In 2024, Ozempic has tippled us over the edge of a weight loss revolution, with the drug remaining wildly popular in Australia despite still being increasingly difficult to access. Previously used only in the social circles of Hollywood, the diabetes medication has gone mainstream and has swiftly become more in demand than ever before.
To meet the overwhelming push for accessbility, the weekly injectable is now slowly multiplying under different manufacturers, with pharmaceutical companies such as Wegovy, Mounjaro and Reybelsus popping up alongside Ozempic.
It's big business and the pharmaceutical industry knows it.
In a recent episode of SBS Insight, titled 'The Ozempic Games' (if you missed it, you can watch it here SBS On Demand), the show explored the popularity of weight loss drugs in Australia, highlighting the experiences of real people when it comes to the long term effects and how it's unequivocally changed our relationship with weight — including our approach to fertility.
Prescribed as a means to increase fertility and pregnancy after losing weight, diabetes medication is now being offered as a solution to women hoping to start a family.
And it's a journey nurse educator Zoe Robins knows all too well.
Watch: Speaking of SBS Insight, here's a snippet from another recent episode on 'Pushing The Boundaries'. Post continues below.
Speaking with Mamamia, she shared, "In my 20s, I had a notion of 'I'll get married and then I'll have children'. The actual fertility itself really wasn't in the forefront of my mind."
After meeting her husband and getting married in 2012 at the age of 33, she said she went back and forth on the idea of having children.
"I was extremely concerned about passing on mental health conditions. Both my husband and I have mental health diagnoses, and so does my mum — who has always felt very guilty. But it really hit home to me, and I was thinking, do I want a future child to go through what I've been through? So there's all that nuance there."
By 2019, the couple had decided they would try to have a child and a year later, they started IVF treatment.
The connection between weight loss and fertility.
In order to increase her chances of falling pregnant via IVF, Zoe's doctor advised her to lose weight.
"I decided to go through Weight Watchers. I've got OCD and I've got a very type A personality. I love goals. So Weight Watchers, hook, line and sinker was going to 'work' for me."
Over the course of a year, Zoe managed to lose a large amount of weight. But at the same time, it took a massive toll on her mental health.
"I became way too obsessed, and I look back at photos where I see this poor girl. She looks terrible. But our society is so obsessed with 'skinny', so I thought I was doing great and everyone was saying 'congratulations!'.
Unlike age, Zoe said weight loss was something she could control.
"You're not only told to lose weight to have a baby, but in addition to that, it's also your age. So it's this mounting pressue of needing to lose weight, fast. And a lot of that pressure is placed on the female."
At 39, Zoe said her dream of having a child was shadowed further by her endometriosis diagnosis — for which she underwent surgery. Slowly, she felt her chances of becoming a mother were dwindling.
After researching her options, Zoe came across the possibility of using semaglutide (Ozempic) to help her 'speed up' the weight loss process and reach her goal.
"In 2022, I spoke about it [Ozempic] to one doctor and he was very against it, saying the medication was only for people with diabetes. And I understood where he was coming from. But I saw another doctor, recommended through my nutritionist, and she didn't hesitate. It was almost like one extreme to the other. I think she could really empathise with how hard it is for some people to get pregnant."
In Australia, Ozempic is only approved and subsidised for patients with diabetes, but doctors can use their own discretion to prescribe it for patients wanting to lose weight — at full price.
"She told me it wouldn't be easy to access. I've already got an anxiety condition, and I didn't want to be anxious about trying to find it and stopping and starting medication — especially one that's so unknown as Ozempic. I was trying to lose that extra bit of weight but I would also have to come off it probably about a month before doing the embryo transfer. There were all these extra factors."
Mamamia also spoke with GP, dietitian, and Chair of RACGP Specific Interests Obesity Dr Terri-Lynn South, who explained the link between semiglutide, fertility and obesity.
"In general, these drugs don't necessarily increase fertility, per se. But there may be some women who, with some weight loss, may increase their fertility. It really depends on the women and their reason for subfertility. So I think that's important."
"There could be lots of women out there whose issues with fertility have nothing at all to do with their weight and going on semiglutide is not going to help them. But for women where there may be an association of subfertility caused by what we are labelling 'obesity', then semaglutide may help."
