Ozempic and Wegovy: How to Prescribe in Australian General Practice

Obesity is now one of the most common chronic conditions managed in primary care.

With the rise of GLP-1 receptor agonists such as Ozempic and Wegovy, patients are increasingly requesting these medications directly.

But prescribing them properly requires more than writing a script.

It requires:

structured clinical assessment
behavioural foundations
medication review
long-term monitoring

GLP-1 medications work best when integrated into a structured chronic disease management plan.

For background information:

Step 1: Perform a Proper Obesity Assessment
Step 2: Establish Behavioural Foundations First
Step 3: When to Prescribe GLP-1 Receptor Agonists
Step 4: Consider Other Pharmacological Options
Step 5: Review and Deprescribe Obesogenic Medications
Step 6: Safety Considerations
Step 7: Ongoing Monitoring
Obesity Is Chronic Disease Management
Quick Comparison: GLP-1 Therapies
Final Thoughts
Explore AI Tools for Structured Care Planning

Step 1: Perform a Proper Obesity Assessment

Before prescribing medication, confirm that obesity has been assessed comprehensively.

Avoid relying on weight alone.

Clinical assessment should include:

BMI
waist circumference
neck circumference (useful if OSA suspected)
blood pressure
HbA1c or fasting glucose
lipid profile
liver function tests
thyroid function (if indicated)
sleep apnoea screening
medication review

The World Health Organization recognises obesity as a chronic disease requiring long-term management.

Reference:

WHO – Obesity and Overweight Fact Sheet

Step 2: Establish Behavioural Foundations First

Medication alone rarely produces durable results.

Behavioural strategy remains essential.

Practical habit-based interventions include:

fixed walking schedule
structured grocery shopping plan
removal of trigger foods from the home
protein-first meal structure
reducing liquid calories
improving sleep hygiene

These approaches reflect behaviour-change principles described in Atomic Habits.

Tiny sustainable habits compound into major metabolic change over time.

Atomic Habits System for Exercise That Actually Sticks

Step 3: When to Prescribe GLP-1 Receptor Agonists

Ozempic (Semaglutide)

PBS listed for Type 2 Diabetes
Not PBS listed solely for obesity
Weekly injection

Typical titration:

Week	Dose
1–4	0.25 mg weekly
5–8	0.5 mg weekly
Maintenance	up to 1 mg weekly

Appropriate in:

T2DM with obesity
insulin resistance
cardiovascular risk patients

See:

TGA Product Information – Ozempic

Wegovy (Semaglutide for Weight Loss)

Specifically indicated for obesity management.

Typical titration:

Week	Dose
1–4	0.25 mg
5–8	0.5 mg
9–12	1 mg
13–16	1.7 mg
Maintenance	2.4 mg weekly

Indicated for:

BMI ≥30
BMI ≥27 with comorbidities

Common comorbidities include:

hypertension
type 2 diabetes
obstructive sleep apnoea
dyslipidaemia

Evidence source:

NEJM – Semaglutide for Obesity Trial

Mounjaro (Tirzepatide)

Dual GIP/GLP-1 receptor agonist.

Clinical trials suggest greater weight reduction than semaglutide.

Prescribing requires checking:

current TGA approval
PBS eligibility

Reference:

NewsGP: The TGA has approved tirzapetide for the treatment of overweight and obesity

Step 4: Consider Other Pharmacological Options

GLP-1 therapy is not the only tool.

Alternative medications may include:

Metformin (insulin resistance / prediabetes)
Topiramate
Phentermine (short-term use)

Combination strategies may be appropriate in selected patients.

Medication choice should always be individualised.

Step 5: Review and Deprescribe Obesogenic Medications

One of the most effective obesity interventions is often deprescribing.

Common medications associated with weight gain include:

SSRIs (some agents)
gabapentin
pregabalin
quetiapine
olanzapine
valproate

When clinically appropriate:

reduce dose
switch to weight-neutral alternatives
rationalise polypharmacy

You cannot treat obesity effectively while continuing multiple weight-promoting medications without review.

Step 6: Safety Considerations

Before prescribing GLP-1 therapies, screen for:

medullary thyroid carcinoma history
MEN2
pancreatitis history
severe gastroparesis
gallbladder disease

Counselling should include discussion of:

nausea
vomiting
constipation
early satiety
potential lean muscle loss

Encourage:

adequate protein intake
resistance exercise

Step 7: Ongoing Monitoring

Follow-up every 4–12 weeks.

Review:

weight
waist circumference
HbA1c (if diabetic)
medication tolerance
adherence
dietary protein intake
muscle preservation

If there is no meaningful weight response after adequate dose and duration, reassess treatment strategy.

Obesity Is Chronic Disease Management

Obesity should be managed similarly to:

hypertension
diabetes
cardiovascular disease

Management tools include:

GP Management Plans
team care arrangements
dietitian referral
exercise physiology referral
sleep clinic referral if OSA suspected

Structured care pathways improve long-term outcomes.

Official frameworks:

Quick Comparison: GLP-1 Therapies

Medication	Mechanism	Primary Indication
Ozempic	GLP-1 agonist	Type 2 Diabetes
Wegovy	GLP-1 agonist	Obesity
Mounjaro	GIP + GLP-1 agonist	Diabetes / emerging obesity use

These medications should always be used within a structured metabolic care plan.

Final Thoughts

Ozempic and Wegovy are powerful therapeutic tools.

But they are not magic treatments.

The real prescription includes:

measurement beyond weight
behavioural architecture
medication optimisation
deprescribing obesogenic drugs
structured follow-up

When integrated into a chronic disease management system, GLP-1 therapies can significantly improve patient outcomes.

When used alone, results are often disappointing.

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