Why is it so hard for Māori and Pasifika to access weight loss drugs?

At the start of May, Kayla Dove Tangira (Ngāpuhi, Ngāti Mutunga, Ngāti Tama and Te Ātiawa) did something she hadn’t seen any other Māori do: she started sharing her weight loss journey using Wegovy, the celebrity-backed obesity management medication better known as Ozempic.

“This is my body, and I’m going to do whatever it takes to stick around for my whānau,” the 29-year-old Taranaki resident says in an Instagram post.

“God, that sounds a bit dramatic,” she added.

For as long as Tangira can remember, she has been concerned about her weight. It has been up and down due to fad diets, diet shakes, and less-miraculous weight-loss medications like Contrave (Wegovy only became available in New Zealand on July 1 2025, after years of success overseas, and is privately funded at about $400 a month). Her parents, and now Tangira, were always prepared to feed an army, but a deep guilt of wasting kai meant she ended up eating far more than she needed.

Despite Māori and Pasifika being at higher risk of obesity and the diseases associated with it, such as heart disease and diabetes, they are far less likely to take Wegovy, or the more costly Mounjaro, according to prescription data from Health NZ and anecdotal reports from doctors. The reasons aren’t just financial but are wrapped up in a lack of knowledge about the drug class known as GLP-1s, perceptions of food shaped by colonialism and poverty, as well as unequal healthcare access.

"It’s something that many of us have: this undeniable belief that some things are just not for us,” says Tangira.

“And when I say that, I mean either we’re not good enough for them, or they shouldn’t be for us because they’re expensive and we’ve got better things to be spending our money on.”

Tangira, a mother of a three-year-old daughter, used additional income from a promotion and increased work hours to fund her medication.

At Manu Ora, a kaupapa-Māori charity that offers healthcare in Blenheim, about 2 percent of the practice’s 900 Māori patients use Wegovy, according to Dr Sara Simmons, Manu Ora’s director. Māori and Pasifika represented just over 15 percent of Wegovy and Mounjaro prescription data from July 2025 to May 2026, according to Health NZ, whereas they make up about 26 per cent of New Zealand's population. About 33 percent of New Zealand's general population is considered obese, compared to 45 percent of adult Māori and close to 70 percent for Pasifika adults.

“Unfortunately, again, our patients are so high needs that often weight loss isn’t high on their list of priorities. So for many, and sadly, living in poverty often… increases obesity because of being unable to buy quality nutritious food,” says Simmons.

Kim Tupene, a 59-year-old from Invercargill, fought hard to secure Ministry of Social Development funding to cover her $370-a-month Wegovy prescription via an add-on to her disability allowance.

Despite her expectations that Wegovy would end her struggles with weight, the journey since March has not been smooth. Tupene described the side effects, such as unending nausea and fatigue, as almost unbearable. About 17 percent of people in Wegovy clinical trials stopped the medication due to side effects, and she might too.

“But I still want to keep trying to go on this journey and hopefully get some results. I think I have definitely lost some weight but definitely not a lot.”

Dr Gerard McQuinlan, a Wellington-based GP who specialises in weight loss, says about five percent of his patients are Māori or Pasifika. While many Pākehā patients come to him with a bank of knowledge about GLP-1 medications, many Māori and Pasifika patients haven’t heard of it.

“In my general practice, not many Māori and Pasifika come out and say I want to talk about my obesity, whereas Pākehā patients will say ‘I want an appointment to talk about my weight'.”

Sara, a 41-year-old from Auckland, doesn’t know any other Pasifika who are taking a prescription GLP-1. She started taking Mounjaro at the start of May, which costs about $800 a month and typically has better weight loss than Wegovy with fewer side effects. So far, her weight loss is about a kilo a week. She is hoping it will curb her trajectory towards pre-diabetes, another disease that Pasifika are at greater risk of.

“It’s amazing. I actually don’t know this life,” says Sara, who works in real estate.

Growing up in a large Samoan family with a low income, Sara often turned to bread or other high-carb foods to quiet her hunger. Yet, an abundance of food at family gatherings was seen as an indicator of wealth as well as love for others. That was fine when she was an active teenager, but after five kids and being on the edge of menopause, her approach to food needed a drastic shift. With Mounjaro, she now only thinks about food when it is time to eat, rather than be endlessly preoccupied with her next meal.

The cost of the drug is the main barrier for Pasifika, says Sara. Instead, friends, whānau and those she follows on social media have turned to the grey market and offshore websites to obtain the illicit peptide Retatrutide - or what they hope is Retatrutide. The drug is undergoing clinical trials and isn’t approved by the Food and Drug Administration in the US let alone New Zealand’s Medsafe. The trials indicate that weight loss is around 25 percent of body weight compared to Wegovy’s 15 or so percent.

Studies and data from overseas, where Wegovy and Mounjaro have been available for several years, demonstrate the wide-ranging impact of GLP-1s on more than just weight loss. The medications can reduce the risk of sleep apnea, kidney disease, severe liver disease and some cardiovascular issues among other benefits. All of these conditions strike Māori and Pasifika at disproportionately higher rates than non-Māori and Pasifika populations in New Zealand.

While there is great interest from clinicians in the benefits of GLP-1s, dietitian and Māori health researcher Dr Hannah Rapata advises some caution in framing the medication as a silver bullet for indigenous health.

“I think a lot of the time in clinical spaces, and in Māori communities as well, fat bodies are often problematised… and thought that medication might be the solution due to weight stigma and racialised blame.”

Many have pointed the finger at the prevalence of GLP-1s overseas (about 12 percent of Americans are taking some form of the medication) for reversing the body positivity movement of the 2000s and 2010s. The decline in size representation within the modelling industry was explored last year in the six-part RNZ documentary Cutting the Curve. People of Māori and Pasifika descent typically have a higher muscle mass and less body fat than Pākehā of the same BMI, making it an out-of-tune measure for those with Polynesian heritage.

When RNZ interviewed Tangira a second time, she was on day 39 of Wegovy. The weight loss has been less than expected. She is down only two kilos from her start of 109 kilos and predicts her weight loss will increase as her dose increases, which is typical prescribing strategy for Wegovy.

But her other goal of showing other Māori that GLP-1s are for them as well has been thrilling.

“It’s been quite empowering to know that there are other people that are really interested in starting their own journey, but have no idea where to turn to in the way of, does this work for our people? Is it working for you? Is it not?

“And I’m not sharing just the good stuff.”

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