On her experience in her own clinic, Dr South said she's noticed a rise in requests from women requesting semaglutide for fertility.
"They've have been advised by their fertility doctors and then they come and see someone like myself. I think it's really important for women to know that the biggest factor on their fertility is their age, not their weight."
"The difficulty is that Australian adults are gaining weight throughout their lifetime. So it does become a double jeopardy if you happen to be an older, fertile-window female, knowing that you're likely going to be holding extra weight in your late 30s than you were in your late 20s. But age is definitely more of an impact on fertility than BMI or body weight."
The side effects of Ozempic.
After attempting to have her prescription filled at several pharmacies, Zoe was referred to a compounding pharmacist (who formulated their own version of the drug).
"Sometimes I was able to get it from the pharmacy and then sometimes I'd have to ring around. I was referred to a compounding chemist and was able to access it. There was no judgement — but again there's that constant sort of anxiety that you might not be able to get it next time."
Zoe stayed on the drug for three months — and the side effects, she said, were concerning.
Some of the main side effects of the medication include things like nausea, vomiting, constipation and diarrhea — all issues Zoe said she experienced
"I felt very fatigued, which is a bit of an issue and kind of ironic because you want to still do things like exercise but you're tired just heading up the stairs," she shared.
"Another consequence of the drug was this 'food noise' that everyone talks about — you don't feel like you need to seek out food as much. And that's good, in a way, but it actually came to the point where I didn't feel hungry and didn't really want food, but that was starting to then mess with my mental health."
"I didn't get an official diagnosis, but my nutritionist suspects that when I was doing Weight Watchers I had disordered eating. So I was starting to get those mental health components creep in insidiously and that concerned me a lot."
"I think that when you accumulate feeling more tired, with knowing that you've got this final embryo and asking yourself if it's really worth it and dealing with that discomfort, it very much concerned me. I was almost thinking, why did I bother? With the expense of it, the inaccessibility and the lethargy combined — it was just constant."
What happens when you stop taking Ozempic for fertility?
For drugs like Ozempic, once you stop injecting the medication, it stops working — it's something of an indefinite prescription. Meaning? The impact on patients' habits isn't quite clear yet.
Dr South said, "I have a lot of empathy for women who've been told to lose weight to fall pregnant because they might use a medication that helps them lose weight, they fall pregnant, but then they're at risk of weight regain, like anyone who uses Ozempic or any sort of weight loss. There is expected weight regain through this simple weight point theory."
After she stopped taking the drug, Zoe said the negative health impacts of abruptly withdrawing was 'terrifying'.
"I basically stopped in June and within days, I was very, very frightened. With my diagnosis, I had bipolar as well, and so I needed to have sleep — but I wasn't able to sleep properly. I was feeling very out of sorts. I was very concerned about my mental health. It really scared me. I was terrified. It was shocking to me how quickly I was simply told to withdraw from it."
After consulting with her psychologist and following the advice of her doctor to lessen the side effects of coming off the drug, Zoe continued on her journey of trying to start a family.
"We transferred our last embryo a couple of weeks back, and unfortunately it didn't take. I knew that it only had a minimal chance because of my age. So, that's the end of our IVF journey. We've been on it for four and a half years."
"I don't think enough is said about when women or couples go through round upon round of IVF and at the end of the day, biology is part of it. We've spent over $100,000 and still… no babies. I've tried to do everything in my power. I can't change my age, but when you're so obsessed with your dream to be a mum you're willing to try anything. The reality is, weight probably wasn't so much of the issue."
Dr South said that in 2024, it's increasingly complex and challenging when it comes to women navigating their subfertility journey. Because it's not black and white. The fact it, there is so much stigma from the medical profession aimed at people who are overweight.
As Dr South added, "I think it's important to get the right messaging that just because a lady is living in a larger body does not necessarily mean that she'll have fertility problems, and does not necessarily mean that she'll need to lose weight to fall pregnant. It may be changing other lifestyle parameters that are with or without weight loss that can increase her background fertility chances."
What do you think about the use of Ozempic for fertility? Share your thoughts with us in the comment section below.
Feature image: Supplied/Zoe Robins.
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