19 Oct 2025 South Africa steps up access to weight-loss drugs

SA has recently seen a flurry of regulatory moves and product launches of weight-loss drugs…. and not before time in a country beset by high obesity and diabetes. Their steep cost, however, will be a limiting factor…

With obesity and type-2 diabetes rates rising sharply, both public health officials and pharmaceutical companies are betting on treatments such as GLP-1 and dual-agonist therapies to help fill treatment gaps.

Recent drug launches and regulatory changes

Wegovy (semaglutide 2.4 mg): In August 2025, Danish pharma company Novo Nordisk launched Wegovy, its semaglutide 2.4 mg weekly injection for chronic weight management in SA. It is the first GLP-1 receptor agonist registered specifically for weight-loss management in SA.

Wegovy’s registration allows it to be prescribed for adults with obesity or overweight, typically in conjunction with dietary reduction and increased physical activity.

Mounjaro (tirzepatide): Originally approved in SA in December 2024 for type-2 diabetes, Mounjaro has more recently been approved by the SA Health Products Regulatory Authority (SAHPRA) for chronic weight management (weight-loss indication) as of October 2025.

Aspen Pharmacare, as the local sales agent for Eli Lilly, is actively positioning Mounjaro to compete with Wegovy and is expecting significant sales growth, with the group’s CEO Stephen Saad telling Business Day he expects the drug to rake in R1bn in sales in the next few years.

Its delivery format will include the “KwikPen” injector, facilitating weekly self-injection.

The obesity and diabetes challenge in SA

To understand the urgency behind these launches, here are recent statistics:

• Roughly 50% of adults in South Africa are living with excess weight or obesity. This includes more than two-thirds of women and about one-third of men.
• Childhood obesity: Among children aged 6-14, about 13% are overweight or obese, according to recent national data.
• Diabetes burden: Approximately 4.2 million South African adults (about one in nine) are estimated to be living with diabetes, the vast majority (≈90%) being type-2 diabetes.
• Treatment gaps: While large numbers are affected by obesity/overweight and diabetes, fewer than 1% of those eligible for weight-loss drug therapies are currently accessing them.

Challenges and caveats

• Affordability and equity: Cost is a big barrier. Unless programs for subsidy, insurance reimbursement, or other cost reduction are in place, uptake may be limited to higher-income patients.
• Long-term safety, monitoring, and adherence: Weight-loss drugs require lifestyle support and ongoing medical supervision. Side-effect profiles, patient adherence, and ensuring the treatment is safe long term remain important.
• Sociocultural and system constraints: Obesity is not just a medical issue. Diet, physical activity opportunities, socioeconomic factors, built environment, food environments, and cultural perspectives all play a role. Drugs are a tool – but not a full solution.
• Regulation and supply chain: Ensuring enough supply, reliable distribution, regulatory compliance, and avoiding misuse/off-label risks will be important.

Where things may go from here

• Growing adoption: Over the next few years, we can expect these weight-loss drugs to become more visible in private healthcare settings, possibly also through medical schemes or partial reimbursement.
• Competitive launches and generics: As patents expire, new entrants or generics may drive down costs, improving access.
• Public health policy integration: There may be pressure for government or health systems to integrate these drugs into national obesity/diabetes strategies, particularly for high-risk groups.
• Holistic approaches: Drugs will likely be most effective where paired with nutrition, lifestyle, behaviour-change initiatives and community prevention programs.

GLP-1 drugs reshape the American food landscape

The rapid adoption of GLP-1 weight-loss drugs such as Ozempic, Wegovy, and Mounjaro has transformed the US health and consumer markets — and is now influencing how food companies think about product development.

An estimated 9 million Americans were using GLP-1 medications by mid-2025, with prescriptions growing at double-digit monthly rates. Analysts estimate the market could exceed $100-billion globally by 2030, as consumers seek medically supported solutions for obesity and metabolic health.

The ripple effect is clear across the food sector. Shoppers on these drugs report reduced appetite and smaller portion sizes, prompting brands to rethink package sizes, portion control, and nutritional profiles. Food giants including Nestlé, PepsiCo and General Mills have all acknowledged in earnings calls that GLP-1 use is starting to reshape demand patterns.

Innovation pipelines now include higher-protein, fibre-rich, and functional foods aimed at satiety and muscle maintenance. Beverage companies are similarly exploring low-sugar, nutrient-enhanced formulations that complement weight-management goals. Even fast-food operators are monitoring the trend closely, testing smaller, premium menu items designed for health-conscious consumers.

In short, GLP-1 drugs are not just transforming waistlines — they are redefining what “better-for-you” means in product innovation, forcing the US food industry to adjust to a leaner, more mindful era of consumption.

Sources: Diabestes SA, BusinessLive.co.za, Reuters, University of Pretoria, EWN