
<p><strong>A class of prescription weight-loss drugs is transforming weight management to the point that manufacturers are struggling to keep up with demand. big pharma continues to bet big on it and the market could be worth $150 billion by 2030.</strong></p>



<p>W<strong>hen Johannesburg-based </strong>Kendi (<em>name changed to protect privacy</em>) was pregnant with her second child, she developed gestational diabetes. She didn’t have a family history of the disease so learning how to manage her sugar while nursing a newborn was a mine- field. After years of interchanging injections, patches and pens, her endocrinologist recommended Ozempic to go along with her insulin. Kendi wasn’t on Ozempic for weight loss although in the beginning, she did lose a few kilograms. Her doctors were happy because the drug was working as it was meant to and her blood glucose levels were signifi- cantly lower. The only problem was that when she went to collect her prescription, the pharmacy had no stock. Even the diabetic center was struggling to keep up with scripts, eventually creating a rule that they would only dispense medication if you were a patient at the center. “There are still times when I can’t get the right dosage and only the smaller pens are available,” she says. “You end up injecting double the amount; the pen finishes much quicker and then it’s back to the beginning…”</p>



<p>Welcome to the Ozempic era. A drug originally devel- oped to help treat adult-onset diabetes by stimulating insu- lin resistance is now being used to fight the global obesity epidemic. Novo Nordisk’s Ozempic (and Wegovy) belong to a class of drugs known as GLP-1 receptor agonists and they’re transforming weight management to the point that manufacturers are struggling to keep up with demand, something that hasn’t happened since anti-HIV drugs launched in the 1990s. But it’s not only injectable sema- glutide, the active component in Ozempic and Wegovy, there’s liraglutide (or Saxenda, also from Novo Nordisk) and tirzepatide (Eli Lilly’s Mounjaro and Zepbound) on the market which also target GLP-1 receptors, though they work through different mechanisms and have varied dos- ing schedules.</p>



<p>It’s a lot to take in. To say anti-obesity medicine is big business is an understatement, with Goldman Sachs ana- lysts predicting that the market could be worth $150 billion by the early 2030s.</p>



<p>Shares for both Eli Lilly and Novo Nordisk are also booming, with the two pharmaceutical giants controlling around 80% of the obesity market. And while global spend- ing on obesity medications hit $24 billion last year, Ameri- can multinational company IQVIA’s estimation is that it should reach $131 billion by 2028. It’s no wonder that big pharma and biotech companies like Viking Therapeutics, Pfizer, Amgen and AstraZeneca are all hoping to break the weight-loss duopoly and launch their own GLP-1-based treatments.</p>



<p>In the United States (U.S.), a month’s supply of Ozem- pic costs around $1,000 (R18,000), depending on insurance coverage and dispensing pharmacy. Each box of Ozem- pic contains four weekly doses, administered by a pen. In South Africa, the price is significantly lower, starting at R1,500 ($85) for the minimum weekly dose. According to SAHPRA (South African Health Products Regulatory Au- thority), Ozempic is not registered for weight-loss use in South Africa. Saxenda, which is the same product as Vic- toza when used for diabetes, costs between R2,500 ($141) to R4,000 ($226), depending on the dose required.</p>



<p><strong>Satiety</strong><strong> </strong><strong>and</strong><strong> </strong><strong>sugar</strong><strong> </strong><strong>control</strong><strong></strong></p>



<p>First approved by the U.S. Food and Drug Administration in 2005, GLP-1 drugs like Ozempic or Wegovy, an injectable form of the drug semaglutide, was approved for adults with type 2 diabetes back in 2017. Semaglutide mimics a natural hormone in the body known as GLP-1 that plays a key role in controlling blood sugar and appetite. When blood sugar levels rise, these drugs help the body produce more insulin to lower it, while also reducing the amount of glucose re- leased by the liver.</p>



<p>Dr Brad Merwitz, a Johannesburg-based endocrinolo- gist, sees a number of patients every week that enquire about Ozempic. Of course, not everyone who comes to him is looking for a weight-loss miracle. Some people have pre- existing medical issues like diabetes or other co-morbidities and have read up about the drug. But with Ozempic, there’s something that he has never experienced before as a doctor – people asking for a drug by its name. “There’s been a shift. People used to ask about weight-loss drugs [in general] but not to this extent,” says Merwitz. “People now know the names of the drugs but not necessarily the side-effects, the cost or indications. They just know that there is this ‘wonder drug’ out there that can help them lose an enormous amount of weight in a short amount of time.”</p>



<p>Weight loss is not only the positive side-effect of Ozempic. Once the drug is in your system and the common, gastrointestinal side-effects like nausea, vomiting and diarrhoea dissipate, there are long-term benefits like improved liver function and lower stroke rates. A study published in <em>The</em><em> New England Journal of Medicine </em>found that semaglutide reduced the risk of cardiovascular diseases (CVDs), including events like heart attacks and strokes, by around 20%.</p>



