In his home in Denmark, Casper Nielsen retrieves a package from the refrigerator and prepares to inject his next dose. “This is Wegovy. You take it four times a month. I used to think I wouldn’t make it to 60, that maybe I wouldn’t see my grandchildren, but now I see a brighter future. I started at 159 kg. Now I weigh 93.5 kg, so I’m doing really well,” says Nielsen, 45. Driven by social media buzz and famous patients like Elon Musk, Wegovy is an obesity drug that’s flying off the shelves despite its recent availability and doubts about the treatment’s duration.
Global sales growth has been such that Novo Nordisk, its Danish manufacturer, became last year the most valuable listed company in Europe. Intended for patients with severe obesity, the active ingredient in Wegovy is semaglutide, a substance that helps control blood sugar levels, decreases appetite, and increases the feeling of fullness. It’s also the active ingredient in Ozempic, a drug used to treat type 2 diabetes. Research suggests that patients treated with Wegovy can lose more than 10% of their body weight. However, some consumers may experience side effects such as nausea and vomiting. Some studies also indicate that patients often regain weight after discontinuing treatment. These issues haven’t slowed down Wegovy’s sales, which multiplied by five in 2023. It’s currently available in Denmark, Germany, Iceland, Norway, Switzerland, the United Arab Emirates, the United States, and the United Kingdom. Japan is expected to join this group by the end of February. US, UK, and European regulators indicate that it should be administered by prescription to patients who meet specific criteria. The causes of obesity are multiple and complex, but the World Health Organization (WHO) and other leading health institutions indicate that many are preventable and reversible.
No country seems to have been able to reduce the growth of this condition considered an epidemic. According to the WHO, the main cause is the lack of balance between calories consumed and expended. This imbalance has been perpetuated by the increased consumption of high-calorie, high-fat, and high-sugar foods, as well as the decrease in physical activity. To reduce the risk of obesity and overweight, the WHO recommends:
Reducing calories from fats and sugars, Increasing daily intake of fruits, vegetables, legumes, whole grains, and nuts , and Engaging in physical activity for 60 minutes a day for children and 150 minutes a week for adults.
Various studies show that exclusive breastfeeding from birth to six months reduces the risk of obesity and overweight in children. Ozempic is now the world’s best-selling drug for treating diabetes. The skyrocketing sales of both drugs boosted Novo Nordisk’s profits. At the end of January, the company announced that its net income had increased by 51% to 83 billion Danish kroner (US$12 billion). Novo Nordisk’s chief financial officer, Karsten Munk Knudsen, admits that the great popularity of Ozempic and Wegovy took the company by surprise. “The demand in the market, both for diabetes and obesity, just increased much more than we predicted,” he says. Knudsen expects strong sales to continue in 2024. “We’re heading for 18-26% growth.” It remains to be seen if Novo Nordisk can manage the demand for Wegovy, explains Emily Field, a pharmaceutical sector analyst at the British bank Barclays. “The underlying demand is so overwhelming that they can’t meet it enough,” she says. Knudsen acknowledges that the company won’t be able to meet demand “in the short term,” but adds that a lot is being invested to expand manufacturing capacity. “We’re building new facilities like never before.” For Denmark, a small country with fewer than six million inhabitants, Novo Nordisk is so big that it’s having a huge impact on the Danish economy. Danish economic growth was 1.1% in the first nine months of 2023. If you remove the weight of pharmaceuticals, dominated by Novo, the economy would have contracted by 0.8%. Now the country publishes economic statistics separately, without the drug industry.
For nearly a century, Novo Nordisk focused on producing insulin. However, the company transformed after discovering semaglutide in 2004. Several years later, the drug was developed as a treatment for diabetes. Its effect on weight loss was a surprise. Ozempic’s marketing was approved in the United States in 2017 and in the European Union in 2018. Wegovy’s turn came in 2021 and 2022 respectively. Dr. Maria Kruger, a spokesperson for the Danish Society of General Medicine, says that the number of patients now requesting Wegovy has surprised doctors. She thinks that more decisive guidance is needed to determine who should receive it. “Social media is affecting people. I think it has to do with this idea we have that the perfect body should be thin.” Likewise, she says that some people in Denmark who could benefit from the drug find it very expensive, as they must pay the full price. “Many patients who really have weight problems and can’t work and have some physical disability can’t afford this medication. I think this is health inequality,” says Kruger.
