’t crave junk food; it’s not what your gut is used to.
Nevertheless, sometimes cheat days, or at least cheat meals, choose us rather than the other way around. If your social group is having a pizza night or meeting up at the burger bar, probably you’re going to be having a meal that’s not ideal.
So, what to do about it?
Well, first of all, relax. If it really is an exception and not a regular occurrence, it’s not going to have a big health impact. Assuming that your basic dietary requirements are taken care of (e.g. free from allergens as necessary, vegan/vegetarian if that’s appropriate for you, adhering to any religious restrictions that are important to you, etc), then you’re going to have a good time, which is what scientists call a “pro-social activity” and is not a terrible thing.
See also: Is Fast Food Really All That Bad? ← answer: yes it is, but the harm is cumulative and won’t all happen the instant you take a bite of a chicken nugget
Think positive
No, not in the “think positive thoughts” sense (though feel free, if that’s your thing), but rather: focus on adding things rather than subtracting things.
It’s said:
❝It’s not the calories in your food that make the biggest impact on your health; it’s the food in your calories❞e
…and that’s generally true. The same goes for “bad things” in the food, e.g. added sugar, salt, seed oils, etc. They really are bad! But, in this case you’re going to be eating them and they’re going to be nearly impossible to avoid in the social scenarios we described. So, forget that sunk treasure, and instead, add nutrients.
10almonds tip: added nutrients remain added nutrients, even if the sources were not glowing with health-appeal and/or you ate them alongside something unhealthy:
- Those breaded garlic mushrooms are still full of magnesium and fiber and ergothioneine.
- The chili-and-mint peas that came as an overpriced optional side-dish with your burger are still full of protein, fiber, and a stack of polyphenols.
…and so on. And, the more time you spend eating those things, the less time you spend eating the real empty-calorie foods.
Fix the flaw
We set out to offer this guide without arguing for abstemiousness or making healthy substitutions, because we assume you knew already that you can not eat things, and as for substitutions, often they are not practical, especially if dining out or ordering in.
Also, sometimes even when home-cooking something unhealthy, taking the bad ingredient out takes some of the joy out with it.
Writers example: I once incorrectly tried to solve the fat conundrum of my favorite shchi (recipe here) by trying purely steaming the vegetables instead of my usual frying/sautéing them, and let’s just say, that errant-and-swiftly-abandoned version got recorded in my nutrition-tracker app as “sad shchi”.
So instead, fix the flaw by countering it if possible:
- The meal is devoid of fiber? Preload with some dried figs (you can never have too many dried figs in your pantry)
- The meal is high in saturated fat? Enjoy fiber before/during/after, per what’s convenient for you. Fiber helps clear out excess cholesterol, which is usually the main issue with saturated fat.
- The meal is salty? Double down on your hydration before, during, and after. If that sounds like a chore, then remember, it’s more fun than getting bloated (which results, counterintuitively, from dehydration—because your body detects the salt, and panics and tries to retain as much water as possible to restore homeostasis, resulting in bloating) and hypertensive (which results from the combination of the blood having too much salt and too little water, and cells retaining too much water and pressing inwards because it is the cells themselves that are bloated). So, tending to your hydration can help mitigate all of the above.
- The meal is full of high-GI carbs? Preload with fiber, enjoy the carbs together with fats, and have something acidic (e.g. some kind of vinegar, or citrus fruit) with it if that’s a reasonable option. Yes, this does mean that a Whiskey Sour is better for your blood sugars than an Old Fashioned, by the way, and/but no, it doesn’t make either of them healthy.
- The meal is inflammatory? Doing all of the above things will help, as will eating it slowly/mindfully, which latter makes it less of a shock to your system.
See also: How To Get More Nutrition From The Same Food
Enjoy!
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Which Vitamin Brands Are Effective?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝As far as specific brands of vitamin…some are good some not. I don’t like being told what buy but I guess I want to know which are effective. Could there be some brands recognized as good given to us?❞
The most reliable brands are generally those with the most transparency:
- They tell you what is in the supplement; not just the active ingredient(s), with doses, but also any buffers etc.
- They tell you, in the case of ingredients that can have various different sources, what the source is.
- They are, ideally, well-certified and independently tested.
Our previous sponsor Ora is a good example of a company that does this.
Additionally, in terms of bioavailability, generally speaking the order of preference goes liquid > capsule/softgel > tablet, so that’s something to look out for, too.
Note: “liquid” includes powders that are ingested when dissolved/suspended in water, and also includes tablets that become a liquid when dissolved/dispersed in water and ingested that way.
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Fluoride Toothpaste vs Non-Fluoride Toothpaste – Which is Healthier?
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Our Verdict
When comparing fluoride toothpaste to non-fluoride toothpaste, we picked the fluoride.
Why?
Fluoride is indeed toxic; that’s why it’s in toothpaste (to kill things; namely, bacteria whose waste products would harm our teeth). However, we are much bigger than those bacteria.
Given the amount of fluoride in toothpaste (usually under 1mg per strip of toothpaste to cover a toothbrush head), the amount that people swallow unintentionally (about 1/20th of that, so about 0.1mg daily if brushing teeth twice daily), and the toxicity level of fluoride (32–64mg/kg), then even if we take the most dangerous ends of all those numbers (and an average body size), to suffer ill effects from fluoride due to brushing your teeth, would require that you brush your teeth more than 23,000 times per day.
Alternatively, if you were to ravenously eat the toothpaste instead of spitting it out, you’d only need to brush your teeth a little over 1,000 times per day.
All the same, please don’t eat toothpaste; that’s not the message here.
However! In head-to-head tests, fluoride toothpaste has almost always beaten non-fluoride toothpaste.
Almost? Yes, almost: hydroxyapatite performed equally in one study, but that’s not usually an option on as many supermarket shelves.
We found some on Amazon, though, which is the one we used for today’s head-to-head. Here it is:
However, before you rush to buy it, do be aware that the toxicity of hydroxyapatite appears to be about twice that of fluoride:
Scientific Committee on Consumer Safety Opinion On Hydroxyapatite (Nano)
…which is still very safe (you’d need to brush your teeth, and eat all the toothpaste, about 500 times per day, to get to toxic levels, if we run with the same numbers we discussed before. Again, please do not do that, though).
But, since the science so far suggests it’s about twice as toxic as fluoride, then regardless of that still being very safe, the fluoride is obviously (by the same metric) twice as safe, hence picking the fluoride.
Want more options?
Check out our previous main feature:
Less Common Oral Hygiene Options
(the above article also links back to our discussion of different toothpastes and mouthwashes, by the way)
Take care!
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