<p>Professor John Deanfield, the study’s lead author, said that semaglutide should be routinely prescribed to treat CVDs — a significant breakthrough, given that no previous weight-loss drugs have demonstrated similar cardiovascular benefits.</p>



<p>This is especially impactful for Africa, where car- diovascular disease is a major cause of death. What makes this finding even more remarkable is that the benefits extend beyond weight loss; participants with only mild obesity or limited weight loss still saw signifi- cant improvements in cardiovascular health.</p>



<h2 class="wp-block-heading" id="h-a-mental-shift">A mental shift</h2>



<p>Another unexpected side-effect links to the brain and has neuroscientists excited about the connec- tion between GLP-1 and substance abuse disorders and behavioral issues. There are already signs that drugs in this category could treat neurological con- ditions like Parkinson’s disease, Alzheimer’s or even be repurposed as anxiety, depression or eating dis- orders’ medication. One of the most common pa- tient responses to taking semaglutide is that it helps to reduce ‘food noise’, a term often used to describe cravings or continual thoughts about eating. In the <em>European Journal of Clinical Nutrition</em>, they refer to GLP-1 as a ‘satiety hormone’. This is because sema- glutide works by mimicking the hormone GLP-1, which affects multiple areas in the brain responsible for appetite regulation and fullness.</p>



<p>Merwitz says that what’s important to remember is that these drugs don’t work as a stimulant, like am- phetamines which were used in the past for medical weight loss. “They don’t have those central, neurologi- cal side-effects like the older weight-loss formulations. There is no addictive potential to them,” he adds. That said, Merwitz’ advice is that patients with diabetes should take precedence because there are multiple deleterious effects to uncontrolled sugar. That said, not every diabetic needs Ozempic – the ideal candidate for the drug should also be obese and have cardiovascular issues. “Moving forward, should funding and public health models allow it, these will probably become drugs that are used a lot earlier because of their cardio- protective effects and cardiovascular benefits,” he says.</p>



<h2 class="wp-block-heading">A silver bullet?</h2>



<p>For off-label use, it’s recommended that patients fol- low strict, calorie-controlled diets alongside other healthy habits like regular low-impact workouts. In fact, research from the <em>Diabetes Care </em>journal found that people who used Ozempic in conjunction with exercise lost significantly more weight than those who used Ozempic alone. “It’s not a silver bullet,” adds Merwitz, who says that what the literature says is that a third of people will have a very good response to GLP- 1, the next third will have an average response, and the last third of people will have no response. “Anecdot- ally, it’s not been my experience that as many as a third have no response.” While these drugs are designed for chronic disease, and the guideline is that you should be on them for a minimum of 12 weeks, people do stop for a number of reasons ranging from that they haven’t seen any weight loss to simply not being able to afford the treatment long-term.</p>



<p>The question really is – is the weight loss worth the cost? And when you stop a drug like Ozempic, have you put enough lifestyle modifications in place that the weight doesn’t return? In a <em>CNBC </em>interview with a senior executive from Novo Nordisk, it was said that most people will recover most of their weight within five years of stopping an obesity drug.</p>



<p>Some individuals may actually gain more weight after stopping an obesity drug than they initially lost. ‘Ozempic rebound’ is common, without the right life- style interventions in place.</p>



<p>But unlike bariatric surgery, which is a permanent procedure (and that comes with post-operative com- plications), GLP-1 drugs are a well-tolerated and re- versable solution.</p>



<p>Goldman Sachs estimates that GLP-1 agonist drugs could be used by up to 70 million consumers world- wide by 2028. In South Africa, where obesity is wide- ly prevalent, Ozempic could be revolutionary. “It’s a very exciting space,” says Merwitz. “Hav- ing these drugs available has really changed the way we manage obesity. It’s given us options we’ve never had before.”</p>


Ozempic

Worth The Weight: Medicine’s Gold Rush


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>A class of diabetes and weight loss drugs that includes Novo Nordisk’s Ozempic and Eli Lilly’s Mounjaro could also help protect against a variety of cancers, according to new research published Friday, adding to mounting evidence the injections offer&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/04/18/weight-loss-and-diabetes-drugs-like-ozempic-and-mounjaro-could-treat-sleep-apnea-and-parkinsons-too-here-are-other-conditions-scientists-are-looking-at/?sh=62e373b67f76">numerous additional health benefits</a>&nbsp;as pressure builds for insurers and public health providers to cover the popular medication in spite of&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/04/30/wegovy-is-available-again-after-shortages-fda-says-but-supplies-are-still-limited/?sh=4773390761b4">persistent shortages</a>&nbsp;and cost&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/05/13/bernie-sanders-urges-ozempic-maker-novo-nordisk-to-be-fair-over-outrageously-expensive-us-drug-prices/?sh=2d9c1973404c">concerns</a>.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Glucagon-like peptide receptor agonists, a class of drugs often known as GLP-1s or GLP-1RAs, were associated with a “significant risk reduction” for 10 different cancers when used to treat type 2 diabetes compared to insulin, according to new&nbsp;<a href="http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2024.21305?utm_source=For_The_Media&amp;utm_medium=referral&amp;utm_campaign=ftm_links&amp;utm_term=070524" rel="noreferrer noopener" target="_blank">research</a>&nbsp;published in JAMA Oncology.</p>



