Why diabetes changes your options
Having type 2 diabetes affects your weight loss medication choices in two important ways:
- Lower eligibility threshold: Diabetes qualifies as a weight-related comorbidity, so you're eligible at BMI ≥27 (instead of 30)
- PBS access: Ozempic is PBS-subsidised for diabetes (~$41/script), making it far more affordable than private-only options
Your medication options
| Medication | PBS for diabetes? | Monthly cost | Avg. weight loss | Best for |
|---|---|---|---|---|
| Ozempic | Yes ($41/script) | ~$41 | ~15% | Cheapest option with diabetes |
| Mounjaro | Partial | $350–500 | ~21% | Maximum weight loss + blood sugar |
| Wegovy | No | $400–460 | 15–17% | CV risk reduction (if also have heart disease) |
| Contrave | No | ~$300 | 5–10% | Emotional eating + diabetes |
Our recommendation for diabetes patients
Start with Ozempic on the PBS — at ~$41/script, it's by far the most affordable GLP-1 option and it simultaneously manages your blood sugar and promotes weight loss. If Ozempic doesn't produce sufficient weight loss (less than 5% after 6 months), discuss upgrading to Mounjaro or Wegovy with your endocrinologist.
Mounjaro is worth considering if you can afford the private cost ($350–500/month) because its dual mechanism (GLP-1 + GIP) provides superior blood sugar control alongside higher weight loss.
How much weight loss improves diabetes?
- 5% loss: Meaningful improvement in blood sugar control
- 10% loss: Significant reduction in HbA1c. May be able to reduce diabetes medications.
- 15%+ loss: Diabetes remission is possible for some patients — defined as normal blood sugar levels without diabetes medication for at least 3 months
GLP-1 medications regularly achieve 15%+ weight loss, putting diabetes remission within realistic reach for many patients.
Important: medication interactions
If you're on insulin or sulfonylureas (glipizide, gliclazide), adding a GLP-1 medication increases hypoglycaemia risk. Your doctor will likely need to reduce your insulin dose when starting a GLP-1. Never adjust diabetes medications yourself — always discuss with your doctor.