Obesity related illnesses, as you well know, cost this country a fortune. The direct healthcare costs of obesity, well, they estimated it at $2 billion per year, per year, and that was in 2021, so it'll be a hell of a lot more now. It's more difficult to calculate the total economic impact that obesity has on this country. Estimates range between $4 to $9 billion per year. It depends whether you include lost productivity and how you quantify the loss of quality of life. If you are chair bound and you're in your 20’s, how do you calculate the cost of that? Cardiovascular disease linked closely to obesity costs New Zealand a minimum of $13.8 billion.  

We're looking for hundreds of millions at the moment to try and balance the books with the Budget coming up – look at the billions being spent on healthcare costs. Type 2 diabetes, that costs an estimated $2.1 billion annually. Over two in three adults and nearly one third of children in New Zealand are overweight or obese, placing a severe strain on the health system. So it costs the country a lot. It would make a meaningful difference reducing the numbers of people who are obese and then see that obesity is triggering all kinds of health conditions. The cost in terms of New Zealanders not being able to live their lives, fulfil their potential, that too is staggering. So if there is a way to fix it, why wouldn't we fix it? If somebody said there's a pill for that, you'd take it. 

And indeed, turns out there is. Pharmac thinks we can and should solve the problem through medication. It has added the semaglutide drug to its list of medicines suitable for future funding. In a decision released yesterday, the drug funding agency confirmed it had added Wegovy, as you know it, to its list of options for investment. The options for investment includes all the medications Pharmac would fund if the budget allowed. It's currently unfunded, and if you want to buy it yourself, Wegovy costs someone about $400 a month. The order of Pharmac's list isn't made public for commercial reasons, as Radio New Zealand writes, but if chosen, the drug would be available to people with a BMI of more than 50 and also to those with a BMI of more than 35 with at least two comorbidities.  

There is a cure for obesity, but there will be a group of people, and you might be one of them as you're standing or sitting here listening to me, who don't want to fund obesity drugs despite the clear cost benefits, because you see fat as being a moral failing, and fat people as being inferior beings. You think it's simply a matter of willpower. There were no fat people during wars, food was scarce, and that's the end of that. Pull up your socks, go for a walk, say no, put down the fork, problem solved. Despite the fact that medical experts and psychiatrists say it is way more complicated than that. The ads we're running for weight loss drugs at the moment on this station give an indication of what it's like to see food as a reward and as an enemy. It's the voice chatter that Oprah Winfrey talked about when she went on Ozempic. She said the medication stopped the constant mental chatter about what to eat, what to resist, the constant negotiation about food, which was a feeling she'd experienced for 50 years. The okay, well, if I have an egg for breakfast, that's protein, that's good, but then there's the toast and that's carbs, should I try and put it on say a rice cracker? That doesn't feel very nice. Okay, I've been for a walk so I can reward myself with a piece of cake. Constant. And that's what the ads give an indication of, that's what Oprah Winfrey was talking about. She had an aha moment when she realised that overeating doesn't cause obesity, it's obesity that causes overeating. It is not a moral failing. And I know that when you exercise and when you restrict your food, you lose weight. I've done it before. I'll do it again. I'm in and out like an accordion – I can still hear the chatter sometimes, other times I let it go.  

But for some people, the chatter is so great that they simply don't have the option of going for a walk. Some people can't tie their own shoelaces. It's a psychological illness rather than a physical one. And that's what the experts say, that's not just me. And I know you feel smuggety smug smug smug smug when you're out there running in the early morning and having your chia and your sliced berries and that's your bag, or your marinated vegetables for breakfast, and you're feeling super fit. I used to feel smuggety smug smug smug too when I'd go for my early morning marathon training runs and you knew that people were lying in bed at 7:30 in the morning. Now I think, bloody who was the fool? But you go on feeling smug, you go on feeling smug and feeling superior, and in the meantime, there is a solution to a problem. It's a problem that affects a significant proportion of people. Some people can put down the fork, some people can reset their minds themselves. Great. Others need more assistance. As with many psychiatric illnesses, some people need to have their brain rebooted. And if we can do that and save ourselves billions, why would we not do that?