<p>The findings come from an analysis of the electronic health records of 1.7 million U.S. patients over 15 years who were prescribed GLP-1RAs, insulins or metformin for type 2 diabetes — all help control blood sugar — between 2005 to 2018, though it did not specify which drugs were examined.</p>



<p>GLP-1 drugs, which mimic the action of a gut hormone and can help control blood sugar, include popular obesity and diabetes treatments like Ozempic and Wegovy (brand names for semaglutide), Mounjaro and Zepbound (or tirzepatide), Victoza and Saxenda (liraglutide) and Trulicity (dulaglutide).</p>



<p>Semaglutide was only authorized for medical use towards the end of the study timeline and tirzepatide was not approved until much later, though findings for some drugs can give an indication for what might happen with closely related drugs.</p>



<p>All of the 13 cancers studied are considered obesity-associated cancers as excess body fat has been linked to a greater risk of developing them and worse prognosis among patients who do.</p>



<p>GLP-1RAs were linked to a greatly reduced risk of developing esophageal, colorectal, endometrial, gallbladder, kidney, liver, ovarian, and pancreatic cancers, as well as meningioma and multiple myeloma, compared to patients taking insulin.</p>



<p>There was no firm evidence for a lower risk for developing the obesity-associated cancers compared to patients taking metformin for their diabetes, however, though the researchers said there were promising but statistically insignificant indications of a lower risk for gallbladder and colorectal cancer.</p>



<h2 class="wp-block-heading" id="h-surprising-fact">SURPRISING FACT</h2>



<p>While GLP-1RAs were associated with a decreased risk for most obesity-associated cancers studied compared to other standard diabetes treatments, the researchers said drugs were also associated with a risk of developing some cancers. Compared to patients on metformin, patients taking GLP-1RAs had a higher risk of kidney cancers, the researchers said, though the risk was also lower than patients taking insulin. There have been no previous reports of kidney cancers associated with using GLP-1s, which are known to have direct effect on kidney function and have been&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/05/25/ozempic-drug-semaglutide-could-protect-kidneys-study-finds/">linked</a>&nbsp;to lower rates of kidney disease. Nevertheless, the researchers said the findings should be followed up for “full evaluation” and suggest the need for continuous monitoring of patients being treated with GLP-1RAs. There was also no significant reduction in the risk of developing thyroid cancer for patients taking GLP-1RAs compared to insulins, the researchers said. This finding adds weight to existing research highlighting concerns the drugs are associated with an increased risk of developing thyroid cancer and support warnings on drug packages advising caution among patients with endocrine or thyroid problems.</p>



<h2 class="wp-block-heading" id="h-what-we-don-t-know">WHAT WE DON’T KNOW</h2>



<p>The study was observational in nature and therefore can only determine relationships, not cause and effect. It’s possible the reduction in risk for obesity-associated cancers comes from the weight loss and diabetes control afforded by such medications, as these are both issues linked to higher risks of cancers, or from some action of the drug itself or another thing entirely. Given the data available, the researchers said the study doesn’t consider “newer and possibly more effective antidiabetic and weight loss agents,” which could show even more pronounced effects, as well as those with multihormone agonist activities that are increasingly coming to market (tirzepatide, for example, is a multihormone agonist).</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>These results add to a growing pile of research suggesting the health benefits of popular weight loss and diabetes injections extend far beyond control of the conditions they were brought to market for, which themselves are implicated in a variety of physical and mental health problems. These data will be crucial to helping companies <a href="https://www.forbes.com/sites/roberthart/2024/03/27/heres-why-ozempic-and-mounjaro-rivals-wont-topple-weight-loss-drugmakers-novo-nordisk-and-eli-lilly-anytime-soon/?sh=76a10ccf2b38">maintain an edge</a> over <a href="https://www.forbes.com/sites/roberthart/2024/03/13/ozempic-and-wegovy-rivals-here-are-the-companies-working-on-competitor-weight-loss-drugs/">competitors</a> racing to bring their first products to market and will add heft to arguments the drugs should be funded by insurers, employers and public health authorities dragging their heels on coverage. A <a href="https://www.forbes.com/sites/roberthart/2024/04/18/weight-loss-and-diabetes-drugs-like-ozempic-and-mounjaro-could-treat-sleep-apnea-and-parkinsons-too-here-are-other-conditions-scientists-are-looking-at/?sh=3724094f7f76">myriad of other conditions</a> are being explored by drugmakers, including <a href="https://www.forbes.com/sites/roberthart/2024/06/21/mounjaro-drug-tirzepatide-could-treat-sleep-apnea-study-finds/">sleep apnea</a>, addiction, anxiety, Parkinson’s and fatty liver disease and Novo Nordisk has already secured convincing enough data to add cardiovascular disease to Wegovy’s label.</p>



