GLP-1 medicines
Ozempic and semaglutide in South Africa
What you should know about GLP-1 medicines for obesity, from a Cape Town physician who has studied them in African patients and helped shape global guidance.
Ozempic (semaglutide) is widely discussed in obesity care. Interest has grown in South Africa among people living with overweight, type 2 diabetes, and metabolic disease. These medicines are not right for everyone. A clinician should prescribe and monitor them.
I am an obesity physician and clinical scientist based in Cape Town. My work includes some of the first African trials of liraglutide in people living with HIV. I have also published research on access to GLP-1 medicines and the health effects of modern HIV treatment. I serve on international groups working to improve obesity care.
This page explains how Ozempic and related medicines work, who may benefit, and what to consider before treatment. It does not replace a personal medical assessment.
Key points
- Ozempic is semaglutide; Wegovy is the same molecule at a higher weight-loss dose.
- GLP-1 medicines reduce appetite and slow stomach emptying to support weight loss.
- They are not over-the-counter and require a clinician's assessment and prescription.
- Common side effects include nausea, vomiting and diarrhoea; monitoring is essential.
- I have studied GLP-1 therapy in African patients and published research on access and eligibility.
What are GLP-1 receptor agonists?
GLP-1 stands for glucagon-like peptide-1, a hormone your gut releases after eating. It tells the pancreas to release insulin when blood sugar rises, it slows how quickly the stomach empties, and it acts on parts of the brain that control hunger and fullness.
GLP-1 receptor agonists are synthetic versions of this hormone. They last longer than the natural molecule, so a single weekly or daily injection can produce sustained effects. For many people, that means less hunger, smaller portions, and gradual weight loss.
The best-known names in South Africa are Ozempic (semaglutide, approved for type 2 diabetes and often used off-label for obesity), Wegovy (semaglutide at a higher dose, approved for weight management), and Saxenda (liraglutide, a daily injection). Other medicines in this class are expected to reach the market in coming years.
Why medical supervision matters
- Dosing is started low and increased slowly to limit side effects.
- Some people need blood tests before starting, and regular follow-ups after.
- Gallbladder, pancreatic and thyroid history must be reviewed.
- Interactions with other diabetes, HIV or weight-loss medicines need checking.
- Weight regain is common after stopping unless a long-term plan is in place.
Research and media
I have written and spoken about GLP-1 access in South Africa through research papers and national media.
Selected publications
GLP-1 receptor agonists for obesity: eligibility across 99 countries
The Lancet Diabetes & Endocrinology · 2026
Analogue insulin, GLP-1, and the WHO Model Essential Medicines List
The Lancet Diabetes & Endocrinology · 2026
Efficacy and acceptability of liraglutide for obesity in people with HIV: results of an open-label clinical trial in South Africa (LIROH trial)
Clinical Infectious Diseases · 2026
Novel anti-obesity drugs for people with HIV
The Lancet HIV · 2024
Questions people ask
- What is Ozempic?
- Ozempic is the brand name for semaglutide, a GLP-1 receptor agonist. It was originally developed to improve blood sugar control in type 2 diabetes and has also been shown to produce significant weight loss. In South Africa it is sometimes prescribed off-label for obesity, while the same molecule at a higher dose is marketed as Wegovy specifically for weight management.
- How do GLP-1 medicines work for weight loss?
- They mimic a natural gut hormone that slows stomach emptying, reduces appetite, and helps regulate blood sugar. The result is usually reduced food intake and gradual weight loss when combined with lifestyle changes. They are not appetite suppressants in the old sense, and they do not work for everyone.
- Are Ozempic and Wegovy available in South Africa?
- Availability changes, and supply shortages have affected both the public and private sectors. Some patients can access them through private pharmacies or medical schemes, but access rules, cost and stock levels vary. A medical assessment is required before any prescription.
- Who is a good candidate for semaglutide?
- Generally adults with obesity, or overweight with a related metabolic condition such as type 2 diabetes or high cardiovascular risk. It is not suitable during pregnancy, in some endocrine disorders, or for people with a history of certain conditions. A full history, examination where needed, and baseline blood tests are essential.
- What are the common side effects?
- Nausea, vomiting, diarrhoea, constipation and abdominal discomfort are common, especially when starting or increasing the dose. Gallbladder problems, pancreatitis and low blood sugar can occur. These medicines must be started, monitored and adjusted by a clinician.
- Will I need to keep taking it?
- For most people, weight returns when the medicine is stopped. Long-term use depends on response, side effects, cost, and overall health goals. This is why a follow-up plan matters as much as the initial prescription.
Book a GLP-1 and obesity assessment
If you are considering Ozempic, Wegovy, Saxenda or another GLP-1 medicine, start with a 30-minute medical consultation. I will review your history, discuss whether a GLP-1 is suitable for you, and build a monitoring plan.
This information is general and educational. It does not replace a personal consultation with a registered medical practitioner. If you have diabetes, thyroid disease, a history of pancreatitis, gallbladder problems, or you are pregnant or planning pregnancy, speak to a clinician before considering GLP-1 therapy. Telehealth consultations are not for medical emergencies - in an emergency call 10177 or go to your nearest emergency department.