Ozempic is pictured in a pharmacy on April 13, 2023 in Niesky, Germany.

Sales of the diabetes drug Ozempic have exploded as doctors prescribe it for weight loss, an off-label use. Florian Gaertner Photo Library/Getty Images

Blockbuster obesity drugs Ozempic and Wegovy boosted sales for Danish pharmaceutical company Novo Nordisk, up 25% year-on-year in the first quarter of 2023 alone, and the company expects more growth this year . But even though Novo Nordisk enjoys a huge success thanks to its inventions, its scientists have begun work on the next generation of diet drugs that they believe will eclipse the booming market of those currently available: drugs to prevent people from becoming obese. in the first place.

The real big frontier is when we start talking about prevention, said Marcus Schindler, lead scientist at Novo Nordisks and executive vice president for research and early development Fortune in mid-June, sitting in the airy top-floor lounge of the company’s headquarters near Copenhagen. There are particular biological systems that kick in earlier, before you actually have full-blown obesity, he says. We’re starting to ask ourselves, what if we could stop these processes from happening?

Answering this question has become a major concern of Novo Nordisk, as competitors like Eli Lilly and Pfizer race to catch up with Novo Nordisk’s obesity drug sales. Any company that can figure out how to stop people from gaining weight to begin with will unlock untold fortunes in drug sales. Novo expects its revenues from current obesity drugs to exceed $3.66 billion annually by 2025. Morgan Stanley estimates that the global weight-loss drug market could grow more than 2,000% in this decade, from $2.4 billion annually in 2022 to $54 billion by 2030.

That growth is dizzying and doesn’t even take into account possible new inventions by Novo Nordisk and others.

Limitations of Ozempics and Wegovys and long-term effects

It may take years to develop new drugs, but Schindler believes they are on the way. Last month, Novo Nordisk launched an internal obesity prevention unit to begin researching new weight-loss drugs. Schindler says the goal is to overcome the major limitations of Ozempic and Wegovy: the fact that prescription drugs are given only when patients already have type 2 diabetes or have become medically obese. And second, that they only work as long as people take them. Just like the conventional diet, much of the weight could come back once patients stop the medications.

Ozempic was approved by the Food and Drug Administration in 2017 for the treatment of type 2 diabetes, while Wegovy was approved two years ago for weight loss. Over the past year, demand has reduced supplies of Wegovy, so dieters have asked their doctors to prescribe Ozempic for weight loss, an off-label use. As a result, Ozempic’s sales soared. Novo Nordisk says the US accounted for the majority of its global sales last year.

Novo Nordisk is still riding its sales boom led by Ozempic and Wegovy as it looks for the next big thing.

LISELOTTE SABROEScanpix Denmark/AFP/Getty Images

Both drugs are so-called semaglutides. They mimic a Novo Nordisk hormone discovered in the 1980s that makes people feel full even after a small amount of food. The invention proved to be a major breakthrough, allowing people on Ozempic and Wegovy to lose 10% to 15% of their body weight relatively quickly, depending on one’s metabolism, something Schindler says scientists had always thought it was nearly impossible.

But despite their huge popularity in the U.S. as diet drugs, Ozempic and Wegovy weren’t intended for use as continuous weight-loss methods, and Schindler says scientists still don’t know what happens if people take them for long periods. of time. Wegovy has only been on the market for two years. We just don’t have enough data yet about what’s going to happen in the body. Will it remodel? he says. We do not know yet. It’s too early to tell.

The gene that causes obesity

This led Schindler and others to start thinking about ways to stop obesity before it starts. The research would likely involve identifying people’s genetic makeup. Schindler says it’s based largely on the quality of those early, early symptoms or markers. He compares the new work to discoveries in cancer research, which has helped pinpoint genetic characteristics that show how likely someone is to develop certain types of cancer in the future. Maybe you could do the same for obesity, he says. Finding those genes could then determine which drugs to develop to prevent obesity and help people maintain a stable weight. Among the clues researchers are looking for is why some obese people develop medical complications while others don’t.

Few expect quick answers. Novo Nordisk is used to long drug searches. It’s very early and will take a long time to do, says Camilla Sylvest, executive vice president of Novos, who is an economist. But if we don’t start now it will take even longer.

As company scientists look into how to prevent weight gain, Schindler thinks other advances may come sooner. That includes making Ozempic and Wegovy more effective at helping severely obese people maintain weight long-term, even after they stop taking the drugs, which drugs aren’t yet powerful enough to do. Novo Nordisk also hopes to develop next-generation drugs that can last for months. Right now, Ozempic and Wegovy are given in weekly injections, which patients give themselves. What if it’s not every week, but every month? Schindler says. Eventually, an anti-obesity shot could become like a COVID-19 vaccine, rarely administered by a doctor or pharmacist. I’m particularly interested in how we can simply make drugs more affordable, she says. What are the features of our drugs that would help bring it to a larger population?

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