<p>.</p>


Ozempic Manufacturer Sued Over Side Effects Of Medication Used For Weight Loss

Drugs Like Ozempic Could Lower Cancer Risks, Study Suggests


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Nestlé is tapping into the lucrative weight loss drug market by catering to customers’ “shifting” nutritional needs, CEO Mark Schneider&nbsp;<a href="https://www.cnbc.com/2024/05/30/nestle-ceo-discusses-impact-of-weight-loss-drugs-on-food-industry.html" rel="noreferrer noopener" target="_blank">told</a>&nbsp;CNBC on Thursday, an optimistic pivot from one of the industry’s biggest players in the face of dire early predictions suggesting wildly popular drugs like Ozempic, Mounjaro and Wegovy would take a bite out of the food industry.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>When GLP-1 drugs like Ozempic and Wegovy really started taking off, the food industry and&nbsp;<a href="https://www.forbes.com/sites/tylerroush/2023/10/06/will-ozempic-users-really-buy-fewer-groceries-major-food-stocks-drop-after-walmart-execs-claim/?sh=87779f55c5d0">investors initially feared</a>&nbsp;people would just eat less food, Schneider told CNBC’s Silvia Amaro, affecting industry profits in the process.</p>



<p>These fears have since transformed into a sense of opportunity, Schneider said, explaining that the nutritional needs of customers’ on the drugs are “just shifting,” rather than going away completely.</p>



<p>“Consumers still have nutritional needs, but they may be different from someone who is not on a weight loss regimen,” he said, noting that people on GLP-1 drugs should take care to ensure they get enough nutrients and vitamins from the food they eat, as well as enough protein to retain muscle mass.</p>



<p>Schneider said the different needs of people using weight loss drugs open up a big market opportunity for companies like Nestlé, which he said has big plans to respond to what has rapidly become a “major consumer trend.”</p>



<p>He said Nestlé has an “ambitious goal” to fulfill this need by pushing healthier “companion products,” including the company’s upcoming<a href="https://www.forbes.com/sites/caileygleeson/2024/05/21/nestl-launching-frozen-food-brand-for-ozempic-users/?sh=54e2808d75a0">&nbsp;frozen food</a>&nbsp;line, Vital Pursuit, which is geared towards GLP-1 users and due to launch later this year.</p>



<p>Schneider also hinted at Nestlé launching further “companion offerings” targeting consumers taking obesity drugs, though he did not indicate what these would be or when they might launch.</p>



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<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>Schneider said new lines and offerings targeting GLP-1 drug users will be an “addition” to the food and drinks industry moving forward, rather than its sole focus. “Remember, there’s going to be a lot of consumers out there that are not on a GLP-1 diet,” he told CNBC. “And there is lots [sic]</p>



<p>of situations where a snack and a chocolate product may still be of a lot of interest.” Many products geared towards GLP-1 drug users will likely “make a lot of sense to consumers” on any kind of weight loss journey, he said. “The same fundamentals apply, and that is you want to be sure that you’re losing fat and not lean muscle mass and you want to be sure that you don’t develop any vitamin deficiencies.”</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>While there have always been profits to be found in the weight loss industry, a <a href="https://www.forbes.com/sites/roberthart/2024/03/13/ozempic-and-wegovy-rivals-here-are-the-companies-working-on-competitor-weight-loss-drugs/?sh=11ef23101f52">growing class of drugs</a> called GLP-1 agonists have upended the sector in recent years. This is largely through their ease of use and unparalleled efficacy. By mimicking the action of a gut hormone involved in regulating appetite and blood sugar, GLP-1 drugs offer a degree of weight loss previously unattainable except through surgery and research indicates they may be able to help with a <a href="https://www.forbes.com/sites/roberthart/2024/04/18/weight-loss-and-diabetes-drugs-like-ozempic-and-mounjaro-could-treat-sleep-apnea-and-parkinsons-too-here-are-other-conditions-scientists-are-looking-at/?sh=3724094f7f76">myriad of other conditions</a> too, including <a href="https://www.forbes.com/health/body/what-is-sleep-apnea/">sleep apnea</a>, addiction, anxiety, Parkinson’s and <a href="https://www.forbes.com/sites/roberthart/2024/05/25/ozempic-drug-semaglutide-could-protect-kidneys-study-finds/?sh=1bdbbc967a51">kidney disease</a>. They are currently authorized for treating diabetes, cardiovascular problems and obesity. Drug titans Novo Nordisk and Eli Lilly — which respectively produce semaglutide, the drug inside Ozempic and Wegovy, and tirzepatide, the drug inside Zepbound and Mounjaro — dominate the field and are <a href="https://www.forbes.com/sites/roberthart/2024/03/27/heres-why-ozempic-and-mounjaro-rivals-wont-topple-weight-loss-drugmakers-novo-nordisk-and-eli-lilly-anytime-soon/?sh=32d91f1f2b38">experts anticipate</a> they will continue to <a href="https://www.forbes.com/sites/roberthart/2024/03/13/ozempic-and-wegovy-rivals-here-are-the-companies-working-on-competitor-weight-loss-drugs/?sh=63f916101f52">see off rivals</a> for some time, despite chronic <a href="https://www.forbes.com/sites/roberthart/2024/04/30/wegovy-is-available-again-after-shortages-fda-says-but-supplies-are-still-limited/?sh=48543f161b49">shortages</a>. The food industry, as well as other industries aligned with weight loss, initially <a href="https://www.forbes.com/sites/tylerroush/2023/10/06/will-ozempic-users-really-buy-fewer-groceries-major-food-stocks-drop-after-walmart-execs-claim/?sh=87779f55c5d0">feared</a> the soaring popularity of the drugs would eat into sales, though the long term impact has yet to be seen.</p>



