Hello! Today we’re diving deep into the meteoric rise of prescription drugs like Ozempic and Wegovy, which have taken America by storm, promising to help with something that millions of people struggle with — weight loss. History suggests we may one day see this latest dieting phenomenon with the same glassy-eyed nostalgia that we view faddy food movements like the Atkins diet... but the data, so far, shows little sign of demand for the drugs slowing down.

In 2012, Danish pharmaceutical giant Novo Nordisk developed semaglutide, a medication to be taken once a week to help tackle type 2 diabetes. The injectable drug was trialed in 2016 and was approved by the FDA a year later, under the brand name Ozempic.

‍Unintended consequences

‍As is common in the process of developing and bringing new drugs to market, users quickly began reporting on Ozempic’s various side effects. Generally, these weren’t particularly pleasant — nausea being one of the most common. But there was one by-product that wasn’t completely unwelcome for some Ozempic patients — as many reported significant weight loss while taking the drug.

Fast forward to today, 2 years after Novo Nordisk’s re-trialed and rebranded version of semaglutide known as Wegovy was approved by the FDA specifically for the purpose of “chronic weight management”, and Ozempic has been called “Hollywood’s worst-kept secret”. Oscars host Jimmy Kimmel even referenced the weight loss injectable in the first two minutes of his opening monologue in March — but it’s not just paid-up members of the Hollywood glitterati that have turned to the drug in recent years.

Scaling up

‍Prescriptions for Ozempic, which is still technically only approved as a treatment for type 2 diabetes, have soared in recent years as word continues to spread about the drug and its reported pound-shifting properties. Indeed, at the start of 2018, US Ozempic prescriptions weren’t even breaking the 100 mark — by 2020, there were over 100,000 a week. That figure has risen even higher since, making it the most prescribed diabetes drug in America by some distance, with doctors increasingly prescribing Ozempic "off-label" — that is for a different purpose from what the medication is explicitly intended for.

And Ozempic isn't the only diabetes drug that's seen a surge in demand. Novo-produced Rybelsus has also soared, as has Mounjaro, which is one of the fastest-rising diabetes treatments, and being tipped by some doctors as the most powerful on the market in terms of weight loss credentials. Developers Eli Lilly are looking to get FDA approval of the drug for that purpose by the end of 2023.

Weighting game

‍While there’s nothing particularly new about people trying to manage and keep their weight down, the number of people who may be tempted to experiment with medical remedies like Ozempic, Wegovy, and Mounjaro is higher than ever, as obesity rates have risen in the US.

The CDC has been taking periodic surveys of the nation’s health since 1960 when the overall share of obese US adults (those whose Body Mass Index exceeded 30) was just 13%. That figure, as well as the number of Americans who are severely obese (BMI at or over 40), has soared in the years since, hitting 43% according to the latest survey in 2018. The rises have affected men and women similarly too, with male obesity rising ~4x from 1962-2018, and the share of severely obese women in the US soaring more than 10x across the same period.

‍Some experts suggest the late 1970s and early 1980s as points at which the obesity epidemic picked up in the US, with many nodding to increasing levels of dietary fat, sugar, and ultra-processed foods as possible causes. However, even with that backdrop, the acceleration in obesity rates in recent years has been stark — and the full effects are being felt today. Indeed, obesity in America costs an estimated $260 billion each year in inpatient and outpatient care and causes thousands of preventable illnesses and deaths annually according to the National Institute of Health. Given the scale of the issue, many have been waiting for a "magic solution" for years.

Tightening belts

‍When set against that not-insignificant backdrop, it’s perhaps too soon to say whether weight loss drugs — or diabetes drugs that make you lose weight — could provide a lasting answer to the US obesity issue. However, with annual courses of Mounjaro and Wegovy reportedly setting users back$12,000 and $16,000, respectively, it’s doubtful any potential solutions would reach far across different financial groups at current price points. Like many other weight loss methods before them, the drugs have been creating a bit of a buzz — this time amplified by social media.

HealthTok

‍At the time of writing, videos tagged with #ozempic have garnered over 1.2 billion views on TikTok. That level of hype has been blamed for causing a national shortage of the drug, leaving some diabetic Americans without the medication that they’ve relied on for years. Wegovy and Mounjaro have been experiencing similar moments in the social media spotlight too, and the increased attention has been accompanied by a swathe of scrutiny too.

A new analysis published just days ago, for instance, suggested that around two-thirds of patients ditch weight loss drugs like Wegovy within a year. News that an EU drug regulator would be widening the focus of its investigation into Novo Nordisk’s drugs and their reported suicidal side effects by taking other manufacturers into account also broke this week, in another potentially damaging sign for the burgeoning treatments.

‍Easy come, easy go

‍Indeed, while the new wave of medication is generating a lot of hype, which could well be valid given the reported success from some patients, it's no guarantee of longevity in such a market filled with fads. Food plans and programs that once promised to rock the dieting scene have come and gone over the years. The low-carb Atkins diet, for example, was immensely popular through the late 90s and early 2000s, though it’s since faded into obscurity, and similar fates have awaited the paleo, or caveman, diet as well as the keto diet which really exploded at the end of the 2010s.

Given the scale of the opportunity, if Ozempic and its peers do prove to be more than a fad, big pharma will have little issue diverting resources to make sure that supply can eventually keep up with the insatiable demand.