Type 2 diabetes is a common condition in our community – one that can have serious health consequences. However, with the right approach, especially significant weight loss, its impact can be limited, and even reversed.
“Ultimately, diabetes remission should be the goal for many people,” says Dr Zane Stevens, an endocrinologist based in Cape Town. “To achieve remission, a patient typically needs to lose at least 15% of their body weight. That can be a major challenge. Of course, lifestyle changes are also possible – for instance, amending one’s eating habits may make a huge difference.”
And new treatments like GLP-1 medications are making a difference. The most well-known is Ozempic, which has gained widespread attention for its weight-loss effects.
“These drugs were originally developed to help manage diabetes,” Dr Stevens explained at a recent Union of Jewish Women event. “GLP-1 is a family of gut hormones that assist with blood sugar control and promote weight loss. With society’s focus on weight management, it’s this secondary benefit that has captured public interest.”
As a result, supply shortages have emerged. Pharmacies are struggling to meet demand as many people seek these medications primarily for weight loss, making access difficult for diabetic patients who need them most.
At the same event, Dr Stevens was joined by Robyn Palmer, an Integrative Nutrition & Health Consultant. Together, they unpacked the complexity of weight-related health issues. “Unfortunately, there’s a societal belief that people who are overweight simply lack discipline,” said Dr Stevens. “But obesity is a biological disease, not a moral failing.”
Palmer emphasised the importance of a more comprehensive approach to weight and health. “Telling someone to eat less and exercise more often isn’t necessarily likely to provide the solution,” she said. “Many other factors – like hormonal changes, particularly during menopause – can affect weight gain and fat distribution. And we need to move beyond just the number on the scale. There’s a difference between healthy fat and metabolically unhealthy fat, so consideration should be given to where the fat is located in the patient’s body.”
Palmer added that patient education is key. “We need to consider the whole person – their biology, environment, and lifestyle – to effectively address obesity and related conditions.”
Both experts agree that GLP-1 medications represent a major breakthrough. These drugs can support substantial and sustained weight loss, which in turn improves overall health. Palmer points to the excitement around how they are being researched and used for age-related metabolic decline (brain and heart health), menopausal effects, and PCOS insulin resistance, as well as turning off addictive behaviour patterns.
“There are some side effects, but these are usually manageable,” noted Dr Stevens. “What’s more concerning are the issues of accessibility and high cost. Some patients are turning to non-FDA-approved brands, which is risky. But with generics expected soon, more affordable options should become available in due course.” ●
60 minute informative talks is a recent addition to the UJW’s programme. The talks address topics of interest in today’s world. Thus far, two sessions have been held. The first addressed transgender identity, and the most recent was ‘Ozempic – a magical pill?’
Keep an eye out for forthcoming topics. Contact projects@ujw.co.za for more information.
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