From Ronald Hoffman, MD – ANH-USA Board President and Medical Director
Obesity is one of the most daunting health challenges America faces. Nationally, 41.6% of Americans qualify as obese; in the 1950s only 10% were obese. Rates are also soaring among children and adolescents, with nearly 20% of U.S. children ages 2 to 19 having obesity— triple the rate in the mid-70s.
It’s not merely a cosmetic problem: overweight increases the risk of virtually every physical and psychiatric ailment.
Enter a new class of drugs that are revolutionizing our approach to overweight: GLP-1 agonists. The latest are the semaglutides, the ingredient in Ozempic, Wegovy, and Rybelsus. Originally intended for non-insulin dependent diabetes, their propensity to yield double-digit percentages of body mass reduction has propelled them to ubiquity.
So successful have they been that they’ve created a boom in the country that’s the home base of Novo Nordisk, the pharmaceutical firm that makes them. Denmark has doubled its economic forecast for the year; share price of Novo Nordisk has tripled since June of 2021.
The newest weight loss drug, dual-action Mounjaro, which combines semaglutide with a gastric intestinal peptide (GIP) analogue, just saw its quarterly sales grow year over year from $16 million to nearly $1 billion.
The medications don’t just provide cosmetic benefits. In addition to helping to normalize blood sugar, they’ve been shown to lower the risk of heart disease. It’s been proposed that semaglutides—or their even more potent successors—will join the ranks of statins as mainstays of cardiovascular prevention. Their market share is projected to top $82.8 billion per year by 2032.
Most of the current drugs are injectable, requiring self-administered weekly shots, but it’s expected the options will soon expand to more oral alternatives, and soon, triple-action drugs that promise even more spectacular weight loss. There’s even talk on an “exercise pill”, pioneered in mice, that conferred the weight loss benefits of exercise without the appetite suppression of current GLP-1 drugs.
A barrier is the price of the current medications—up to $15,000 per year—which many insurances cover only for diabetes but not for weight loss per se; patients’ rights groups argue that we can’t restrict access to the privileged rich; even the Congressional Black Caucus has advocated coverage as an equity issue. Following the money trail reveals that some of these initiatives are underwritten by Big Pharma.