<p>.</p>


Nestle SA Chief Executive Officer Mark Schneider Interview

Weight Loss Drugs Won’t Eat Into Food Industry Profits, Nestlé CEO Says


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Novo Nordisk’s weight loss injection semaglutide — the ingredient inside its wildly popular drugs Ozempic and Wegovy — could slash the risk of heart attacks and strokes whether patients lose weight when taking it or not, according to new research, a finding that bolsters the&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/04/18/weight-loss-and-diabetes-drugs-like-ozempic-and-mounjaro-could-treat-sleep-apnea-and-parkinsons-too-here-are-other-conditions-scientists-are-looking-at/?sh=62e373b67f76">public health case</a>&nbsp;for the in-demand drug amid increasing&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/05/13/bernie-sanders-urges-ozempic-maker-novo-nordisk-to-be-fair-over-outrageously-expensive-us-drug-prices/?sh=2d9c1973404c">concern over costs</a>&nbsp;and&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/04/30/wegovy-is-available-again-after-shortages-fda-says-but-supplies-are-still-limited/?sh=4773390761b4">persistent supply issues</a>.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Patients taking semaglutide had a 20% lower risk of heart attack, stroke or death due to cardiovascular disease after three years of treatment, according to an analysis of data from the five-year Select trial&nbsp;<a href="https://www.nature.com/articles/s41591-024-02996-7" rel="noreferrer noopener" target="_blank">presented</a>&nbsp;at the European Congress on Obesity conference in Venice, Italy.</p>



<p>Select, which is funded by Novo, involves 17,604 overweight or obese adults over the age of 45 from 41 countries, all of whom have previously had a heart attack, stroke or peripheral artery disease but no diabetes, is the longest clinical trial of Wegovy.</p>



<p>While the cardiovascular benefits of Wegovy are now well recognized, including on the drug’s U.S. label, researchers found patients taking semaglutide received the drug’s cardiovascular benefits of the drug regardless of their starting weight or how much weight they lost when taking it.</p>



<p>University College London’s professor John Deanfield, who led the study, said the “findings have important clinical implications” and suggests semaglutide has another mechanism to lower cardiovascular risk other than reducing unhealthy body fat, adding that many more patients than are taking it now would likely benefit from the drug.</p>



<p>Other&nbsp;<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2307563" rel="noreferrer noopener" target="_blank">research</a>&nbsp;based on Select data, also presented at the conference, found patients taking semaglutide were able to maintain weight loss after four years of treatment, which researchers said held across different ages, sexes and races.</p>



<p>Patients taking the drug for four years lost and sustained an average of 10% of their bodyweight while remaining on the medicine, the researchers found, compared to just 1.5% in the placebo group.</p>



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<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Novo’s semaglutide, alongside Eli Lilly’s tirzepatide, the drug inside blockbusters Zepbound and Mounjaro, are at the forefront of a promising<a href="https://www.forbes.com/sites/roberthart/2024/03/13/ozempic-and-wegovy-rivals-here-are-the-companies-working-on-competitor-weight-loss-drugs/?sh=11ef23101f52"> class of drugs</a> called GLP-1 agonists causing a huge stir in public health and the pharmaceutical industry. The drugs mimic the action of a gut hormone that plays a role in regulating satiety and blood sugar. They were initially tapped to treat diabetes — such as Mounjaro and Ozempic — before being deployed to treat obesity and, more recently, cardiovascular disease. A <a href="https://www.forbes.com/sites/roberthart/2024/04/18/weight-loss-and-diabetes-drugs-like-ozempic-and-mounjaro-could-treat-sleep-apnea-and-parkinsons-too-here-are-other-conditions-scientists-are-looking-at/?sh=3724094f7f76">myriad of other conditions</a> could also benefit, according to growing reports and emerging research, including <a href="https://www.forbes.com/health/body/what-is-sleep-apnea/">sleep apnea</a>, addiction, anxiety, Parkinson’s, kidney disease and fatty liver disease. Obesity is an enduring public health issue in its own right and the weight loss industry is booming even without the health aspect, meaning demand for the drugs is often beyond supply. Both Novo and Lilly readily acknowledge they are unable to keep up and while a range of <a href="https://www.forbes.com/sites/roberthart/2024/03/13/ozempic-and-wegovy-rivals-here-are-the-companies-working-on-competitor-weight-loss-drugs/?sh=73033ce21f52">competitors</a> from startups to pharma titans are rushing to get their own products to market, it is still <a href="https://www.forbes.com/sites/roberthart/2024/03/27/heres-why-ozempic-and-mounjaro-rivals-wont-topple-weight-loss-drugmakers-novo-nordisk-and-eli-lilly-anytime-soon/?sh=10a3819b2b38">going to be years</a> until these products make it and there is no guarantee they will equal or trump the incumbents.</p>


