GLP-1 Medications: Ozempic, Wegovy and Mounjaro

In Australia, there are a number of medications available for weight management. The new generation of these fall into the medication class called Glucagon-Like Peptide 1 Receptor Agonists, or GLP-1s for short. These work by mimicking the naturally occurring GLP-1 hormone, which is released by the gut after eating. GLP-1 medications were designed for Type 2 diabetes, however, it turned our they were a powerful weight loss drug too. Hence the explosion in popularity! Ozempic is the most common version of this medication, and the active ingredient is called Semaglutide. There are also other options available right now in Australia and they all do a similar thing.

What GLP-1 medications are available in Australia currently?

Currently there are a number of GLP-1 specific medications for both weight loss and diabetes management. In regard to diabetes, the research is conducted in people living with type 2 diabetes, however, can be used in those with type 1 diabetes under medical supervision. 

• Semaglutide: (active ingredient) once weekly injection and comes in 2 options.  
  • Ozempic – Type 2 diabetes (available on the Pharmaceutical Benefits Scheme). Starting dose of 0.25mg, once a week for 4 weeks. Available in 0.25mg, 0.5mg and 1.0mg doses in Australia. 
  • Wegovy – Weight loss version (not currently available on the Pharmaceutical Benefits Scheme). Starting dose of 0.25mg, once a week for 4 weeks. Available in 0.25mg, 0.5mg, 1.0mg, 1.7mg and 2.4mg doses in Australia. 

• Tirzepatide: (active ingredient) once weekly injection.
  • Mounjaro – is a dual agonist, which targets both GLP-1 and GIP receptors. Approved for both diabetes and weight management (not currently available on the Pharmaceutical Benefits Scheme). Starting dose of 2.5mg, once a week for 4 weeks. Available in 2.5mg, 5.0mg, 7.5mg, 10.0mg, 12.5mg, 15.0mg doses in Australia. 

Currently Ozempic, Wegovy and Mounjaro are the most common versions of GLP-1 medications in Australia right now. Below are some other available options.  

• Dulaglutide: (active ingredient) once weekly injection.
  • Trulicity – Type 2 diabetes. The usual starting dose is 0.75mg once a week for 4 weeks. Available in 0.75mg, 1.5mg, 3.0mg and 4.5mg.

• Liraglutide: (active ingredient) once daily injection 
  • Saxenda – Weight loss version. The usual starting dose is 0.6 mg once a day for the first week. Each week is increased by 0.6mg per day until week 5 you are on 3.0mg dose per day. 
  • Victoza – Type 2 diabetes version. The usual starting dose is 0.6 mg once a day for the first week. Increase to 1.8mg dose per day.

How can a GLP-1 dietitian help you with GLP-1 medications?

A GLP-1 dietitian is one who specialises in these GLP-1 medications can help support you by:

• Provide advice before starting, by making lifestyle changes to help you get the best out of these medications.
• Guiding you through the early phase (first 3 to 6 months) as this is the time when the gastrointestinal (GI) side effects can occur.
• Supporting you through the ‘maintenance phase’ (after 6 months) where weight loss often stops.

Why dietitian support is crucial for GLP-1s:

So, you are thinking of taking a GLP-1, how can a dietitian help?

Most people don’t come to us looking for support before they start taking a GLP-1, however, getting support before starting them can help in a number of ways. 

Expectations:

The first is that we can discuss your expectations for taking these medications. Everyone’s experience is different and how you navigate this will also be different. To get the best results, we can look at making some specific nutrition and lifestyle changes either before starting and during the first phase of taking these medications.

Nutritional Risks:

GLP-1 medication suppresses the appetite and slows digestion, leading to reduced food intake and potential deficiencies in protein, vitamins, and minerals. This then increasing risk for muscle and bone loss.

We can suggest adjustments to the portions and make up of your food to reduce the onset of medication side-effects. With the right support from us, you may not even need to start on these GLP-1 medications right away!

Gastrointestinal side-effects:

Common side effects of GLP-1 medications are nausea, vomiting, diarrhoea, constipation, excessive belching and abdominal pain. These may be mild and only last a short time, or they can be more serious and last longer than expected. Nutritional support can help reduce the severity and duration of these side effects. 

What about for the long-term?

The first 3 to 6 months is when you work your way through the dose increase phase, and this is often when you struggle the most with the potential side-effects. After 6 months they usually disappear and a new issue can arise. We often refer to this as the ‘maintenance phase’, because if you were able to achieve some weight loss at the start, by now it has slowed down or even stopped.

Behavioral Changes: 

GLP-1 medications alter eating patterns, and without proper guidance and support, old habits can return. Succeeding in long-term lifestyle changes will help you with your ongoing GLP-1 journey or once treatment stops.

Malnutrition & Disordered Eating: 

Lack of proper nutrition support puts individuals at risk of malnutrition and developing unhealthy relationships with food. 

This is where we can help support you with specific nutrition and lifestyle changes to help you on your journey. Wherever you are on your GLP-1 (Ozempic, Wegovy or Mounjaro) journey, please do not hesitate to reach out to chat with us. Or book an appointment now through our online booking system.