Weight Loss Drugs As US Prescriptions Skyrocket

Ozempic Drug Semaglutide Could Cut Heart Risk By 20%—Regardless Of Weight Loss, Study Finds


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Ozempic maker Novo Nordisk on Thursday teased a potential successor to its blockbuster weight loss drug Wegovy, the latest in a line of next-generation obesity treatments in development as consumers flock to the powerful drugs and competitors including Eli Lilly, Pfizer and an array of <a href="https://www.forbes.com/sites/roberthart/2024/02/28/viking-weight-loss-drug-targets-ozempic-and-mounjaro-makers-supremacy---what-to-know/?sh=15da62cf2e43">startups</a> close in to claim a share of the lucrative market.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>At an investor event on Thursday, Novo Nordisk&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/03/07/novo-nordisks-new-obesity-pill-beats-wegovy-in-early-trial/?sh=20baa926456e">shared</a>&nbsp;data from an early stage clinical trial of an experimental weight loss drug called amycretin, an oral treatment that trial results suggest could be more powerful than the company’s popular weight loss drug Wegovy.</p>



<p>The pill, taken once a day, helped patients in the trial drop 13% of their weight over 12 weeks, a more impressive&nbsp;<a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796491" rel="noreferrer noopener" target="_blank">rate</a>&nbsp;than Wegovy, where patients lost around 6% at 12 weeks.</p>



<p>Amycretin effectively combines the functionality of two different drugs into a single molecule that targets two hormones involved in regulating hunger and blood sugar levels: GLP-1 and amylin.</p>



<p>GLP-1 is the same hormone targeted by semaglutide and tirzepatide—generic names for Novo and Lilly’s diabetes and obesity blockbusters Ozempic, Wegovy, Mounjaro and Zepbound—and companies including Novo and&nbsp;<a href="https://www.biospace.com/article/releases/zealand-pharma-presents-data-for-amylin-analog-zp8396-at-obesityweek/" rel="noreferrer noopener" target="_blank">Zealand Pharma</a>&nbsp;view amylin as a one potential target to build next generation of weight loss drugs around.</p>



<p>Novo is also testing a subcutaneous form of amycretin delivered through regular injections like Wegovy and Zepbound, though the early stage trial is ongoing and data is not expected to be released until around 2025.</p>



<p>Novo’s head of development Martin Lange Holst said the promising trial results justify further research into the pill and that a larger Phase 2 trial would begin in the second half of the year.</p>



<p><strong>When will amycretin be available?</strong></p>



<p>It will still be many years before Novo’s amycretin hits pharmacy shelves. Data from the mid-stage trial will not be available until around 2026, at the earliest, and regulators are likely to want an even more comprehensive trial to assess efficacy and safety to authorize it. It’s possible later trials won’t replicate the promising results from the early stage trial—the&nbsp;<a href="https://www.nature.com/articles/nrd.2016.136" rel="noreferrer noopener" target="_blank">majority</a>&nbsp;of drugs fail during clinical testing—or Novo may choose to focus its attention elsewhere. Data from the injectable amycretin is likely to have an impact on Novo’s future development pathway for the drug. Side effects and safety will also need to be monitored in a larger cohort of people to see whether the drug makes a viable treatment. Novo said the safety and side effect profile is in line with its other GLP-1 drugs, which can include a variety of gastrointestinal issues like nausea, vomiting, constipation and diarrhea.</p>



<p><strong>News Peg</strong></p>



<p>Novo’s stock hit a&nbsp;<a href="https://www.forbes.com/sites/roberthart/2024/03/07/novo-nordisks-new-obesity-pill-beats-wegovy-in-early-trial/?sh=20baa926456e">new high</a>&nbsp;after the company revealed some of its future plans on Thursday, gaining 9% and sending its market capitalization soaring to almost $610 billion. The company, which dethroned Bernard Arnault’s LVMH as Europe’s largest last year, is now more&nbsp;<a href="https://www.forbes.com/sites/dereksaul/2024/03/07/ozempic-maker-novo-nordisk-more-valuable-than-tesla/?sh=27a8c60133f9">valuable</a>&nbsp;than Elon Musk’s Tesla.</p>



<p><strong>Big Number</strong></p>



<p>$100 billion. That’s how much some analysts <a href="https://www.bloomberg.com/news/articles/2023-10-17/lilly-lly-and-novo-novob-seen-dominating-100-billion-obesity-market-in-2030" target="_blank" rel="noreferrer noopener">believe</a> the obesity drug market will be worth by the end of the decade. Some think the market is <a href="https://www.cnbc.com/2023/04/28/obesity-drugs-to-be-worth-200-billion-in-next-10-years-barclays-says.html" target="_blank" rel="noreferrer noopener">potentially</a> worth much more. Novo, alongside Eli Lilly, dominate the market and are likely to continue doing so for some time.<a href="https://www.forbes.com/sites/roberthart/"></a></p>


Ozempic Maker’s New Weight Loss Pill Beats Wegovy In Early Trial — What To Know About Novo Nordisk’s Amycretin


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Ozempic and Mounjaro manufacturers are being sued over claims that the drugs cause gastroparesis, a severe stomach disorder, but some experts believe this assertion is inaccurate because the drugs only cause a temporary delay in stomach emptying.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Earlier this month, a personal injury law firm filed a&nbsp;<a href="https://www.forthepeople.com/sites/default/files/2023-08/Morgan%20%26%20Morgan%20Ozempic%20Bjorklund%20complaint%208.2.23.pdf" target="_blank" rel="noreferrer noopener">lawsuit</a>&nbsp;against Novo Nordisk—the makers of Ozempic—and Eli Lilly, the makers of Mounjaro, claiming the drugs cause gastroparesis.</p>



<p>The lawsuit also alleges the manufacturers knew of the link between the GLP-1 drugs and “the risk of developing severe gastrointestinal issues, including gastroparesis.”</p>



<p><a href="https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787" target="_blank" rel="noreferrer noopener">Gastroparesis</a>, or stomach paralysis, slows or completely stops the movement of food from the stomach to the small intestine, preventing the stomach from properly emptying—neither drug lists gastroparesis as a potential side effect.</p>



<p>Semaglutide (the generic name for&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2022/12/26/what-to-know-about-ozempic/?sh=2336a35a5adb">Ozempic</a>) and tirzepatide (the generic name for&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/01/31/diabetes-drug-mounjaro-expected-to-be-approved-for-weight-loss-soon-what-to-know-and-how-it-compares-to-similar-drugs/?sh=68aef4ef477a">Mounjaro</a>) are a type of drug known as a GLP-1, and they work by&nbsp;<a href="https://www.uclahealth.org/news/semaglutide-weight-loss-what-you-need-know" target="_blank" rel="noreferrer noopener">interacting</a>&nbsp;with the hunger part of the brain and suppressing the appetite, causing patients to feel full quicker.</p>



<p>In July, CNN released a&nbsp;<a href="https://www.cnn.com/2023/07/25/health/weight-loss-diabetes-drugs-gastroparesis/index.html" target="_blank" rel="noreferrer noopener">report</a>&nbsp;about patients who’ve been diagnosed with severe gastroparesis, and their doctors believe weight loss drug Wegovy (manufactured by Novo Nordisk) and its sister diabetes drug Ozempic may be to blame.</p>



<p>The patients noticed they were vomiting days-old food and doctors noted it was common for people on Ozempic to have stomachs full of food when doing an endoscopy—one patient even had to have a stomach bypass surgery to help relieve the gastroparesis.</p>



<p>The American Society of Anesthesiologists (ASA) put out a&nbsp;<a href="https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/patients-taking-popular-medications-for-diabetes-and-weight-loss-should-stop-before-elective-surgery" target="_blank" rel="noreferrer noopener">warning</a>&nbsp;in June asking patients to stop taking GLP-1 drugs at least a week before elective surgeries due to an increased risk of the drugs causing vomiting during operation.</p>



<p>The ASA has received reports that an “increased risk of regurgitation and aspiration of food into the airways and lungs during general anesthesia and deep sedation” was potentially being caused by the drugs’ ability to “delay” stomach emptying.</p>



<h2 class="wp-block-heading" id="h-chief-critic">CHIEF CRITIC</h2>



<p>A spokesperson for Novo Nordisk&nbsp;<a href="https://thehill.com/policy/healthcare/4134614-ozempic-mounjaro-sued-stomach-paralysis/" target="_blank" rel="noreferrer noopener">told</a>&nbsp;The Hill “patient safety is of utmost importance” to the company and they continuously monitor “the safety profile of our products and collaborate closely with authorities to ensure patient safety, including adequate information on gastrointestinal side effects in the label.” In a similar statement, a spokesperson for Eli Lilly told The Hill patient safety is “top priority,” and it “actively [engages] in monitoring, evaluating and reporting safety information” for their medications.&nbsp;<em>Forbes&nbsp;</em>has reached out to both companies for comment.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Gastroparesis, also called delayed stomach emptying, affects the movement of food even though there isn’t a blockage in the small intestine or stomach,&nbsp;<a href="https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the National Institute of Diabetes and Digestive and Kidney Diseases. It typically takes about&nbsp;<a href="https://www.mayoclinic.org/digestive-system/expert-answers/faq-20058340#:~:text=After%20you%20eat%2C%20it%20takes,move%20through%20the%20entire%20colon." target="_blank" rel="noreferrer noopener">six to eight hours</a>&nbsp;for food to pass from the stomach to the small intestine, though the amount and type of food consumed can affect this. With gastroparesis, the&nbsp;<a href="https://www.medicalnewstoday.com/articles/318753#stomach-emptying" target="_blank" rel="noreferrer noopener">digestion process</a>&nbsp;is extended, and specific times differ from person to person.&nbsp;<a href="https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/symptoms-causes" target="_blank" rel="noreferrer noopener">Symptoms</a>&nbsp;include too much bloating, feeling full after starting a meal, feeling full long after finishing a meal, vomiting, heartburn, pain in the upper abdomen, poor appetite and too much burping. Gastroparesis has many causes, including diabetes, which is the most common cause of gastroparesis, the Centers for Disease Control and Prevention&nbsp;<a href="https://www.cdc.gov/diabetes/library/features/diabetes-digestion.html#:~:text=Nausea%2C%20heartburn%2C%20or%20bloating%20can,common%20known%20cause%20of%20gastroparesis." target="_blank" rel="noreferrer noopener">reports</a>. Though both Ozempic and Mounjaro are used off-label for weight loss, they are only approved by the Food and Drug Administration for use in treating Type 2 diabetes. High blood sugar can lead to gastroparesis. Besides suppressing the appetite, another result of Ozempic’s ability to slow down the digestion process is the lowering of blood sugar,&nbsp;<a href="https://www.ozempic.com/why-ozempic/how-ozempic-works.html" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to Novo Nordisk.</p>



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>Steven Batash, founder of Batash Endoscopic Weight Loss and an expert on nonsurgical weight loss procedures, told&nbsp;<em>Forbes&nbsp;</em>that “to say [Ozempic] causes gastroparesis is not really an accurate statement.” This is because gastroparesis is the “end product” when no food or almost no food moves in the digestive tract. Instead, Batash believes Ozempic causes a delay in gastric emptying. However, this delay only lasts for a short period of time and once the medication’s effects wear off, patients’ “motility will return to [their] baselines,” according to Batash. Ozempic and other GLP-1 drugs are known to&nbsp;<a href="https://www.ozempic.com/faqs.html" target="_blank" rel="noreferrer noopener">cause</a>&nbsp;gastrointestinal issues, like nausea, vomiting and diarrhea. Side effects of Ozempic will be present but will be “mild” in most patients. If these effects are too extreme, Batash recommends either lowering the dosage or stopping usage altogether.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>A&nbsp;<a href="https://pubmed.ncbi.nlm.nih.gov/28958851/" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in the&nbsp;<a href="https://www.thelancet.com/journals/langas/home" target="_blank" rel="noreferrer noopener"><em>Lancet Gastroenterology and Hepatology</em></a><em>&nbsp;</em>examined how liraglutide—another GLP-1 drug—affected digestion. Participants took either liraglutide or a placebo for five weeks and then ate a meal with a radioactive tracer so researchers could see how long the food stayed in their stomachs. It took those taking liraglutide 70 minutes for half their food to leave their stomachs compared to four minutes in the control group, a drastic slow in digestion. In some participants taking liraglutide, it took up to two hours and 30 minutes for half the meal to leave their stomachs. However, this group did see weight loss, and there was a correlation between a bigger delay in stomach emptying and the more weight participants lost.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2022/12/26/what-to-know-about-ozempic/?sh=13edf6c65adb">What To Know About Ozempic: The Diabetes Drug Becomes A Viral Weight Loss Hit (Elon Musk Boasts Using It) Creating A Shortage</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/07/what-is-berberine-supplement-dubbed-natures-ozempic-for-possible-weight-loss-benefits-but-evidence-is-limited/?sh=154e8d5a1068">What Is Berberine? Supplement Dubbed ‘Nature’s Ozempic’ For Possible Weight Loss Benefits—But Evidence Is Limited.</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/01/31/diabetes-drug-mounjaro-expected-to-be-approved-for-weight-loss-soon-what-to-know-and-how-it-compares-to-similar-drugs/?sh=68aef4ef477a">Diabetes Drug Mounjaro Expected To Be Approved For Weight Loss Soon: What To Know And How It Compares To Similar Drugs</a> (Forbes)</p>


Tag: Ozempic

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